Changes to services: Understanding people’s experience of thresholds for elective surgery in York

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Summary of report content

Healthwatch York gathered public feedback on changes to the thresholds for elective surgery regarding body mass index (BMI) and smoking in York. This work was carried out following a survey that identified the issues that local people wanted Healthwatch York to look at – including these thresholds for elective surgery. Since January 2017 NHS Vale of York Clinical Commissioning Group (VoYCCG) has required that adult smokers quit and people over a certain weight reduce their BMI by a specific amount before being referred for surgery. Individuals still receive a referral for a consultant opinion, however they may have their referral for surgery delayed for six months and one year respectively, before they are put on a waiting list for most kinds of elective surgery under local or general anaesthetic.

Key themes drawn from people’s experiences included: all of those who took part reported negatively on the new thresholds and the various effects it had on their quality of life, health or wellbeing; people faced difficulties coping with pain in their day to day lives, and this led to them struggling to exercise and be active; some people faced financial and emotional distress due to being out of work and off sick for increasing amounts of time whilst waiting to access the surgery they need; people felt that the BMI threshold was arbitrary, and that they had received confusing or unclear messages from healthcare providers; and there was a lack of quality information and support about how to lose weight.

Healthwatch York made three recommendations to VoYCCG about: considering ways to gather the data needed to know if the thresholds for elective surgery are effective in saving money and improving patient outcomes; working in coproduction with the public to understand how to support people who have difficulty engaging with weight loss activities; and creating accessible and clear pathways of support, considering what proactive steps can be taken to prevent people from falling through the gaps, and to help more disadvantaged people engage with support programmes and services.

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General details

Report title 
Changes to services: Understanding people’s experience of thresholds for elective surgery in York
Local Healthwatch 
Healthwatch York
Date of publication 
Wednesday, 1 May, 2019
Type of report 
Key themes 
Communication between staff and patients
Food and nutrition
Health promotion
Information providing
Lifestyle and wellbeing
Waiting times and lists for treatment
Healthwatch reference number 

Methodology and approach

Was the work undertaken at the request of another organisation? 
What type of organisation requested the work 
Primary research method used 
User stories
How was the information collected? 
Not known
If an Enter and View methodology was applied, was the visit announced or unannounced? 

Details of health and care services included in the report

Secondary care services 
General surgery

Details of people who shared their views

Number of people who shared their views 
Age group 
Specific ethnicity if known 
Sexual orientation 
Not known
Does the information include public's views? 
Does the information include carer's, friend's or relative's views? 
Not known
Does the information include staff's views? 
Types of health and care professionals engaged 
Does the information include other people's views? 
What was the main sentiment of the people who shared their views? 

Outcomes and impact

Were recommendations made by local Healthwatch in the report? 
Does the information contain a response from a provider? 
Is there evidence of impact in the report? 
Is there evidence of impact external to the report? 

Network Impact
Relationships that exist locally, regionally, nationally have benefited from the work undertaken in the report
Implied Impact
Where it is implied that change may occur in the future as a result of Healthwatch work. This can be implied in a provider  response, press release or other source. Implied impact can become tangible impact once change has occurred.
Tangible Impact
There is evidence of change that can be directly attributed to Healthwatch work undertaken in the report.