Key points:
•If you are considering private surgery at home or abroad, you should follow advice on the NHS website and Government websites before deciding if private surgery is right for you
•Your GP practice is not able to provide or arrange the necessary specialist follow-up care in the 2 years after you have had bariatric surgery – this applies whether you have accessed surgery via the NHS or chosen to pay for private surgery at home or abroad
•If you are planning private bariatric surgery, either abroad or in the UK, you should budget for at least two years of private specialist care after surgery, which must be purchased as a standalone care package or as part of the package of care alongside the surgical procedure
•When you have reached the end of your privately funded bariatric surgery after-care, you will have access to the same monitoring and treatment support as patients who have received bariatric surgery care in the NHS.
Treatments for people who are obese (very overweight) can include increasing physical activity, changing their diet so they take in fewer calories, drugs to help them lose weight, bariatric (weight loss) surgery, or a combination of some or all the above. People who are treated for obesity will also usually need regular long-term follow-up care, for example to help them adjust to and stick with their new lifestyle or to help them stay healthy after surgery.
Weight loss surgery (called a bariatric operation) is only recommended for people who are seriously obese, have tried all the other ways of losing weight without success, and have already been treated by a specialist obesity team. Other groups of people who are overweight or obese may be assessed and prioritised for bariatric surgery because of additional risks from clinical conditions or genetic factors.
Bariatric surgery is a major operation, and patients will need checks from a specialist team to make sure that they don’t have any medical conditions that could make the operation dangerous for them, and that they will be able to cope with
- the operation itself
- recovering from the operation
- adjusting to the long-term lifestyle changes needed
- the need for ongoing diet supplements and monitoring.
Patients will need to make long-term changes to their eating habits to get the full benefit from the operation, and the specialist team will need to be sure that they can do this. Patients will also need to agree to regular appointments with the specialist team afterwards to check their health (to make sure any medication that they have is working well and that they aren’t having any other problems) and diet (they may need extra supplements and nutrients), do tests to make sure they are getting the nutrients that they need and they should be given help to increase physical activity and psychological support if needed. National healthcare guidance advises that this follow-up and monitoring should carry on for at least 2 years with the same group of specialist healthcare professionals who cared for the patients at the time of their surgery. After that, they will still need to have their health, diet and need for any extra nutrients and supplements checked regularly by their doctor for the rest of their lives.
Some people choose to pay privately to have bariatric surgery in the UK or abroad and are strongly advised to be cautious and take into account all aspects of the full care that they will need to fund in addition to the surgery itself. The many specific concerns about people having private surgery in UK or when travelling overseas for self-funded surgery include access to the required routine post-operative follow up care from a specialist bariatric service for 2 or more years after surgery, without which there is increased risk of poor outcomes such as weight regain and nutritional deficiencies.
BOB ICB has comprehensive policies covering patient eligibility for bariatric surgery and covering boundaries between NHS and Private Healthcare, based on national guidance. A patient is not entitled to “pick and mix” elements of NHS and private care in the same treatment, and so is unable to have privately funded and NHS funded care provided as part of the same care episode. The NHS national service specification and NICE guideline for this surgery is clear that the bariatric surgery pre- and post-operative care is part of a single episode of care and should all be provided by the specialist service provider multidisciplinary team.
It is important that patients who are considering seeking private treatment of any kind should always discuss it with their GP surgery before taking action. Patients who have surgery abroad or in the private sector in the UK should budget for at least two years of private specialist care after surgery. The specialist nature of the bariatric surgery aftercare and national guidance means that it is not considered appropriate or expected for a GP practice to provide or arrange any bariatric surgery follow-up care in the 2 years after surgery, regardless of whether the patient has accessed surgery via the NHS or privately. Provision of standalone NHS post-surgery care to a patient who has had bariatric surgery privately in UK or abroad is not routinely provided or commissioned by the NHS. While the NHS will always provide - emergency care where necessary, all routine pre- and post-operative care should be part of the package of private bariatric surgery care purchased by the individual patient. Once patients have reached the end of their privately funded bariatric surgery after-care follow up, they will have access to the same monitoring and treatment support as patients who have received bariatric surgery care in the NHS.
- References
- NICE Clinical Guideline CG189 Obesity: identification, assessment and management updated: 26 July 2023. Information for the public.
- NICE Quality Standard QS127 Obesity: clinical assessment and management. Updated July 2023 Quality statement 6: Follow-up care after bariatric surgery
- British Obesity & Metabolic Surgery Society (BOMSS). (2023, September 06). BOMSS statement on going abroad for weight loss surgery.
- NHS website Weight loss surgery : Recovery and Treatment Abroad Checklist
- Patient : Weight loss surgery
- UK Gov Foreign, Commonwealth & Development Office : Going abroad for medical treatment and planned elective surgery
- BOB ICB Clinical Commissioning Policy Statements