The introduction of weight and BMI restrictions in patients requiring knee replacement by the National Health Service has led to a reduction in surgery in England and could contribute to a health zip lottery, according to a study.
Researchers at the University of Bristol have suggested that NHS contracting groups that have imposed restrictions on access to knee replacement surgery based on a patient’s weight or body mass index (BMI) have seen a decline in surgery.
The study says that for one in 10 people who are likely to need a knee replacement, many thousands of patients are directly affected by these policies.
The rules have been bought over the last decade, but there are many regional differences.
Our study raises concerns that these policies are linked to worsening health inequalities
Dr. Joanna McLaughlin, lead author
The research team analyzed the frequency of knee replacement surgery in 481,555 patients between January 2009 and December 2019, using data from the National Joint Registry and compared regions with and without a BMI policy.
They found that linking access to knee replacements based on the patient’s weight or BMI led to a reduction in surgery and potential health inequalities in the postal code.
The research team calls on commissioners and decision-makers to urgently review restrictive policies that affect access to elective surgery.
Lead author Dr Joanna McLaughlin of the University of Bristol said: “NHS policy on whether people can be referred immediately for knee replacement surgery if they are overweight or obese varies depending on where you live in England .
“Our study raises concerns that these policies are associated with worsening health inequalities with fewer NHS operations for the poorest groups in society when the policies are implemented.
An NHS spokesman said: “Patients and clinicians work together before surgery to optimize the chance of achieving the best results, and in some cases, weight loss before surgery reduces the risk to patients and improves the chances of success.
“The National Health Service is focusing on reducing the time to wait for a knee replacement, and overall, since the recovery plan was published in February, the number of people waiting more than two years for treatment has dropped by two-thirds. .
The study was published in the journal PLOS One.
Add Comment