Doctors from 50 surgeries in the Hertfordshire area are to turn away obese patients and smokers seeking a routine hip or knee replacement surgery, until they have sought help from a weight management or smoking cessation scheme
These restrictions came into play around eight weeks ago and are soon to be extended to cover all routine surgery over the next few months.
After Health Secretary Andrew Lansley’s plans to give the bulk of the NHS budget to GPs instead of managers, the move has inspired other doctors up and down the UK to consider the introduction of similar rules themselves.
Smokers who refuse to make an effort to give up cigarettes will not be banned completely from having surgery but instead of a direct referral to hospital the GP will first discuss the added risks of their behaviour and will recommend solutions.
Chair of the north east clinical commissioning group, Tony Kostick, said: “This is about GPs accepting a greater gatekeeping role. The NHS spends a fortune on treatments of limited clinical value. We trawled through the evidence and found outcomes were poorer for smokers and the obese. They are in hospital longer, have more complications, more post-operative infections and do less well.”
He also added that putting a block on surgeries will hopefully help GPs to understand that if they spend money on one patient, this money is then available for the next. The idea is that obese patients for example, may no longer need surgery after they lose weight.
Critics argue that the blanket ban is a form of discrimination against patients who may require vital care and believe that each patient should be considered on a case by case basis.
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