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Accessing NHS Wales care and support after private bariatric surgery

 

Position Statement for CTM UHB

CTM UHB has developed our position statement based on views from medicine, pharmacy, primary care, weight management service and CTM Public Health teams.

In February 2024 the Welsh Government issued the Welsh Health Circular WHC/2024/005 regarding patients who have accessed private bariatric surgery and the role of the Welsh NHS. Welsh Government state:

  • “Emergency or urgent care of private sector patients lies with the NHS in the event that the patient presents to the NHS services.”
  • “If a post-operative bariatric patient cannot, or chooses not to access private sector follow-up, the GP may refer into secondary care, for specialist level 3/ 4 post-operative follow-up as per NICE guidance.”

Currently in Wales, the Welsh Institute of Metabolic and Obesity Surgery (WIMOS) are commissioned to deliver bariatric surgery including post-operative follow-up for a period of 2 years. CTM UHB’s weight management service do not provide this service.

CTM UHB are therefore advising all GPs encountering private post-operative bariatric patients with complications following surgery, and/ or those wishing to access monitoring and supplementation via the NHS rather than through their private provider to refer them to WIMOS for assessment and support via:

Welsh Institute of Metabolic and Obesity Surgery (WIMOS)
Morriston Hospital
Morriston
Swansea
SA6 6NL
Tel: 01792 545771

Welsh Government are currently reviewing the implications on the level 4 WIMOS service and level 3 services across Wales as a consequence of the Welsh Circular.

Read and download a copy of our patient information leaflet ‘Thinking of having private bariatric surgery?’.

An accessible version of the leaflet is also available.

Thinking of having Private Bariatric Surgery?

Increasing numbers of people living with being overweight or obesity are paying privately to have surgery in the UK and abroad. If you are thinking about this option, please do your research first to ensure that the service you buy will meet your needs and expectations.

What care and support should you access prior to the surgery?

It is advised that all patients seeking bariatric surgery should be adequately prepared for the procedure. This includes optimising your diet and eating habits prior to surgery, ensuring you are able to identify physical hunger and fullness, making sure that your expectations around the surgery are realistic, and making sure that you are psychologically ready for the procedure.

We recommend that anybody who is seeking private bariatric surgery engage with preparation for surgery, either with a private surgical provider, or through self-help material. One good self-help text that is recommended to NHS patients seeking bariatric surgery is ‘Living with Bariatric Surgery: Managing your Mind and your Weight’ by Denise Ratcliffe. This book includes information and activities on preparing for surgery, as well as guidance for continuing your progress post-surgery.

Travelling Abroad for Bariatric Surgery?

You’ll need to make the arrangements yourself, including finding a healthcare provider and making the travel arrangements. You will also need to ensure you have adequate insurance. Most travel insurance policies will not cover planned treatment abroad, so you may need specialist cover.

This means it’s important to do your research and gather enough information to make an informed choice. You should consider:

  • Any potential language barriers
  • Whether you know enough about the people who’ll treat you and the facilities available
  • What healthcare and support is available when you return home
  • Communication between medical staff abroad and in the UK, such as your medical records, discharge summary and any other relevant medical and nutritional information
  • How to make a complaint if things go wrong – NHS Wales is not liable for negligence or failure of privately accessed treatment

NHS UK have developed a checklist for treatment abroad and further information that can help you to get organised and provide information about some of the risk involved.

What care and support will you access after the surgery?

It is important that before you arrange to have surgery privately that you have a clear and agreed ‘aftercare’ (follow-up) plan. Having an aftercare plan in place prior to surgery can help prevent potential complications, such as malnutrition or gastrointestinal problems which can lead to severe ill health if ignored.

NICE guidance recommends that bariatric aftercare should be provided for 2 years following surgery.

Bariatric aftercare considers your general health, monitoring your nutritional intake after surgery, reviewing any medication or nutritional supplements you may need, as well as offering individually tailored dietary, psychological and physical assessment, advice and support.

Aftercare is usually provided by the company undertaking your private surgery. If you are considering accessing treatment abroad, you may need to identify a private provider in the UK who can provide this service in the UK for you.

How will you share your health records?

If you have bariatric surgery privately we recommend that you ask your treatment provider to provide a copy of your discharge summary, aftercare plan and any other relevant medical and nutritional information and documents that have been given to you. If you have surgery abroad, make sure that this information is available to you in English or Welsh.

Accessing NHS Wales care and support after surgery

If you require emergency or urgent care following your private bariatric surgery, NHS Wales will provide you with the care and support you need.

If you do not have an aftercare package in place and require ongoing health monitoring and support, please note that Cwm Taf Morgannwg University Health Board does not provide routine aftercare services. If you require aftercare, your GP can make a referral to the all Wales service provided by Swansea Bay University Health Board. There is a significant waiting list to access this service.

Remember: It is your responsibility to undertake relevant research and seek sufficient advice to ensure an informed choice can be made on the credibility and safety of the provider delivering your treatment whether in the UK or abroad. There is useful information designed for patients about bariatric surgery on the British Obesity & metabolic Surgery Society website.

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