Private Business Intermediaries

Concerns over Weight Loss Surgery

18/10/2012 | By Peter Walker
An expert group at National Confidential Enquiry into Patient Outcome and Death (NCEOPD) has issued a report that highlights very real concerns in the area of weight loss surgery. 
NCEOPD is a government funded body whose goal is to look in to standards of medical and surgical care via confidential research and reposts. It is a highly respected body and its findings give very real cause for concern. 
Obesity is a real problem for the UK population,  and pardon the pun, but one that is growing all the time.  There is widespread consensus that poor diet and lack of exercise are the main cause.  All too often grossly overweight patients claim not to eat excessively, to have tried diets & exercise that ‘does not work for them’, only to be found to be eating too many calories ‘grazing’ and exercising far too little for it to be possible to sustain a healthy weight . Many practitioners feel the dependency on high sugar and fatty foods should be treated as an addiction.  Many patients who receive good psychological and expert help with diet & exercise do manage to lose weight, which can bring enormous benefits to health such as lowering the risk of diabetes, heart disease and stroke.  Whilst not the focus of this report, it is clearly vital that better education and support be provided in primary practice via GP’s to help as many obese patients as possible avoid surgery. 
NICE, who set treatment guidelines for the NHS, consider weight loss surgery a valid and beneficial option, with long term health benefits for patient for whom diet & exercise have not worked.  Yet for many surgery did not prove to be the ‘quick fix’ they had hoped for. Good diet and exercise, often in combination with psychological support,  is still required to ensure the weigh less benefits are attained post surgery. 
Ian Martin, the report's co-author found, that whilst surgery could offer real benefits, it also came with all to real risks. Almost a fifth of patients who had weight loss surgery required readmission and further surgery to try and correct complications, risks of which may not have been well explained prior to surgery.  The report found that less than a third did not receive psychological support prior to referral for surgery and many did not get the expert dietitian advice that should have been offered. 
This is a highly detailed report, which highlights failings around follow up / aftercare and safeguards. 
The private sector was also in the spotlight with worries over advertising methods and special offers, not appropriate in the setting.
Overall recommendations are that the hospitals and commissioning clinicians work to a checklist that has been published to ensure that where failing exist, they are rectified and that a ‘code of conduct’ be established to protect patients of the very serious consequences of any gaps in the quality of care before, during and after this type of surgical intervention, which for some view as a ‘last chance’’ at re-gaining a better quality of life and good health.