Santa needs to lose the weight and the pipe.
New rules from the Welsh government say that if a patient who is obese and/or a smoker and is scheduled for orthopedic surgery in Wales, they must lose weight and stop smoking before surgery.
The move is an attempt to curb the rise in orthopedic referrals which have risen by 30% since 2005. According to Caroline White, writing for Onmedia, that is more than double the increase in all other specialties put together.
Orthopedics is the biggest single planned care service in Wales, she reports, with more than half a million trauma and orthopedic outpatient consultations every year. There are around 40, 000 routine planned treatments. The growing prevalence of obesity as well as advances in clinical practice are believed to be behind the rise in referrals to hospitals for treatment.
Smoking is known to worsen the outcomes of some foot and ankle procedures, White noted. Numerous studies have shown that the rates of postoperative complications and length of stay are higher in patients who smoke.
The ruling by the Welsh government is not totally heartless. Smokers and those with a body mass index of 35 or more will be supported to join a weight-loss or stop-smoking program before having their surgery. The Wales’ Planned Care Programme Board drew up the National Orthopaedic Implementation Plan. It stipulates that local health boards must provide a suitable range of stop smoking and weight reduction support services and appropriate referral mechanisms for patients.
Peter Lewis, Wales’ national clinical lead for planned care, said. “Understanding patient-reported outcomes and addressing the key issues that can impact on them, such as lifestyle factors, is a fundamental component of volume-based medicine and benchmarking Welsh healthcare systems against best-in-class organizations in the UK and abroad.”
