Means patients are denied life-changing hip and knee replacements and left in pain in an attempt to lower spiral NHS costs, The independent can reveal.
A third of the NHS areas in England and several health councils in Wales block the patient access based on their Body Mass Index (BMI).
The move, considered “unfair” and “discriminatory”, goes against guidelines of the National Institute for Care Excellence (Nice), which states that BMI should not be used to limit the access of patients to joint replacement operation.
Instead, patients are told that they have to lose weight before they are eligible, but waiting lists for NHS programs for weight loss are bleached, with some people waiting for three years to see while other services are closed, unable to meet the demand.
The Royal College of Surgeons of England criticized the policy and said that denying the care of patients could cost them their mobility and ensured that their health is deteriorating, while Tory Peer and former Minister of Health James Bethell called on the government to do more to tackle the obesity crisis.
More than 64 percent of adults in England were overweight or lived with obesity in 2022-23, an increase of 63 percent the year before, according to the most recent data from the Office for National Statistics.
The news comes when 7.4 million people waited for NHS treatments in March, while health care leaders have warned that they are forced to reduce services to comply with government heavy savings requirements.
The shocking revelation of refusal of surgery was discovered in an audit of referral criteria used by NHS authorities in England by the National Institute for Health and Care Research (NIHR).
It turned out that 15 of the 42 areas limit access to surgery by BMI, while The independent Discovered that at least two health councils did the same in Wales. The thresholds varied per area, with some limiting access to people with a BMI of less than 35 (patients who are obese) or 40 (severely obese).
Dr. Joanna McLaughlin, main researcher and NIHR clinical teacher at the University of Bristol, said The independent The fact that her research investigators, commissioners and surgeons “acknowledged that NHS -Financial pressure was a central administration for BMI threshold policy use, and that they had no confidence that the policy was based in evidence of health benefits”.
The study also showed that NHS support services were “insufficient” for weight management and could not ensure that those excluded from the operation could be supported to lose sufficient weight. Some patients had resorted to pay privately for surgery.
Dr. McLaughlin said: “The variety in the BMI limits and in the requirements to prove that patients have made attempts chosen for weight loss chosen by different ICBs [integrated care boards] Emphasizes the postcode lottery and inequalities created by this policy. “
Various ICBs identified by the study told The independent That some patients with a high BMI still had access to care if they endured an assessment, while others said they should prove that they were “suitable for surgery”.
“The designs of this choice will cause millions of misery,” warned former Health James Bethell (PA Media) minister
But Doctors told The independent That BMI should not be used as the only limiting measure.
Tim Mitchell, president of the Royal College of Surgeons of England, said that losing weight could reduce the risk of complications before the operation and that patients should be supported in this.
He said, however, that “only BMI should not be a barrier,” and added: “We should not punish for those who are less fit but are still eligible for surgery, because this approach is unfair and ignores clinical guidance.”
Mark Bowditch, president of the British Orthopedic Association, said: “Losing weight before the operation can be very difficult for people with limited mobility issues.
“Moreover, obesity is more likely in people from certain social -economically disadvantaged areas or ethnic groups, so care must be taken to prevent unintended disadvantages of certain patient groups.”
Deborah Alsina, chief executive of charity versus arthritis, said: “We hear heartbreaking stories from people who are desperately looking for the pain, and reports of people who are dealing with barriers to access, even when they are referred to the operation they urgently need.
“We often hear from people who have refused a reference or are taken from the waiting list because of their weight, whereby Body Mass Index is cited as a reason. We must ensure that this discriminatory practice does not become standard.”
Lord Bethell said that the row over BMI thresholds for operations showed that the NHS “should make a choice” about preventing disease with weight loss jabs, which cost £ 100 per month, or to treat obesity-related diseases, such as those who lead to hip operations, which can cost £ 10,000.
He said that the government has the choice to combat “junk food britain” with a tough food strategy or to give the NHS much more money to pay for the consequences of a sick population.
He added: “It is one or the other. That choice will cause misery for millions, the bankruptcy of our nation and the end of the starmer administration.”
A spokesperson for the Ministry of Health and Social Care said it expected that ICBs would adhere to a nice guidance. They added that the plan of the Department for Change for the NHS includes rolling out drugs for weight loss “those who need it the most”.
