15.11.17
Denying surgery based on lifestyle judgements ‘compromises patient trust’
Denying access to NHS treatments based on lifestyle choices will hamper doctor-patient relationships, the Royal College of GPs (RCGP) has cautioned.
The warning has come in response to the latest CCG to opt to restrict access to NHS treatment.
Speaking of the Hertfordshire Valley CCG’s decision to refuse routine surgery of morbidly obese patients until they have lost weight, Professor Helen Stokes-Lampard, chair of the RCGP, stressed the importance of a patient’s trust in their doctor.
“As frontline GPs, we fully understand the struggles of the NHS and that funding decisions are becoming increasingly difficult, but patients go to see their GP expecting non-judgmental care and it’s important that their trust in us is not compromised,” she said.
“To prevent patients from receiving NHS treatment that they would benefit from is not the solution and goes against the founding principles of our health service.”
Following a 10-week public consultation, the CCG announced a series of changes, including not referring morbidly obese patients for routine surgery until they have either lost 15% of their body weight over nine months or reduced their BMI to less than 40 – whichever equates to the greater weight loss.
Obese patients who have a BMI of 30 or more will not be referred for routine surgery until they have lost 10% of their body weight over nine months or reduced their BMI to below 30, and smokers will not be referred for routine surgery until they have stopped smoking.
“We always encourage patients to take responsibility for their own health and will work with them to ensure that if they need surgery, they can go into it knowing they are as healthy as they can be,” Stokes-Lampard added. “GPs and our teams work very hard with patients to improve their health through lifestyle changes, and initiatives such as smoking cessation clinics have been hugely successful.
“Our best chance at making sure GPs can carry on supporting patients in this way is to ensure general practice has the investment it needs.”
Speaking following the announcement of the changes, Dr. Nicolas Small, chair of Hertfordshire Valley CCG, said that the decisions were not taken lightly, but that there is “wide public backing for most of the changes.”
“Although we are asking people to take more responsibility for some aspects of their healthcare where possible, we won’t be withdrawing any support from people who are not able to do this,” he explained.
“GPs will still make decisions based on the individual needs of their patients, and will be able to refer individual cases to a specialist decision-making panel if their patient faces exceptional clinical circumstances.”
The CCG’s decision follows suit of other commissioning bodies, including the Vale of York and Devon.
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