Obesity surgery blocked for non-diabetic patients

Exclusive - NICE guidelines are ignored as trusts seek to limit the impact of costly bariatric procedures.

Obese patients are being denied potentially life-saving bariatric surgery, as PCT commissioners look to cut costs by only offering the treatment to diabetics.

Current NICE guidance states that bariatric surgery should be offered to all patients with a BMI over 50 as a first-line treatment.

Bariatric surgery is considered to be one of the most clinically and cost-effective treatments on the NHS. However, the initial costs of the surgery can reach up to £14,000.

A number of PCTs across England are defying NICE and are offering the surgery only to obese patients who have diabetes or severe sleep apnoea.

Research has shown that gastric banding is effective in achieving remission of type-2 diabetes, and offers huge cost savings to PCTs in terms of reducing diabetes drug budgets.

Bedfordshire, East and North Hertfordshire, Great Yarmouth and Waveney, Cambridgeshire, Mid Essex and North Essex, South East Essex and Norfolk PCTs are all insisting that obese patients must have diabetes before being considered for surgery, according to an audit conducted by the British Obesity Surgery Patient Association.

East of England specialised commissioning group, which covers these PCTs, confirms on its website that obese patients must have diabetes or severe sleep apnoea, as well as being aged 18-60 to qualify.

Dr David Haslam, clinical director of the National Obesity Forum and a GP in Hertfordshire, told GP: 'It is a ridiculous situation. If you are obese and diabetic then funding is made available as it is deemed cost-effective by the PCT.

'PCT commissioning groups are putting barriers in the way to prevent patients from receiving what can be life-saving surgery.'

Professor John Baxter, a leading expert in bariatric surgery from Swansea University, warned of a UK postcode lottery in bariatric services.

'It is a common ploy to give diabetics preference for treatment, as almost half of all obese patients will have diabetes or pre-diabetes.

'But it is absurd that the other half of obese patients who do not have diabetes will have to wait until their condition gets steadily worse before being considered for treatment.'

sanjay.tanday@haymarket.com

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