Ban on hip and knee ops for obese patients and smokers could be scrapped

CONTROVERSIAL restrictions blocking obese patients and smokers from routine surgery for up to a year are being reviewed by NHS bosses amid concerns over postcode lotteries for treatment.

Thousands are believed to have been denied routine ops because of smoking Picture: Jonathan Brady/PA Wire/PA Images
Thousands are believed to have been denied routine ops because of smoking Picture: Jonathan Brady/PA Wire/PA Images

Thousands of people from the region are believed to have been affected by delays imposed by health officials for patients to lose weight or quit smoking ahead of surgery.

The measures have led to significant variations in access to treatment for planned operations including routine hip and knee replacements and hernia repairs depending on where people live in the region.

Curbs delaying referrals for treatment for six or 12 months have been imposed in areas including Rotherham, Barnsley, the East Riding, York and North Yorkshire, excluding Craven.

But none are in place in other parts of the region including Hull, Sheffield and West Yorkshire.

The delays for smokers and obese patients with a body-mass index (BMI) of 30 or more come on top of existing long waits for treatment. NHS waiting lists are now at record levels following disruption due to the pandemic.

Health chiefs have ordered the reviews following the latest NHS reorganisation which saw 15 clinical commissioning groups (CCGs) serving the region abolished and replaced by three integrated care systems at the beginning of July.

The review decision has been welcomed by surgeons’ leaders who called for the “unfair” thresholds to be abandoned.

Prof Neil Mortensen, president of the Royal College of Surgeons, said: “Rationing surgery on the basis of BMI or smoking was an unhelpful tactic of some CCGs so it’s vital that the new integrated care systems review this approach.

“Timely surgery can dramatically improve a patient’s quality of life.

“Whereas restrictive referral policies, such as BMI thresholds, penalise patients.

“They can lose their mobility and suffer further health problems.

“The approach is unfair and ignores clinical guidance so it’s time to stamp it out.”

Some of the toughest restrictions in the country are in place in Harrogate, Hambleton, Richmondshire, Whitby, Scarborough and Ryedale.

Smokers or adult patients with a BMI of 30 or more must wait a year to be referred by GPs for the majority of routine hospital treatments unless they quit smoking, lose 10 per cent of their weight, or are no longer obese.

It remains unclear what impact the delays have had in the area since the full policy was drawn up in July last year.

Officials from North Yorkshire CCG last month said they had not recorded how many patients had been affected although 100 patients had appealed against treatment delays over the period.

They added: “A decision not to evaluate the outcomes of the policy was made in 2021.”