Obese patients are being denied surgery because of commissioning failures

Patients across England are being denied access to bariatric surgery because GPs in some parts of the country are not commissioning intensive weight loss programmes, a prerequisite to surgery, surgeons have warned.

Since April 2013 NHS England, which is responsible for commissioning bariatric surgery, has said that patients should be operated on only after they have been through intensive “tier 3” weight management services before surgery. These can last up to two years and can also help patients control their diet after surgery.

Guidance from NHS England states that it is the responsibility of clinical commissioning groups (CCGs) to commission and fund these services.1

But the delivery of tier 3 programmes is fragmented and is putting patients’ lives at risk, doctors have told the Royal College of Surgeons.

Sean Woodcock, a surgeon in northern England, told the BMJ that only …