Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how lipoedema is classified within NICE guidance and NHS commissioning frameworks; and whether he plans to review the categorisation of lipoedema-related interventions to ensure they reflect clinical need.

Lipoedema services in England are commissioned locally by integrated care boards (ICBs), which are responsible for assessing the needs of their local populations and determining the most appropriate services to support people with long‑term conditions such as lipoedema.

There is no single national specification for lipoedema services. Instead, ICBs draw on a range of national guidance and best‑practice resources when designing care pathways. These include guidance from the National Institute for Health and Care Excellence (NICE) and best‑practice frameworks produced by bodies such as Wounds UK and the Royal College of General Practitioners. This helps ensure that services are safe, effective, and based on the best available evidence.

Most people with lipoedema are supported through primary and community care services, including assessment by local lymphoedema teams, compression therapy, advice on skin care and movement, and support with self‑management. These services aim to help people manage symptoms and maintain mobility and quality of life.

NICE classifies lipoedema within its interventional procedures guidance on the use of liposuction for chronic lipoedema, reference code HTG618, as a chronic, often painful, and progressive condition characterised by the abnormal, symmetrical accumulation of fat in the legs, hips, buttocks, and sometimes arms. In this guidance, NICE concluded that current evidence on both safety and effectiveness is limited and, therefore, recommends that liposuction should only be undertaken within the context of research or under rigorous governance arrangements. This guidance informs, but does not mandate, local commissioning decisions. NICE will review this guidance once the full results of the ongoing LIPLEG clinical trial are available, and will update its recommendations if new evidence supports doing so.