Obese patients and smokers face delays for NHS surgeries under new reforms requiring them to be assessed as “fit to proceed.”
Obese patients and smokers could see their surgeries delayed under reforms announced by Prime Minister Sir Keir Starmer. The new plan requires patients to be assessed as “fit to proceed” before receiving a surgery date. The measures aim to boost NHS productivity and tackle extensive waiting lists.
Patients waiting for procedures like hip and knee surgeries will first be encouraged to complete a 12-week weight-loss program or quit smoking. The government argues that “prehabilitation” can improve surgical outcomes by reducing complications and cancellations, while increasing the number of procedures performed as day surgeries rather than requiring extended hospital stays.
Under the new system, patients deemed unfit to proceed will remain on waiting lists, while fitter patients will receive priority for treatment. Sir Keir Starmer described the reforms as part of a broader effort to rebuild the NHS, which he said would be “reformed from top to bottom.” The Prime Minister acknowledged the controversial nature of the plan but emphasized its necessity to improve healthcare access and efficiency.
NHS National Medical Director Prof Sir Stephen Powis supported the move, citing clinical evidence that fitter patients experience better outcomes and fewer complications. “The NHS will provide support like weight management and smoking cessation programs to help patients prepare for surgery,” he said, stressing that empowering patients to take control of their health is critical for the NHS’s future sustainability.
The reforms, outlined in the Elective Reform Plan by the Department of Health and Social Care and NHS England, are part of a larger strategy to reduce backlogs and increase productivity. The plan includes a 20% increase in annual NHS appointments, offering up to one million extra consultations. It will also expand partnerships with the private sector, targeting long-wait specialties like gynaecology and orthopaedics. Additionally, the government aims to enhance access to diagnostic centers and surgical hubs to minimize cancellations and delays caused by emergency cases.
To accelerate treatment, GPs will have the authority to refer patients directly for diagnostic tests, bypassing the need for consultant referrals. Family doctors will also receive incentives for seeking specialist advice without making formal referrals. This strategy is expected to cut waiting times, especially in areas where delays are most severe.
Critics of the plan have expressed concerns. The Conservative opposition accused the Labour government of repackaging old policies, citing expanded private-sector use as a continuation of previous strategies. However, the government defended its approach, arguing that the partnership with private providers is necessary to meet urgent healthcare needs. Health Secretary Wes Streeting emphasized the importance of timely treatment, stating, “If the wealthy can access care on time, then so should NHS patients.”
The plan aims to halve the number of patients waiting more than 18 months for treatment by March 2026, addressing a significant backlog that has left millions waiting for care. Particular attention will be given to specialties with severe delays, such as gynaecology, where over 260,000 women are waiting longer than the 18-week target, and orthopaedics, where 40% of patients exceed the waiting threshold.
Efforts will also focus on empowering patients with more control over their care. Around one million appointments will be freed up by eliminating unnecessary follow-ups and enabling patients to decide when checkups are needed. The expansion of standalone surgical hubs and diagnostic centers will further enhance efficiency and reduce delays.
While the reforms represent a significant shift in NHS strategy, they come amidst rising criticism over long waiting times and perceived neglect of the healthcare system in recent years. The government faces the challenge of balancing public concerns about fairness and accessibility while addressing the pressing need for healthcare reform.
The ambitious plan reflects the government’s commitment to reshaping the NHS and ensuring that patients receive timely and effective care. Whether the changes will deliver the desired outcomes remains to be seen, but the focus on improving patient readiness and streamlining processes marks a pivotal moment in the future of UK healthcare.
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