Surgery is a cost effective solution
November 10, 2010
Failure by the NHS to provide cost-effective surgical treatment for morbid obesity is costing the wider economy hundreds of millions of pounds a year. This is one of the findings of the first ever economic impact assessment of obesity surgery released on Wednesday 8th September in a new report by the Office of Health Economics for the Royal College of Surgeons of England, National Obesity Forum, Allergan and Covidien.
The report, entitled Shedding the Pounds (2), analyses government data, National Institute for Health and Clinical Excellence (NICE) clinical guidelines, and reviews the published medical literature to show that a major increase in the number of bariatric surgery operations would pay for itself in just one year by enabling many patients to return to paid employment. The OHE analysis estimates the number of patients getting access to surgery and showed:- If just five per cent of NICE-eligible patients were to receive bariatric surgery, the total net gain to the economy within three years would be £382m.
- If 25 per cent of NICE-eligible patients were to receive bariatric surgery, the total net gain to the economy within three years would be £1.3bn.
- The UK government could also expect savings in benefit payments in the region of £35m-£150m.
- Direct healthcare cost savings of around £56m per annum to the NHS in reduced prescriptions and GP visits if NICE guidance was followed.
The findings suggest the situation is likely to get worse, with funding set to be cut even further. The report shows that, of those who responded:
- Half of PCTs use only 'elements' of the guidelines set out by NICE guidance to determine who qualifies for bariatric surgery.
- One in ten PCTs ignore the guidance completely.
- Three quarters of PCTs do not track the outcomes for patients of bariatric operations.
- One third of PCTs said they would be more stringent with patients when applying the rules; and none said that guidance would be applied less stringently - effectively resulting in further cuts.
- Huge variations in the numbers of procedures carried out per year between Trusts, ranging from just a single procedure in one PCT in 2009/10 to 192 in another.
Around one million people in England have a BMI that meets NICE criteria with approximately a quarter of those both fit for and wanting surgery - yet only 3,600 NHS weight-loss operations were carried out 2009/10. The rise in obesity is unrelenting and the UK is now the fifth most obese nation in the developed world. In 2008, almost a quarter of the population were considered obese, with the figure set to double by 2050. The direct cost of obesity and related illness to the NHS is £4.3bn per annum - 5 per cent of the total budget.
Mr Peter Sedman, Bariatric Surgeon and Council member of the Association of Laparoscopic Surgeons (ALS) said:
"Patients do not choose to have surgery because it is an easy option; they have it because all other treatment methods have failed. Surgery can literally transform lives, getting people back to work and contributing fully to society. If we do not continue to put resources into this cost-effective and proven successful method of treatment the financial burden on society and the NHS caused by obesity related illness in years to come will be crippling."
Professor David Haslam, Chair of The National Obesity Forum, said:
"Healthcare professionals working in the field of obesity management are calling for the Department of Health to invest in long term strategies ensuring that patients have equal access to treatment by experienced multi-disciplinary teams in well-equipped centres offering full specialist assessment, and appropriate treatment providing safe long-term follow up and emergency re-admission."
John Black, President of the Royal College of Surgeons said:
"These figures are simply staggering. The NHS can not afford to ignore the mounting evidence that shows that bariatric surgery, for those patients where all other treatments have failed, is not only proven to be successful but also hugely cost effective."
Many WLSinfo members are not only very well aware of the benefits which accrue from their increased mobility and health post -WLS but also the benefits in terms of work, both inside and outside the home. While it is important that government and the general public wakes up to the reality that this surgery is not only safe but cost-effective, just emphasising post-Op patients in terms of economic activity often overlooks the huge importance that increased health and mobility make to family life.
We can count the money that accrues to the exchequer of getting back to work, but dancing around the dancefloor with your 3 year old WLS miracle baby…. Priceless!
(1) from The Royal College of Surgeons Media Centre
(2) from Shedding the Pounds The Office of Health Economics for the Royal College of Surgeons, Allergan & Covidien