CONTROVERSIAL plans to deny non-life threatening surgery to obese people and smokers have been put on hold by York health bosses.

The plans by Vale of York clinical commissioning group (CCG) could have meant that patients who had a body-mass index (BMI) of more than 30 would face delays in receiving some NHS surgery for up to a year.

The Vale of York CCG had agreed the plan to ask obese people to lose weight before surgery, or to ask smokers to quit, at a meeting this week.

But this afternoon, after an intervention by national health bosses at NHS England, the CCG has confirmed the plans are going on hold.

In a statement, a CCG spokesman said: "NHS England has today asked us to review the draft approach which we will now do, and will hold off implementing anything until we have an agreed way forward.

"We will ensure any plans are implemented in line with national guidance, are in the best interests of our patients and are clinically robust"

Earlier today NHS England told the CCG to review proposals to refuse surgery for obese people or smokers.

The national body  announced it would tell the North Yorkshire bosses to review the policy to make sure it is reasonable - something it can do because the Vale of York is in special measures over financial problems.

A spokesman for NHS England said: "Major surgery poses much higher risks for severely overweight patients who smoke. So local GP-led Clinical Commissioning Groups are entirely right to ensure these patients first get support to lose weight and try and stop smoking before their hip or knee operation.

"Reducing obesity and cutting smoking not only benefits patients, but saves the NHS and taxpayers millions of pounds.

"This does not and cannot mean blanket bans on particular patients such as smokers getting operations, which would be inconsistent with the NHS constitution.

They added: "Vale of York CCG is currently under 'special measures' legal direction, and NHS England is today asking it to review its proposed approach before it takes effect to ensure it is proportionate, clinically reasonable, and consistent with applicable national clinical guidelines."

The policies were condemned by the Royal College of Surgeons, who dubbed them "the most severe the modern NHS has ever seen".

President Clare Marx added: "We would support any attempts by Vale of York to expand its weight loss and smoking cessation programmes, but introducing blanket bans that delay patients’ access to what can be life-changing surgery for up to a year is wrong.

“In some cases patients needing surgery may find it difficult to lose weight, for example if they have mobility problems. Their condition may also deteriorate if made to wait unnecessarily for surgery."

She called for an "honest national debate" on what the NHS could afford, and people were willing to pay for.

Labour's Diane Abbott, shadow health secretary, called the policy an "unacceptable breach of the NHS principle of a universal service".

Others, however, have warned that similar decisions could soon be made elsewhere.

A spokesman for NHS Providers, which represents health service leaders, said a number of considerations are taken by health services outside of costs when deciding whether to operate.

He added: "However, given that we are in the middle of the longest and deepest financial squeeze in the NHS's history, we are likely to see more decisions like this in future.

"What is important is that this is managed on an NHS-wide basis.

"There is now a clear and widening gap between what the NHS is required to deliver and the funding available, and this will only get worse as overall funding increases drop from next year."

The Vale of York CCG agreed the plan to ask obese people to lose weight before surgery at a meeting this week.

Under the plans presented to the governing body of the Vale of York Clinical Commissioning Group, people needing hip or knee replacement surgery will be asked to get their body mass index (BMI) below 30, the point at which people are defined as obese.

The estimated cost of obesity to the NHS annually for the Vale of York CCG was £46.6 million in 2015.

As The Press reveals today, the CCG's financial forecasts have hugely deteriorated by millions of pounds.

Under the plans, people needing hip or knee replacement surgery would also be asked to stop smoking ahead of the operation in order to improve their health and reduce the risks of complications from surgery.

Dr Shaun O'Connell presented the plans in the context of ongoing financial difficulty for the NHS in the Vale of York. He said the city needs to make difficult decisions to get back on track.

"There are no quick wins and that makes us look for mid to long term wins," he said, "We don't want to spend the NHS resources on avoidable illnesses - in fact we can't afford to.

"There's no doubt the population is getting older and getting fatter and it's an outrage that the local NHS is not shouting from the rooftops that people need to look after themselves."

York Press:

Under the plans, patients will be asked to lose at least ten per cent of their body weight before being referred for surgery or surgery will be delayed for 12 months with the aim of patients losing ten per cent of their body weight. Referral should also be delayed until the patient has stopped smoking for eight weeks or delayed for six months.

The report states that obesity is a significant risk factor for osteoarthritis and other problems such as diabetes. Obese patients have a "significantly higher risk of a range of short term complications during and immediately after surgery" such as deep vein thrombosis, and the implant is likely to fail more quickly.

Members of the meeting, including Sian Balsom, manager of Healthwatch York, questioned whether the necessary support was in place to support people with exercise and diet advice. She was told groundwork would be done so patients could be signposted to necessary support.

Dr O'Connell also added that the measures would be equality assessed. There will be some exceptions to the rule, the meeting heard, and abdominal circumference may be taken into consideration as well as BMI.

A spokesperson for the Vale of York Clinical Commissioning Group said: “The local system is under severe pressure. This work will help to ensure that we get the very best value from the NHS and not exceed our resources or risk the ability of the NHS being there when people really need it.

“Tackling common risk factors for many of the preventable diseases affecting people in the Vale of York such as improving the appropriate use of health and care services and ensuring patients gain the most benefit from the interventions they receive is a strategic priority.

“The CCG wants to support work that helps the community to stop smoking and where needed, lose weight.”