Over­weight peo­ple de­nied knee ops

Health­watch says pa­tients should be able to de­cide if they want to risk hav­ing surgery

Harefield Gazette - - NEWS - By Will Ack­er­mann will.ack­er­mann@trin­i­tymir­ror.com

SCORES of pa­tients in Hilling­don are be­ing de­nied knee surgery re­fer­rals be­cause they are over­weight, in de­fi­ance of NHS guide­lines, ac­cord­ing to a watch­dog group.

Hilling­don Hos­pi­tals NHS Foun­da­tion Trust says an­nu­ally only around ‘half a dozen’ of its pa­tients are not re­ferred to CHIL­DREN cheered as bal­loons were let off into the sky to mark the open­ing of their new school.

Pupils at Har­lyn Pri­mary School cel­e­brated the a sur­geon to dis­cuss knee re­place­ment be­cause they have a Body Mass In­dex (BMI) higher than 40.

How­ever, Health­watch Hilling­don, a group that mon­i­tors health ser­vices in the bor­ough, es­ti­mates that the true num­ber is closer to 60.

Raj Gre­wal, the group’s op­er­a­tions co­or­di­na­tor, said this dis­crep­ancy ex­isted be­cause when pa­tients are not re­ferred for surgery, the rea­sons are of­ten not recorded. com­ple­tion of their school in Tol­carne Drive, North­wood Hills, by wel­com­ing the Mayor of Hilling­don, Cather­ine Dann, to cut the rib­bon.

Singing and speeches com­pleted the day.

The weight re­stric­tion goes against Na­tional In­sti­tute for Health and Care Ex­cel­lence ( NICE) guide­lines, which say obe­sity should not be a bar­rier to re­fer­ral for joint surgery, although it may be a le­git­i­mate rea­son for not hav­ing the surgery it­self.

NICE guide­lines, how­ever, are not legally en­force­able.

Mr Gre­wal said: “When you are over­weight there is an el­e­ment of ad­di­tional risk in any pro­ce­dure. We ac­cept that. But it should be up to an in­di­vid­ual to come to their own decision, to­gether with a med­i­cal pro­fes­sional, rather than a pol­icy which bans it out­right.”

The BMI re­stric­tion for knee op­er­a­tions is used by all eight Clin­i­cal Com­mis­sion­ing Groups (CCGs) re­spon­si­ble for NHS ser­vices in north­west London, to­gether known as the NWL CCGs. In some other parts of the UK, how­ever, no such re­stric­tion ex­ists.

And in north-west London, the same re­stric­tion does not ap­ply to other sim­i­lar surg­eries, such as hip re­place­ments.

Cather­ine Brown, a NWL CCG spokes­woman, said: “The NWL CCGs have a joint Planned Pro­ce­dure with a Thresh­old Pol­icy (PPwT) on knee re­place­ment surgery, which was based on an as­sess­ment of the like­li­hood of a suc­cess­ful sur­gi­cal out­come, which re­quires pa­tients to have a BMI un­der 40 in or­der to be el­i­gi­ble for surgery.

“The NWL CCGs will con­sider this thresh­old when re­view­ing the PPwT poli­cies for North West London for 2015/16.”

Ev­ery year around 300 knee re­place­ment surg­eries are com­pleted in Hilling­don, at an av­er­age cost of around £3,600, ac­cord­ing to the bor­ough’s NHS trust.

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