Doctors have agreed to sign off on a range of new broad-ranging restrictions recommended by NHS managers that will prevent people who are overweight or smoke from being referred for surgery. The move comes as primary care trusts (PCTs) across England and Wales are looking to introduce new measures and restrictions in an attempt to reduce their costs.
Many GP leaders, as well as local medical committees (LMCs), have supported the changes by NHS Hertfordshire to ensure patients that have a body mass index (BMI) of more than 30 are blocked from being referred for routine joint replacement surgery before they have been referred to a weight management scheme.
In addition, doctors will be stopped from referring smokers for orthopaedic surgery unless they have already been referred to a programme to help them stop smoking.
Leaders of doctor consortia are taking legal advice about the plans and some PCTs in England may follow suit, but there are concerns over the ethics of such a move to restrict people from necessary operations.
Tony Kostick, joint chair of the clinical executive committee at NHS Hertfordshire and chair of East &North Herts GP Commissioning Consortium, argued that such a move was supported by sound clinical evidence, commented “It’s divisive in the sense some GPs don’t want to confront the rationing debate. We spend fortunes on treatments of limited clinical value.”

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