1) What Are Your Trust's Criteria for Qualifying for NHS Funded Weight-Loss Surgery

1) What are your trust's criteria for qualifying for NHS funded weight-loss surgery? Specialised Morbid Obesity Services, including Bariatric Surgery, are commissioned on behalf of the PCTs in South East Coast (SEC), with the exception of NHS Surrey, by the South East Coast Specialised Commissioning Group (SECSCG). All PCTs in SEC use consistent eligibility criteria for the approval of funding for referral to a Specialised Morbid Obesity Service. Originally approved in 2008, these have been reviewed and reissued in 2011. The eligibility criteria are below;

1) The patient’s age is 18 years or over at the point of referral, and 2) The patient’s BMI is greater than 35kg/m2 but less than 40kg/m2 with co- morbidities that would be improved by losing weight. 3) Co-morbidities include: a. Established ischæmic heart disease; b. Type 2 diabetes requiring oral medication or insulin; c. Life-threatening sleep apnoea; d. Severe uncontrolled hypertension; e. Benign intracranial hypertension; f. History of transient ischæmic attacks or stroke; g. Severe lower limb major joint disease requiring orthopaedic intervention which is precluded on safety grounds due to patient's BMI; h. Other co-morbid condition which has been agreed by the PCT as exceptional, on an individual patient basis; 4) Or, the patient’s BMI is greater than 40kg/m2 with or without obesity related co- morbidities, and 5) The patient has tried to lose weight over the course of 1 recent full year (i.e. a continuous 12 month period that ceases at the point of referral), without success. This includes but is not restricted to: a. Weight management programme under the supervision of a dietician or GP or membership of a weight loss organisation, with evidence that a programme has been followed over a 12 month period without successful weight reduction. The weight loss programmes do not have to be provided by the NHS. 6) And, it is imperative that the patient has received support from their GP throughout this non-surgical management phase and that there is evidence of the patient’s attendance of weight loss programmes, including drug therapy (Specialised Services Definitions state that drug treatment of obesity should follow at least three month’s supervised diet). The weight loss programmes do not have to be provided by the NHS. 7) Or, the patient’s BMI is 50Kg/m2 or greater.

2) How many patients from your trust's area had gastric band surgery on the NHS in 2010? See Table 1 below

3) How many patients from your trust's area had gastric bypass surgery on the NHS in 2010? See Table 1 below

4) The same figures for Questions 2 and 3 for the years 2005, 2006, 2007, 2008 and 2009. See Table 1 below

Table 1: Number of admissions for Bariatric Surgery 2005 – 2010, by PCT, by procedure;

PCT Year Gastric Gastric Other Total Band Bypass

2005 – 06 0 4 3 7 2006 - 07 43 19 6 68 2007 – 08 65 46 14 125 West Sussex 2008 – 09 65 77 28 170 2009 – 10 68 134 22 224 2010 – 11 41 159 44 244

5) In the last five years, how many patients have received revision surgery on the NHS following a complication resulting from weight-loss surgery?

The table below contains the number of patients receiving a revision, including renewal/removal of a gastric band; band removal and conversion to a bypass; redo of a bypass.

Table 2: Number of Admissions for Revisional Bariatric surgery PCT Year Gastric Gastric Other Total Band Bypass

2005 – 06 0 0 0 0 2006 - 07 0 0 0 0 2007 – 08 0 0 5 5 West Sussex 2008 – 09 2 1 10 13 2009 – 10 2 3 5 10 2010 – 11 0 12 12 24

6) How many patients in question 5 had previously been treated privately in the UK or abroad? We do not hold information on patients requesting NHS funding for Revisional Bariatric Surgery who have previously been treated privately.