Obese patients and smokers face being sent to the back of the queue for NHS surgery under government plans.
Reforms announced by Sir Keir Starmer will mean that patients will only be given a date for an operation if they have been assessed as “fit to proceed”.
Tens of thousands of patients waiting for hip and knee surgery will be asked to first undergo a 12-week weight-loss programme, while smokers will be urged to quit.
The moves are part of plans announced by the Prime Minister which he said would see the NHS “reformed from top to bottom”.
The Elective Reform Plan, drawn up by the Department of Health and Social Care and NHS England, says “prehabilitation” of patients before surgery can increase productivity by minimising complications and reducing cancellations.
Getting patients fitter before treatment also increases the number who are suitable for day surgery, instead of long hospital stays, the plans say.
“Stopping smoking four weeks before surgery means patients have a 25 per cent lower risk of respiratory complications and 30 per cent lower risk of wound healing complications than those who continue to smoke,” the plans state.
Advice to lose weight or give up smoking is often given to patients in need of surgery.
But the new plan will mean that all patients waiting for routine surgery other than cancer operations would only be given a date for an operation “once they have been confirmed in their pre-assessment as fit to proceed”.
The plans do not specify the criteria which make a patient fit enough for surgery, with decisions expected to be made on a case-by-case basis.
Some NHS authorities have previously banned obese patients and smokers from having some surgery, while others have said operations could only go ahead if patients lost at least 10 per cent of their body weight.
Such rulings met a backlash from surgeons who said the policies were “brutal”.
Under the new plan, patients who are not deemed fit enough would remain on the waiting list, with speedier treatment for those assessed as eligible to proceed.
Prof Sir Stephen Powis, the NHS national medical director, said: “The clinical view is that being fighting fit and as prepared as possible for surgery can result in better post-op outcomes and increase productivity, by reducing any complications in surgery.
“So, as part of the Elective Care Reform Plan, the NHS will do everything within its power to help patients get ready for treatment including by offering the option of weight management support or help to stop smoking so that they can begin recovery before treatment even begins.
“It is really important as we work on the 10-year health plan to make the NHS fit for the future, and to do that we need to give people the tools they need to take more control of their own health.”
Prof Sir Stephen Powis said the NHS would do everything in its power to get patients ready for treatment – Yui Mok/PA
The measures are part of efforts to boost NHS productivity and clear waiting backlogs.
The plans will also see NHS patients offered up to one million extra NHS appointments a year – a 20 per cent increase on current levels.
The agreement with the private sector will target specialties with some of the longest waits including gynaecology and orthopaedics.
It also aims to ensure more private care offered to patients in deprived areas.
The Tories on Monday accused the Government of attempting to “reheat and re-serve” their own policies, with expanded use of the private sector among the policies pushed by the previous government.
‘Further and faster’
Sir Keir said the Government would go “further and faster” than any predecessor in reform of the NHS.
At a press conference at Epsom Hospital in Surrey, where he attempted to reset his premiership, the Prime Minister said rebuilding the NHS would be the “cornerstone” of efforts to rebuild Britain.
Sir Keir said “some people won’t like” the deal with the private sector, which was “in the national interest”.
“We will, of course, protect the principles we all cherish – that you will work to every day – care free at the point of use, treatment according to need, key principles.
“But to catapult the service into the future, we need an NHS that is reformed from top to bottom, millions of extra appointments signed, sealed and delivered with the plan that we are launching here today.”
The plan promises to cut the number of patients waiting more than 18 months for treatment by almost half a million by March 2026.
Ministers have promised to free up around one million appointments by scrapping “pointless” follow-ups, putting the onus on more patients to decide when checks are required.
The plan will expand access to community diagnostic centres, to speed up access to diagnostic tests, with the creation of 17 more standalone surgical hubs, so that operations are not cancelled because of emergencies.
The plans will also mean GPs can refer patients directly for tests instead of via a consultant. Family doctors will be paid extra for every case they seek advice on from hospital doctors, rather than automatically making a referral.
The new deal will set out how independent sector capacity can be used to tackle some of the longest waits in specialist areas of treatment, such as gynaecology, where there is a backlog of 260,000 women waiting more than 18 weeks for treatment.
Orthopaedics will also be a key focus, where more than 40 per cent of patients are waiting longer than the 18-week target.
Wes Streeting, the Health Secretary, said that the Government would pull every lever available to get patients treated on time – Heathcliff O’Malley/The Telegraph
Patients are already supposed to have the right to choose where they are treated under policies that were first introduced by the last Labour government.
However, latest surveys show fewer than a quarter recall being offered a choice of hospital.
Wes Streeting, the Health Secretary, said: “Millions of patients are being forced to wait unacceptably long for treatment, failed by 14 years of neglect of the NHS. This Government will pull every lever available to get patients treated on time again.
“I’m not going to allow working people to wait longer than is necessary when we can get them treated sooner in a private hospital, paid for by the NHS. If the wealthy can be treated on time, then so should NHS patients.
“This new agreement will help to cut waiting time faster in parts of the country where the need is greatest, and in gynaecological care where women are left waiting far too long.”
