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Message from Herts Valleys Clinical Commissioning Group

Dr Small and Dr Borkett-Jones at today's conference. Dr Small and Dr Borkett-Jones at today's conference.

OVERWEIGHT patients have been told to shift excess pounds before they are allowed operations such as hip and knee replacement, tonsil removal or gall bladder surgery.

It is hoped the new policy will result in patients being in a better state to recover following non-urgent procedures.

Today the Herts Valleys Clinical Commissioning Group held a conference about the scheme, which has been officially running since January 1.

Dr Nicolas Small, chairman of the group, said: “GPs in the area will not list patients for routine surgery until they have lost weight.

“There is a range of support, some from the GP surgery, or they can be sent to groups such as Rosemary Conley or Weight Watchers.”

Nationally, one in four adults is obese, and one in eight is severely overweight. Severely obese people can expect to die an average of 11 years earlier.

Now anybody with a body mass index of more than 35 will have to lose weight before they are eligible for non-urgent surgery.

A person of five feet and ten inches would need to be 17 stone and ten pounds to have a BMI of 35. A healthy BMI is between 20 and 25.

Dr Small said: “Surgery is more effective if people lose weight first, and then surgery might not be needed at all. This is a trigger to help people lose weight.

“There is always a risk when patients are given an anaesthetic but there is strong clinical evidence that this risk is significantly higher when they are overweight."

The group launched a similar scheme last year, when overweight people wanting hip or knee surgery were told to lose weight before being listed.

An obese person is 15 times more likely to need a hip or knee operation, and there were 5,000 of these replacements in West Hertfordshire last year.

Smokers will also have to agree to meet a cessation advisor before being listed for surgery.

Rachel Joyce, consultant in public health, said: “Smoking and obesity are responsible for the vast amount of deaths in Hertfordshire.”

The Herts Valleys Clinical Commissioning Group, a consortium of GPs, will take over responsibility for buying health services when the country's Primary Care Trusts are scrapped in 2013.

It covers about half of the county, and will be responsible for St Albans, Harpenden and Dacorum as well as Watford, Three Rivers and Hertsmere .

Dr Sheila Borkett-Jones, board member for Watford and Three Rivers, said: “It's a free country, but it's our job to inform people about living healthily.”

There is currently no plan to introduce a similar scheme for seriously underweight patients who are waiting for routine surgery.

Dr Borkett-Jones added: “We don't suffer from an epidemic of people who are underweight.”

Comments(6)

Arthur Strong says...
7:53pm Tue 10 Jan 12

Dr Small (how ironic) had better hope he doesn't need one of these ops.

EP Herts says...
1:42am Wed 11 Jan 12

Sorry but who died and left them in charge?

I worked and paid my National Insurance all my life so I don't need a chubby doctor telling me if I or my friends and family can or cannot had an operation.

I thought we now had a choice where we were treated let alone if we are treated at all.

I remember something call the 'Hippocratic Oath' maybe Dr Small should read it sometime.

Arrogant man

mr.taxpayer says...
6:52pm Wed 11 Jan 12

I think this is a GREAT idea.

You wouldn't keep fixing a car if you knew it was going to break down again soon afterwards would you?

Why give help to those that don't help themselves?

After all, these are not life saving operations we are talking about, they are 'non urgent' operations.

People will not die because of this decision so where is all the outrage??

mr.taxpayer says...
6:59pm Wed 11 Jan 12

Sounds like a sensible idea to me, making sure people are a good weight so that they recover better (and at less cost to the taxpayer) and live longer and healthier lives.

I can see the whole 'it's my right to eat chips and cake' attitude, but I think these same people should realise it's also our right NOT to have to subsidise their bad living through our tax money...

Incidentally, I also think that smokers and heavy drinkers should be penalised in the same way, not just fatties.

NHS clinician says...
12:03am Fri 13 Jan 12

My husband is in constant pain from an arthritic hip that has affected his mobility over the past year and a half to the extent that it has wrecked our passion for hiking and made it impossible to even walk around the park with his grandchildren. As a result of his lack of exercise he has gained over a stone in weight whilst waiting for a hip replacement. Yes he is overweight, though not in the obese range (which was recently changed so that many more people fall into the category). So he lost half a stone with difficulty and only then was told to answer a questionnaire which goes before a panel which can report back at its leisure. That was several weeks ago. It has taken 13 months to get this far. It is clear we are being rationed, and the decision is completely in the hands of budget holders.
After a lifetime of paying into the NHS I think my husband has a right to be treated with respect for the pain he endures which has a surgical solution.This is our NHS, yours and mine, paid for by our contributions, not the property of a committee. The refusal to treat is being dressed up as 'its for your own good' when it is anything but. As one can see from some of the earlier comments, these disrespectful judgements of who should and should not have treatment will not stop at the overweight and we should rightly fear what comes next. Whose values will dictate who is worthy? shall we let the suicide risks die from overdoses? unmarried mothers deliver their own babies? sports injuries to be turned away? refuse those with sexually transmitted diseases? These dangerous value judgements have no place in a civilised society and certainly no place in a health system of which I used to be proud.

Panglossian says...
12:50pm Fri 13 Jan 12

I think it's quite a good idea to be honest. Some should be true of heavy smokers and drinkers.

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