Smokers and obese may be refused routine surgery

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SMOKERS and obese people face being denied routine hip and knee replacements under new rules drawn up in the region.

From April, smokers will have to quit and obese patients shed weight before they can have routine joint replacement surgery in North Yorkshire.

Only those who can make exceptional cases for treatment will go under the knife under new clinical treatment thresholds approved by NHS North Yorkshire and York.

The move is in line with regional guidance against referring smokers and obese people due to worse outcomes after surgery.

But it comes amid concerns about limited access to weight loss services, which are likely to be less popular with men, and evidence the limits are more likely to hit deprived communities.

More than one in five people in North Yorkshire are obese and a similar proportion smoke.

Family doctor John Crompton, chairman of the North Yorkshire Local Medical Committee which represents GPs, said doctors were supportive of measures to make people fit for surgery. “But we also believe patients need to be looked at on an individual basis and help needs to be made available to support them lose weight or stop smoking,” he said.

David Geddes, medical director at NHS North Yorkshire and York, said: “A range of factors need to be considered before referring patients for this type of surgery and we have seen that some of our patients are being referred before all non-surgical alternatives have been explored and exhausted.

“Hip and knee replacement is major surgery, which is painful and carries a degree of risk. We have to make sure that patients are as fit for surgery as possible before going forward for it. By managing a patient’s weight and stopping them smoking we can reduce the surgical risk and improve their outcomes afterwards.

“We are not imposing a blanket ban for those who are overweight or smokers. We will consider on a case by case basis any weight loss a patient has achieved and any progress in smoking cessation.”