Patients too obese for surgery are being encouraged by their GPs to take responsibility for their own health by changing their lifestyle.
Almost 500 patients were referred by clinicians on to a six-month weight management programme in the East Riding last year – but only around a half actually took part.
The scheme also targets smokers and aims to improve a patients’ health and wellbeing before they are referred on for ‘non-urgent’ surgery – such as a knee or hip replacement.
Local health bosses have welcomed the approach, which has also been trialled in a number of clinical commissioning group (CCG) regions since its introduction in October 2017.
Will Uglow, assistant director of planned & primary care at East Riding CCG, said: “Part of the reason why we wanted to do this was to try and improve the health outcomes of patients for years to come.
“So with schemes such as this we’re trying to get people to get themselves healthier.
“As well as this we’ll start doing lots of work on self-help and self-management of other conditions as well, which is all about saving money or saving pressure on the [health] system further down the line.”
A total of 499 patients with a Body Mass Index (BMI) of over 35 – those classed as ‘obese’ – were referred from practices across the East Riding between October 2017 and November 2018.
However, an East Riding Council scrutiny committee was told that only 237 (54 per cent) of those referred actually started the programme, while 108 patients did not take it up at all.
Under the programme, non-urgent patients with a BMI score of 35 or over are offered a referral to a sixth-month weight management programme before undergoing surgery.
An East Riding CCG report to councillors read: “After the sixth-month period, the patients will be eligible for surgery providing they have been encouraged and supported to access the weight management service or another weight loss programme or activity, irrespective of whether weight has been lost.”
The report added that 59 per cent of users starting the programme had a BMI of greater than 39, while seven in ten referrals were as a result of potential orthopaedic/joint surgery.
More than 60 per cent of those undertaking the programme are females and six in 10 service users are aged between 55 and 74 years old.
Feedback from participants found that 54 per cent of patients showed a positive change in their Warwick Edinburgh Mental Well Being (WEMWB) score and 60 per cent demonstrated both weight loss and a positive change in their BMI.
Meanwhile, patients who require support to stop smoking can access the cessation service provided by the council, which makes it hard to judge whether the scheme has been successful.
This is because patients can self-refer to such services without having to state whether they were asked to attend by their GP.
Mr Uglow admitted that patient numbers were lower than expected and that some GPs were even sceptical of the scheme at first, but added that they were now “coming on board” with it. He also confirmed that a pilot phase of the scheme will continue for another year.
He said: ”I think we’ve seen some very good outcomes [and] the vast majority of patients have lost weight through the process. You get an excellent service when you go into the leisure services.”
“The issue we’ve got is it’s very difficult to track patients through different systems because you’ve got to get consent, it goes through one section of health into another and although it sounds simple it is almost impossible to track patients through that.”
In the East Riding, there are approximately 15,600 people with a BMI of 35 or higher, which represents around 5.2 per cent of the region’s overall population.
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