Arthritis UK Urges ICBs to Scrap BMI Threshold Policies Used to Ration Surgeries
Almost a fifth of ICBs in England are rationing joint replacement surgery based on a person’s BMI, an approach that contradicts NICE guidance for the diagnosis and management of osteoarthritis.
These policies vary across England, creating a postcode lottery where patients may be denied access to life-changing treatment based on where they live rather than clinical need. Many patients are also required to lose weight before surgery but are not given access to the weight management services needed to do so. This results in longer waits, prolonged pain, and widening inequalities particularly for patients in deprived areas.
In a new report, Arthritis UK are calling for the end of these practices.
The key recommendations set out in the report:
- BMI threshold policies should not be used to ration access to joint replacement surgery. Instead, decisions should be based on individual clinical need and ICBs policies should be updated accordingly.
- ICBs should adhere to NICE osteoarthritis guidelines.
- The Department of Health and Social Care should ensure that any efforts to reduce waiting lists do not rely on policies that contravene clinical evidence or undermine patient’s wellbeing.