Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps he is taking to ensure that ICBs adhere to NICE guidance on the use of BMI thresholds for referral for joint replacement surgery.

The Department has made no specific assessment of the potential impact of body mass index (BMI) based restrictions on health inequalities.

It is the responsibility of individual integrated care boards to determine policies for their local area, including that of the BMI threshold criteria for joint replacement surgery. As with all surgery, BMI should be considered as part of a holistic, personalised perioperative evaluation of the risks versus clinical need for joint replacement surgery of an individual patient. However, BMI should not be considered in isolation and in and of itself should not act as a barrier to surgery.

While National Institute for Health and Care Excellence guidelines are not mandatory, they do represent best practice and National Health Service organisations are expected to take them fully into account in ensuring that local services meet the needs of their populations.

The NHS and local government provide a range of services to help people living with overweight and obesity to manage their weight, which may include individuals waiting for joint replacement surgery, where they meet other eligibility criteria. These range from multi-component behavioural programmes, such as the NHS Digital Weight Management Programme, to specialist services for those living with severe obesity and associated co-morbidities.