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Surgical criteria more stringent in Wales than England

Welsh patients have to be twice the weight and have significant obesity-related co-morbidities

Patient in Wales have to meet stricter criteria than their English counterparts to qualify for bariatric surgery, according to a report for the Welsh assembly's Health and Social Care Committee.

"There is a disparity between entry criteria [for surgery] in England and Wales,” Mr Jonathan Barry, one of Wales' only two bariatric surgeons, told BBC Wales. "Currently in Wales you have to be twice the weight you should be [to qualify] and have significant obesity-related co-morbidities."

He added that at his institution (Morriston Hospital, Swansea), 67 patients are waiting for bariatric surgery but he said they could operate on up to 220 people per year.

It is estimated there are approximately 7,000 patients in Wales who could benefit from surgery but they have to meet a stricter set of guidelines than recommended by the National Institute for Health and Care Excellence (NICE).

The report also found that only one of Wales' seven health boards provides all the weight management services they should. Obesity care is separated into four levels, from community-based intervention (level 1) to bariatric and metabolic surgery (level 4).

"There are some people who don't need surgery," he said. "They need other help. They may fall outside the criteria for surgery and they have to be looked after in their own locality. We need to maximise the throughput of patients."

He backed a committee recommendation to open a second bariatric unit in north Wales.

The Royal College of Physicians supports the report's call for the Welsh government to fully implement its ‘All Wales Obesity Pathway’ which would ensure patients everywhere had access to the higher level services.

"Sufficient provision of specialist dietary, physical, and behavioural support is so important in order to avoid the invasive and drastic option of surgery, which can lead to long-term consequences as well as benefits for patients,” said Health and social care committee chair David Rees. "In our view surgery should only be seen as a last resort."

The Welsh government said it would respond to the report in due course.

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