The health service must adapt to the demands of an increasingly obese nation, according to a report by the Royal College of Physicians (RCP). The RCP working party found that despite the strain put on the NHS by obesity, the delivery of healthcare to patients with an established obesity problem is ‘extremely patchy’.
There are large variations in the way obesity is treated across the country, with the rate of hospital bariatric procedures, such as gastric banding, ranging from 0.4 per 100,000 in some Primary Care Trusts, to 41.3 per 100,000 in others. The figures constitute a 93 fold variation. In many patients, their obesity leads to other complications, such as coronary heart disease, diabetes, arthritis, sleep disorders and gynaecological disorders. Despite this, the report authors found that there are few ‘joined up’ services for people who are overweight. The report, titled Action on obesity; comprehensive care for all, makes a number of key recommendations, including the creation of a new Government role to coordinate the work of departments that could have an impact on obesity. Other recommendations from the report include:
• The appointment of a lead physician for obesity at every hospital Trust. The appointed doctor should interact with commissioning groups, be a source of patient information and act as a link between the hospital and the community.
• Multidisciplinary teams made up of physicians, surgeons, nurses and other health professionals must be available to cover severe and complex obesity throughout the UK.
• General practitioners should, where possible and appropriate, deal with weight issues as part of their agenda to address risk factors.
Professor Nick Finer, co-author of the report and obesity specialist at the UCLH centre for weight loss, metabolic and endocrine surgery, said: “We need to see improved leadership on obesity at every level; from the appointment of a lead physician in every Trust, to the creation of a cross-Governmental role.”
