This has blocked thousands of patients from treatment to which they are entitled under the NHS Constitution.

GP commissioners could end the bariatric surgery postcode lottery in England by following NICE guidance when primary care trusts (PCTs) are abolished, say experts, but failure may lead to legal challenges.

Experts believe GP consortia could improve access to obesity surgery by adhering to NICE recommendations. But the BMA warns that a lack of resources means consortia would be unable to afford this, leaving them open to legal challenges by patients.

Both NICE and SIGN recommend patients with a BMI of 40, or 35 with a co-morbidity, undergo bariatric surgery as a last resort after intensive lifestyle interventions. NICE estimates 240,000 patients could benefit from the procedure.

However, data obtained under the Freedom of Information Act by GP newspaper show 65 of 118 PCOs (55%) have rationed the procedure, often by raising BMI thresholds to 50 or 60, causing a ‘postcode lottery’ in treatment access.

• Do you want to know what your PCO’s policy on bariatric surgery is? Read the full results here.

Read the GP newspaper splash and focus for more detail.

Editor's blog: Can GP commissioning tackle bariatric surgery lottery?