Health

New Government Initiative Prioritizes 'Fit for Surgery' Patients, Raising Concerns Over NHS Equality

January, 09, 2025-02:26

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New Government Initiative Prioritizes 'Fit for Surgery' Patients, Raising Concerns Over NHS Equality

Smokers and overweight patients may find themselves at the end of the line for surgeries under new Government initiatives aimed at reducing waiting lists.
The Prime Minister revealed these plans yesterday, indicating that only patients considered ‘fit for surgery’ will receive a scheduled operation date.

As part of these measures, many individuals waiting for hip and knee operations will be required to participate in a 12-week weight loss program, while smokers will be encouraged to quit.
Research has consistently shown that prehabilitation—including physical, nutritional, and psychological support before surgery—can lower the likelihood of complications or cancellations.

The new Government strategy, referred to as the 'Elective Reform Plan,' also suggests that enhancing patients' fitness prior to procedures will increase the number of individuals eligible for outpatient surgery, thus shortening hospital stays.

However, experts have cautioned that these changes may represent a ‘betrayal of NHS principles’ and could exacerbate health disparities.
Currently, about 6.34 million individuals are on NHS waiting lists for approximately 7.54 million treatments as of the end of October
Sir Keir has committed to diagnosing and treating 92 percent of patients within an 18-week timeframe after a GP referral by the end of this Parliament. According to the plans, ‘quitting smoking four weeks before surgery lowers the risk of respiratory complications by 25 percent and wound healing issues by 30 percent compared to ongoing smokers.’

Criteria for determining patient fitness for surgery remain unclear, with decisions likely made on an individual basis. Those not considered fit would stay on the waiting list.
Professor Sir Stephen Powis, NHS national medical director, stated, "The clinical perspective is that being in top shape and as prepared as possible for surgery can lead to improved post-operative outcomes and increase efficiency by minimizing complications."

"As part of the Elective Care Reform Plan, the NHS will strive to aid patients in preparation for treatment. This includes support for weight management or smoking cessation to facilitate recovery before surgery."

Currently, the NHS recommends that obese patients reduce surgery-related risks by losing weight, quitting smoking, and managing blood sugar.
However, nationally, these guidelines do not impact waiting lists. Some local NHS trusts have faced criticism for imposing restrictions on surgical access, including demands for obese patients to lose 10 percent of their body weight or for smokers to quit for at least two months.

This approach is seen as contradictory to official guidance.
Obesity significantly heightens the risk of severe health conditions, such as hypertension and various cancers.
Roughly two-thirds of adults in the UK are classified as obese or overweight, making it one of Europe’s leading countries for obesity rates.
Last year, a concerning report indicated that Britain's rising obesity rates have contributed to a 39 percent increase in type 2 diabetes among people under 40, leading to 168,000 individuals currently affected by the disease.

Excess weight is also linked to at least 13 different types of cancer and is the second-largest contributor to the disease in the UK, as reported by Cancer Research UK.

A study in June from the US suggested that weight loss injections might help reduce complications for obese patients undergoing surgery.

However, experts emphasized the need for further research before such treatments are approved for this purpose. The plan anticipates creating up to half a million additional appointments annually by extending hours at community diagnostic centers and establishing 14 new surgical hubs while expanding three by June.
Allowing patients to opt out of automatically scheduled follow-up appointments could potentially free up to a million slots.
The use of wearable technology will also be expanded to gather health data, minimizing routine appointments that are not clinically necessary.

NHS trusts that quickly reduce waiting times will receive additional funding for local initiatives, including investment in new diagnostic tools and hospital maintenance.
Health Secretary Wes Streeting asserted that the objective of reducing maximum wait times from 18 months to 18 weeks will succeed by 'bringing care closer to home and granting patients more options regarding their treatment.'

However, he previously warned that fulfilling Labour's promise to restore the 18-week standard by the next election presents a ‘significant and challenging task.’

The health secretary further stated that the NHS could ‘collapse’ like Woolworths unless it embraces essential reforms to modernize its