Bariatric Surgery (Weight Loss Surgery)

Proposal:

As part of a wider review into service restrictions Basildon and Brentwood CCG is proposing not to fund weight loss surgery:

• Gastric band
• Gastric bypass
• Sleeve gastrectomy

NHS England transferred responsibility for commissioning Bariatric surgery to the CCG from 1 April 2016. This service is provided from specialised centres so patients must travel to London for this surgery.

Whilst the funding will return with the service, the CCG feel that it should consult on not providing this service to the population and instead work with Public Health to promote healthier lifestyles and tackle obesity rather than managing the problem once it occurs. However, as stipulated in the latest NICE guidance (CG189; 2014), there will be a group of patients, especially people of different ethnicity, who may benefit from bariatric surgery as they are likely to develop more complex health conditions (especially Diabetes) if they are already significantly overweight.

Obesity & Weight Management
Obesity rates have doubled in 20 years (men 24%, women 26%) but Basildon (30.2%) has a greater percentage of adults that are classified as obese or excess weight compared to the regional and national average, in sharp contrast with Brentwood (18.6%). In regards to children, the rate of obesity is higher in Basildon than Brentwood with both tracking the general upward trend in the past few years but levelling off now. There is over 10% decrease in children with ‘healthy weight’ between Reception year and Year 6 cohorts.

Rationale for change:

The CCG wishes to support people to self-manage their conditions and empower them to have greater control over their lives. Where there is a pressing clinical need, cases will be considered on an exceptional basis. The CCG feels that through working with Public Health and our providers to support people to better manage their conditions and engage and participate in improving their wellbeing the need for bariatric surgery should decrease whilst outcomes for patients should improve.

Both Basildon and Brentwood Health and Well Being Boards (HWB) support the need to prevent obesity and manage it so as to reduce the need to progress onto surgical intervention.

The JSNA outlines the 3 priorities for both Boards as:

Basildon HWB
Reduce smoking prevalence
Reduce obesity prevalence
Reduce health inequalities and tackling poverty

Brentwood HWB
Improve health of older people
Increase vaccination coverage
Reduce obesity prevalence (CVD risk)

Impact:

It is suggested that the proposal should not greatly impact patients with obesity and weight issues as there are already various weight management services available that teach nutrition and lifestyle changes rather than opting for surgery. With any surgery there are risks and if patients can lose weight themselves naturally with the support of local services they are not going to be exposed to the risks of bariatric surgery and any possible complications.

For further information:

Download the Service Restriction Policy Review document here

Download the Equality Impact Assessment - Bariatric document

See our information on Have your say on the Service Restriction Policy Review

Download our current Service Restriction Policy here

Find more information on existing local services at http://www.nhs.uk/service-search

Bariatric Surgery (Weight Loss Surgery)

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