Europe UK (Commonwealth Union) – A recent study published in BMC Medicine has revealed that the weight and body mass index (BMI) policies implemented by NHS commissioning groups in England are deemed inappropriate and are exacerbating health disparities. This comprehensive analysis, which examined approximately 490,000 hip surgeries, sheds light on the direct impact these policies have on patients, considering that 1 in 10 individuals may require joint replacement in their lifetime.
For more than a decade, NHS clinical commissioning groups (CCGs) all over England have implemented regulations to modify access to hip and knee replacement surgeries for individuals who are overweight or obese. However, the application of these BMI guidelines varies across different regions. Some areas have no such policies, while in others, patients are denied access to hip replacement surgery until their BMI falls below a specific threshold or after an extended waiting period.
The University of Bristol researchers carried out a study to evaluate the effects of these BMI policies on access to hip replacement surgery in England and to determine whether there is evidence of worsening health inequalities. The study received funds from the National Institute for Health and Care Research (NIHR).
Researchers evaluated the rates of hip replacement surgery of 480,364 patients from January 2009 to December 2019 with the utilization of data from the National Joint Registry (NJR). This was followed by the contrasting of regions with as well as without a BMI policy.
It was noted in the findings that policies to alter access to hip replacement based on a patient’s weight/BMI were associated with a reduction in surgery rates, particularly for those residing in deprived areas, whereas rates were elevated in localities without a policy. Regions that had strict BMI threshold policies were linked to the sharpest decline in rates.
Dr Joanna McLaughlin, NIHR Doctoral Research Fellow in the Bristol Medical School: Translational Health Sciences (THS) who is the author that led the study says “NHS policy on whether people can immediately access referral for hip replacement surgery if they are overweight or obese varies depends on where you live in England.”
