Question to the Department of Health and Social Care:

To ask His Majesty's Government what mechanisms are in place to ensure that integrated care boards adhere to the National Institute for Health and Care Excellence guideline that body mass index should not be used to exclude patients from referral for joint replacement surgery.

National Institute for Health and Care Excellence guidelines are developed by experts based on a thorough assessment of the available evidence and through extensive engagement with interested parties. They are not mandatory but 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.

It is the responsibility of individual integrated care boards to determine policies for their local area. As with all surgery, Body Mass Index (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.