Weight-loss ops 'inconsistent and unethical'

Medical professionals have warned there is an "inconsistent and unethical" approach to weight-loss surgery in the UK.

The Royal College of Surgeons (RCS) speaking at a conference of UK bariatric surgeons today said constraints on NHS funding means there is a postcode lottery denying some from having access to treatment.

Senior surgeons proclaimed weight-loss surgery is "inconsistent, unethical and completely dependent on geographical location", and warned the situation could force some obese sufferers to eat more to qualify for surgery.

There were also concerns that patients were being made to wait until it was too late, qualifying for treatment only once they had developed a life-threatening illness such as diabetes or stroke.

Surgeons have therefore called for consistency and transparency across the NHS so patients are clear about what they are entitled to and doctors can treat all patients equally.

Mr Alberic Fiennes, president-elect of the British Obesity and Metabolic Surgical Society (BOMSS), said: "We recognise the difficulties faced in dealing with a 'new' disease of epidemic proportions but to limit surgery to the most severely obese is unfair and short-sighted and against basic professional ethics.

"It is also contrary to strategies that are standard for diseases that overwhelm resources."

According to the NHS Constitution published in 2009 morbidly obese patients, i.e. those with a Body Mass Index (BMI) of 40 or more, have a legal right to be properly assessed for weight loss surgery under guidelines set out by the National Institute for Health and Clinical Excellence (NICE).

However, the RCS says it has learned that while some Primary Care Trusts adhere to the guidelines, others are raising the bar so that only the most extremely ill patients with a BMI of 50 or 60 are being referred for surgery.

Surgeons added that around one million people meet NICE criteria with around 240,000 wanting surgery; yet only 4,300 NHS weight-loss operations were carried out last year.

Obesity associated healthcare costs the NHS an estimated £7.2 billion a year.

Surgeons say there is incontestable evidence that surgery is both cost-effective - with surgery costs recouped within three years as obesity associated costs are eliminated - and the only proven successful method of treating the morbidly obese.

As a consequence of today's report the RCS is calling for the Department of Health to "invest in a long term strategy to ensure that all patients have equal access to treatment delivered by experienced multi-disciplinary teams working out of properly equipped centres that can offer a full specialist assessment, an appropriate treatment and provide safe long-term follow up and emergency re-admission".

RCS director of education Professor Mike Larvin added: "NICE guidelines are meant to signal the end of postcode lotteries, yet local commissioning groups are choosing not to deliver on obesity surgery.

"In many regions the threshold criteria are being raised to save money in the short term meaning patients are being denied life-saving and cost effective treatments and effectively encouraged to eat more in order to gain a more risky operation further down the line."