Hospitals to cut costs by denying surgery to smokers and the obese

Smokers and obese people will increasingly be denied surgery on the NHS as hospital managers cut costs to deal with financial restraints, prominent health service figures have warned.

The prediction came as one health authority said it would make people wait up to a year for elective surgery for conditions that are not life-threatening if their body mass index (BMI) – which measures weight in relation to height – was 30 or greater.

To score a BMI of 30, a man of average height in Britain – 5ft 10in – would have to weigh 15 stone. A woman of average height (5ft 5in) would have to weigh 12 stone 12lb.

Vale of York clinical commissioning group (CCG) said it had taken the decision because it was the “best way of achieving maximum value from the limited resources available”.

But the Royal College of Surgeons (RCS) warned that it was a dangerous move that ranked among the “most severe the modern NHS has ever seen”.

Its president, Clare Marx, said that while the RCS supports helping people to lose weight and stop smoking, “introducing blanket bans that delay patients’ access to what can be life-changing surgery for up to a year is wrong”.

She added: “As the true scale of financial pressure on NHS trusts has become clear over the summer, we are fast finding ourselves in a situation where CCGs are introducing draconian commissioning policies, often flouting Nice [National Institute for Health and Care Excellence] or other clinical guidance, in order to balance the books.

“An honest national debate on exactly what the NHS can afford, and what we are willing to pay, is urgently needed.”

Chris Hopson, the head of NHS Providers – which represents acute care, ambulance and community services – told the Daily Telegraph: “I think we are going to see more and more decisions like this.

“It’s the only way providers are going to be able to balance their books, and in a way you have to applaud their honesty. You can see why they’re doing this – the service is bursting at the seams.”

In a statement released on Friday, Vale of York CCG said: “The local system is under severe pressure. This work will help to ensure that we get the very best value from the NHS and not exceed our resources or risk the ability of the NHS being there when people really need it.”

Policy documents produced by bosses in the North Yorkshire authority make clear that adult smokers will have elective surgery postponed “for six months or until they’ve stopped smoking for eight weeks”.

And, for people whose BMI is 30 or more – who are defined as obese – such treatment will be put back a year “or until 10% of weight loss is achieved, whichever is the sooner”.

The CCG added that, in either case, “patients undergoing surgery for cancer will not be affected” and its clinicians would “identify other groups of patients who should be exceptions to the policy”.

In March last year, it was reported that the vast majority of NHS authorities were placing restrictions on access to surgery for overweight people, including one CCG that was refusing all routine surgery to people whose BMI was 35 or greater – those defined as morbidly obese.

The investigation by GP magazine also found that most of England’s CCGs were denying some treatments to smokers.

Hospitals to cut costs by denying surgery to smokers and the obese