A representative from Bury CCG will report at the meeting.
Minutes:
Stuart North, Chief Operating Officer Bury CCG attended the meeting to provide members of the Committee with an update in respect of the CCG’s proposals in relation to the Lifestyle Change Scheme.
The proposed scheme would affect patients in need of non-essential surgery such as knee, hernia and hip. The proposal, which is still being developed will result in patients who would benefit from stop in smoking or reaching a healthier weight, referral for surgery will be deferred for a number of week to enable the patient to attend a smoking cessation or weight management course as appropriate to help them become as fit as possible for surgery.
Under the scheme, a non-smoker would join the surgery waiting list straight away, while an habitual smoker would have to wait to do so while a course takes place – the length of which will depend on the state of their health.
The Chief Operating Officer reported that the proposal is part of a bigger drive by the CCG to persuade people to take more responsibility for their care.
In response to a Member’s question the Chief Operating Officer reported that the proposals , were still to be finalised by clinicians and public health authorities, discussions are ongoing and the CCG may consider including alcohol as a third option.
Councillor Andrea Simpson, Cabinet Member for Health and Wellbeing expressed concern with regards to the proposed changes and reported that she would like to see a patient added to the waiting list irrespective of their weight/smoking status and the intervention taken place whilst already on the list and in the system. Councillor Simpson reported that the NHS Constitution stipulates that an outpatient referral should take place within 18 weeks and this could put this target in jeopardy.
In response to Councillor Simpson’s concerns, the Chief Operating Officer reported that a similar system has been introduced in Wales and the CCG will review the impact of the changes there and incorporate any learning into their proposals.
In response to a Member’s question, the Chief Officer reported that the proposed changes will be in the interest of the patient in terms of their health and outcomes, and for the NHS by ensuring money is saved in the long term.
The Director of Public Health reported that there are strategies in place to assist people to cease smoking and reduce their weight and the trigger shouldn’t necessarily be waiting for an operation. The Director reported that she would like to see healthy lifestyles embedded in all care/health pathways and people are afforded opportunities to make lifestyle changes earlier.
The Chief Officer reported that it would be up to the GP to have the conversation with the patient in respect of improving their diet/reducing or ceasing smoking and for them to explain the improved outcomes of any operation if such lifestyle changes are undertaken.
Members expressed concern that a patient may be unable to work due to ill-health and if their time waiting for an operation is increased this may result in a longer period off work, loss of income and other associated costs to the NHS of repeat visits to the GP, prescribing of painkillers etc.
It was agreed:
Further updates in respect of the Lifestyle Change proposals will be provided at a future meeting of the Health Overview and Scrutiny Committee.