CCG statement on updated ‘Fitness for Surgery’ policy
The ‘Fitness for Surgery’ policy in Hertfordshire updates a policy which has been in place in the area since 2012. The policy received strong public support in a recent consultation, including from local residents who thought that they could be directly affected.
No financial savings are expected as a result of the measures. We do expect to improve the long-term health of our residents through free, targeted stop-smoking services and weight-loss support. The NHS and Public Health in Hertfordshire fund a Weight Watchers and Slimming World service which our GPs can refer patients to at no cost to the patient. There are also additional specialist support measures in place for those who require more help to lose weight.
In line with previous policies, we would expect patients to lose weight and stop smoking over a maximum nine-month period. Switching to vaping or using e-cigarettes would count as stopping smoking for the purposes of this policy, as these are considerably safer alternatives to tobacco.
If at any time the harm of waiting for surgery outweighs the benefit of losing weight or stopping smoking, the patient will go ahead and have the required surgery. In our experience, most patients go on to achieve the recommended weight loss.
If at the end of the nine-month period, as is currently the case, a patient fails to lose the required weight or continues to smoke, then their individual circumstances will be considered by their clinicians and treatment will go ahead if it is clinically safe and appropriate.
Our policies are designed to improve patient safety and their health before, during and immediately after non-urgent surgery under general anaesthetic. This is absolutely not about ‘rationing’ treatment or denying treatment to those who need it.