Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, whether clinical commissioning group restrictions on access to joint surgery for obese patients and smokers are compatible with NICE guidance on osteoarthritis: care and management, that patient-specific factors, including age, sex, smoking, obesity and co-morbidities, should not be barriers to referral for joint surgery.

Clinical commissioning groups (CCGs) are primarily responsible for commissioning services to meet the requirements of their population, including the obese and smokers. In doing so, CCGs need to ensure that the services they provide are fit for purpose, reflect the needs of the local population, are based on the available evidence and take into account national guidelines.

The evidence suggests that major surgery poses higher risks for severely overweight patients who smoke. CCGs are therefore right to ensure these patients first get support to lose weight and try and stop smoking before their operation. Reducing obesity and cutting smoking not only benefits patients but also saves money for the National Health Service and taxpayers.

This does not and cannot mean blanket bans on particular patients such as smokers or overweight people getting operations, which would be inconsistent with the NHS Constitution.