Smokers and obese patients face being ordered to the back of the queue for operations under Government plans to slash waiting lists.
The move, unveiled yesterday by the Prime Minister, means only patients deemed ‘fit to proceed’ will be given a date for an operation.
Under the plans, tens of thousands of patients waiting for hip and knee surgery will be asked to first undergo a 12-week weight-loss programme. Smokers will be urged to quit.
Research has long suggested that prehabilitation — physical, nutritional and psychological support prior to surgery — can reduce the risk of complications or cancellations.
Under the new Government plan known as the ‘Elective Reform Plan’, it’s also proposed that getting patients fitter before treatment increases the number who are suitable for day surgery, avoiding long hospital stays.
But experts have previously warned that such moves are a ‘betrayal of NHS values’ and could ‘fuel’ health inequalities.
An estimated 6.34 million people were on NHS waiting lists for 7.54 million treatments at the end of October, figures show.
Sir Keir pledged to diagnose and treat 92 per cent of patients within 18 weeks of receiving a referral from a GP by the end of this Parliament.
The move, unveiled yesterday by the Prime Minister, means only patients deemed ‘fit to proceed’ will be given a date for an operation
Currently just a third (35 per cent) are seen within this timeframe. The target has not now been met for almost a decade.
‘Stopping smoking four weeks before surgery means patients have a 25 per cent lower risk of respiratory complications and 30 per cent lower risk of wound healing complications than those who continue to smoke,’ the plans said.
It is not yet clear what criteria patients must meet to deem them fit enough for surgery.
The decision is expected to be made on a case-by-case basis. Those who are not deemed fit enough would remain on the waiting list.
Professor Sir Stephen Powis, the NHS national medical director, said: ‘The clinical view is that being fighting fit and as prepared as possible for surgery can result in better post-op outcomes and increase productivity, by reducing any complications in surgery.
‘So, as part of the Elective Care Reform Plan, the NHS will do everything within its power to help patients get ready for treatment including by offering the option of weight management support or help to stop smoking so that they can begin recovery before treatment even begins.’
Currently, obese patients are advised by the NHS to reduce their surgery risks by losing weight, quitting smoking and controlling blood sugar.
But nationwide, this does not affect the waiting list.
Some local NHS trusts have been criticised previously for putting restrictions on access to surgery, including asking obese patients to lose 10 per cent of their body weight, and smokers give up for at least two months.
This was thought to go against official guidance.
Obesity itself increases the chances of person suffering serious health conditions that can damage the heart, such as high blood pressure, as well as cancers.
Around two in three adults in the UK are obese or overweight, giving the country one of the highest obesity rates in Europe.
Last year, a sobering report also suggested Britain’s spiraling obesity levels have fuelled a staggering 39 per cent rise in type 2 diabetes among people under 40, with 168,000 Brits now living with the illness.
Piling on the pounds has also been linked to at least 13 types of cancer and is the second biggest cause of the disease in the UK, according to Cancer Research UK.
In June, one US study suggested that weight loss jabs could help obese patients suffer fewer complications after surgery.
However, experts cautioned that more research was first needed before the injections are given the green light for such use.
Under the plans, tens of thousands of patients waiting for hip and knee surgery will be asked to first undergo a 12-week weight-loss programme. Smokers will be urged to quit
The new elective care plans would see the NHS ‘reformed from top to bottom’, Sir Keir said yesterday.
He also pledged to make ‘better use’ of the private sector so sick Britons can be seen more quickly for a wider range of issues.
GPs will be forced to actively tell patients when they can get their scans, tests or operations at a private clinic.
Under the plan, up to half a million more appointments a year are also expected to be made available by extending opening hours at community diagnostic centres and through the creation of 14 new surgical hubs and the expansion of three by June.
Giving patients the choice to forego follow-up appointments currently booked by default could free up to a million appointments.
Wearable tech will also be used more widely to collect health data to reduce appointments that are routine rather than because of a clinical need.
The fastest NHS trusts to cut waiting times will be rewarded with more funding for local projects such as investment in new diagnostic equipment or hospital ward maintenance.
Health Secretary Wes Streeting said the target to cut maximum wait times from 18 months to 18 weeks would be achieved by ‘bringing care closer to home and give patients more choice over their treatment’.
But earlier in the week, he also warned that delivering Labour’s pledge to restore the 18-week standard by the time of the next election will be a ‘big, tough challenge’.
The health secretary added that the NHS would ‘collapse’ like the retail chain Woolworths unless it embraces reforms designed to drag it into the 21st Century.
