Surgery ban for fat people or smokers in Harrogate

Health commissioners have agreed a number of measures to improve long term patient health and wellbeing and address the financial challenge.

The Governing Body of NHS Harrogate and Rural District Clinical Commissioning Group (CCG) have, after a robust discussion, unanimously approved a range of measures to improve the health and wellbeing of patients and to address the challenging financial imbalance it faces.

  • All people who have a BMI of, or greater than, 30 or people who smoke will be offered a referral to either a weight management programme or stop smoking services for a 6 month period of health optimisation before being considered for an operation.

The CCG’s vision is to achieve the best health and wellbeing for everyone and so local health commissioners must support, and encourage the people they serve to live the healthiest lives possible.

One of the many expectations on CCGs is to prioritise action on smoking, obesity, diabetes and wider lifestyle factors. CCGs are required to reduce health inequalities, prioritise financial sustainability, and show leadership. This means the CCG needs to ensure that it gets the best value from the money it receives and therefore ensures that essential local health services are there when patients really need them.

Last month the CCG shared its savings challenge of £8.4m. The rise in demand on local health services and increasing costs, outstrips the allocation of money the CCG receives from Government. With no extra money available the CCG has found its limited budget stretched.

One way of fulfilling its responsibilities is for the CCG to actively promote healthy behaviours to prevent as much ill-health as possible. This is done through tackling smoking and obesity, identifying patients at risk of diabetes and those with high blood pressure, reducing inactivity and harmful alcohol use, increasing immunisation and uptake of cancer screening and helping people to understand their options and manage their own health through self-care and shared decision making.

The CCG already has plans in place to address a £8.4 million savings plan in 2016/17 but with increasing demand driving rising costs, the CCG has approved further measures to ensure it fulfils its statutory duties to manage within its financial allocation.

The measures agreed include:

  • All people who have a BMI of, or greater than, 30 or people who smoke will be offered a referral to either a weight management programme or stop smoking services for a 6 month period of health optimisation before being considered for an operation.
  • Review of follow-up appointments to reduce unnecessary hospital visits.
  • Work with GPs and community pharmacies to promote a reduction in the cost of prescribing medicines and numbers of GP visits where self-care and medicines can be accessed more quickly and cost effectively from over the counter at a local pharmacy/supermarket.


Speaking about these measures, the CCG’s Chief Officer Amanda Bloor said:

The CCG has undertaken a thorough review of all the services it commissions based on clinical evidence to support the decision making process and I feel the measures we are taking encourage patients to take a  greater responsibility for their lifestyle choices. It is vital that patients are given the skills and knowledge to take accountability for their own wellbeing to ensure we all lead healthier lifestyles.

The CCG are not saying patients can’t have the surgery. By introducing a 6 month health optimisation period, we are encouraging and supporting patients to undertake a lifestyle change which will provide them with the best possible clinical outcome.

The NHS spends around £9bn a year on patient care for those living with diabetes and with spending on obesity related ill-health and smoking related illness increasing year on year, these measures will help protect the future finances of the CCG and the wider local health economy.




Dr Lincoln Sargeant, Director of Public Health for North Yorkshire at North Yorkshire County Council said:

we know that lifestyle changes such as stopping smoking and weight loss in obese patients can greatly improve their surgical outcomes and their general health and wellbeing.

North Yorkshire County Council has commissioned a range of services that effectively support people to make these life changing behaviour changes. I support the Harrogate and Rural District CCG in their leadership on this important issue of prevention and will work in partnership to ensure patients can reduce surgical risk and have the best outcomes possible.

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