While access to good health care is a concern for everyone, residents of Hertfordshire in the UK have a few extra hoops to jump through. Citizens of the United Kingdom have health care provided through the National Health Service (NHS), but some treatment decisions are made locally at the county level. Recently the Hertfordshire Clinical Commissioning Group (CCG), which decides what services the NHS will offer and how they are allocated, announced several changes to the NHS program for residents of that county.
Included were services for infertility and IVF treatment for women trying to conceive. While that did anger some residents, the change that received the most attention was the surgical policy for certain patients. Under the new guidelines, patients who are "morbidly obese" will not be referred for routine surgery until they reduce their weight. The NHS defines morbid obesity as having a Body Mass Index (BMI) of over 40. Those patients would have to lose 15% of their weight over a nine-month period to qualify for surgical services. Patients who are overweight, but who are not morbidly obese must also lose weight before surgery, but their percentage was set at 10%.
Smokers are another group to have their access to routine surgery restricted. Residents who are planning surgery must quit smoking for eight weeks before being put forward for a surgery date. The CCG says that smoking cessation will be verified by a breath test for carbon monoxide levels. The changes are in response to budget issues in some counties. At the local level, officials can change coverage and eligibility for services after holding public discussions and engaging residents to get their feedback.
Dr. Nicholas Small, who is the chair of the Hertfordshire CCG stated, "None of these decisions have been taken lightly, but people understand that the NHS faces major challenges and must adapt to meet them. There is wide public backing for most of the changes that have been agreed today – even from people who told us that they would be directly affected. As we plan the implementation of today's decisions over the months ahead, we will make sure that everyone who needs to make lifestyle changes, including those who need to lose weight or quit smoking, gets the information and support they need to succeed. Although we are asking people to take more responsibility for some aspects of their healthcare where possible, we won't be withdrawing any support from people who are not able to do this. GPs will still make decisions based on the individual needs of their patients, and will be able to refer individual cases to a specialist decision-making panel if their patient faces exceptional clinical circumstances."
Patients will still have the ability to appeal any refusal of surgery, and in some cases, a specialist or GP may make an exception to the policy, based on individual needs. The CCG stated that no patient would be denied emergency care, however between budgetary constraints and health restrictions many in the UK are left wondering what services might be cut next. Check out the video below to learn more.