A health board has defended its scheme to make patients who smoke or are obese attend intervention courses before having non-emergency surgery, insisting it is about helping people.
Cardiff and Vale University Health Board said its optimising outcomes policy, which was approved by the board earlier this week, was designed to support patients live healthier lifestyles and improve their chances of surviving surgery and recovery times.
Smoking and obesity are lifestyle factors which are known to increase the risks of surgery and delay patients in their recovery following a procedure.
Under the scheme, any patient listed for elective surgery who smokes or has a body mass index of 40 or more will have to be offered, accept and complete smoking cessation or weight management support programmes before being put on the waiting list.
Exclusions will apply to patients needing emergency surgery and surgery for cancer treatment.
Those needing bariatric surgery and those who have hormone-related conditions that make them medically unsuitable may also be excluded from the weight management intervention.
If the need for surgery becomes urgent, patients will not be required to complete the programme.
Patients need not have quit smoking or lost weight following the intervention course, but it is hoped the scheme will lead to more long-term improvements in patients’ health.
The health board has been accused by members of the public of “targeting” these patients.
But public health consultant Dr Sian Griffiths said: “This is an opportunity for us to offer support to people and when they need to have surgery to think about their health if they smoke or need to lose weight. We want to offer support to address these issues with the view of improving the outcomes of their surgery. We know that even if they stop smoking for a month, that has a real impact on their recovery time.
“We are not specifying that people have to lose a certain amount of weight or stop smoking but it’s about engaging them with support that can help them and it might have a long term knock-on effect.”
Dr Sharon Hopkins, the health board’s director of public health, said: “We know that for a behaviour change, people have to want to make that change. The key here is to get people to engage in a conversation about their health in relation to these two things and think about their health in the long-term.
“For most people, surgery is quite a big thing that they will worry about, and they will want the best possible outcome.”
Hani Shadad, 39, was offered the chance to take part in the weight loss programme after suffering two slipped discs in his back.
The taxi driver from Grangetown, Cardiff, said: “I had gone through physio and they referred me to the programme and I agreed. It lasted three months long and I thought it was really good.
“I didn’t realise how bad my eating was, but my portion sizes were too big and I ate too many sweets. I used to do sport to burn it off but once I stopped the weight came on.
“The programme changed my views on this and I now know about portion sizes and inventive ways to stop the sugar cravings. I have lost four stones since October and would recommend it.”
Karen Tiltman, 54, from Splott, Cardiff, lost 6.5 stones and said: “It has helped me no end and it’s made me re-think how I eat. I have problems with my knees and my breathing but and I was a real couch potato. It just came at the right time. I still have a way to go but I can get out and I feel so much better.”
Dr Mark Temple, co-chair of the British Medical Association’s public health medicine committee, said:“This scheme is a win-win as it helps the patient but it also saves the NHS money as patients who don’t smoke and lose weight are less likely to have complications, their stay in hospital will be shorter – at a time when there is a shortage of resources – and their long-term health will improve. I really think this is a no-brainer.”