Can you host BOMSS in 2019 or 2020?

We are looking for expressions of interest from anyone who wishes to host the BOMSS Annual Scientific Meetings in January 2019 & 2020.

If you are interested in hosting this event, please email Sarvjit Wünsch your expression of interest by 3pm on Thursday, 21 December.

We will invite you to present your chosen venue to BOMSS Council from 2pm on Wednesday, 24 January 2018 at the Telford International Centre.

Please see venue specifications below.

Criteria for hosting a BOMSS Meeting

The Meeting takes place in the 3rd week on January and runs from Wednesday to Friday.

The Venue

Hotel conference venue

Total number of hotel bedrooms: 350

The current formula is that all delegates and industry are able to stay in same hotel. We would like to encourage this, therefore hotel room prices should be negotiable (easier in January) to a level which allows AHPs and trainees to stay in same venue.

Range of alternative hotel accommodation (if necessary) within walking distance of main HQ Hotel.

Trade Exhibition

  • Minimum Trade Exhibition space of 400sqm²
  • Please note all catering should be contained in Trade exhibition area, this will facilitate delegate footfall and keep Industry very happy!
  • Exhibition set up on Wednesday
  • Breakdown on Friday, after lunch.

BOMSS Training Day

  • This takes place on Wednesday and is sponsored event.
  • 3 – 4 breakout rooms are required for the whole day.
  • It would be beneficial if the Training Day is serviced by a separate entrance.
  • This year there were 72 Training Day delegates.

The Scientific Programme

  • Main conference: Plenary room for 400 to be arranged in a cabaret seating layout
  • 3 x Breakout rooms to hold: 150/100/150 delegates
  • Additional rooms available for Industry sponsored sessions or workshops

Dinners

  • Drinks reception and Gala Dinner in Hotel up to 300 people
  • Council Dinner venue up to 25 people
  • Trainee’s Dinner venue up to 100 people

Transport links


How stigma affects patients after surgery

Dr Yitka Graham, a senior lecturer in public health, has produced a ground-breaking piece of research into how bariatric patients adjust to life after surgery. Healthcare professionals will be able to use her findings to support patients pre- and post-operatively by raising awareness of issues that they may encounter in social situations, discussing how other patients have dealt with these situations and how they might cope themselves.

The study, carried out by researchers from the Faculty of Health Sciences and Wellbeing, University of Sunderland, looked at the experiences of patients who underwent bariatric surgery and how it affected their lives and social interactions. The researchers found that social aspects of bariatric surgery did not appear to be widely understood by those who had not undergone bariatric surgery.

So far there has been little research into patient experiences of daily life and social interactions after bariatric surgery. Now AHPs can look at the paper –  ‘Patient experiences of adjusting to life in the first 2 years after bariatric surgery: a qualitative study’, published in Clinical Obesity ( doi: 10.1111/cob.12205) – for guidance.

Dr Graham’s paper found that after bariatric surgery, patients make major changes to their lifestyles, including dealing with altered eating habits and a rapidly changing physical appearance, while at the same time experiencing a period of psychosocial adjustment.

Patients were involved in the research, from design to dissemination to make sure that the patient voice was embedded into the study.  Patients were encouraged to speak about their experiences openly without being constrained by set questions. Most participants reported that prior to surgery, they had experienced weight-related stigma from others.  This had been a source of anxiety which they felt would reduce following surgery as they lost weight. However, the stigma of obesity was exchanged for the judgment of bariatric surgery as the weight loss mechanism.

Dr Graham says: “This study sought to explore patients’ experiences of adjustment to life after bariatric surgery. We found that many participants were reluctant to discuss their experiences of surgery in social situations, sometimes even with close relatives, with frequent partial or non-disclosure of the method of their weight loss. Within social environments, discussions surrounding bariatric surgery were reported to be a source of worry with regards to the potential risks of revealing having undergone bariatric surgery due to being judged by others.”

 


Call for Abstracts for BOMSS 2018

BOMSS 9th ANNUAL SCIENTIFIC MEETING, 25 – 26 January, 2018
International Centre, Telford

Deadline for abstract submission: 9am on Monday, 20 November 2017
The 9th Annual Scientific Meeting of the British Obesity and Metabolic Surgery Society will be held at International Centre in Telford from 25 – 26 January, 2018.

The deadline date for the submission of abstracts is 9am, Monday 20 November 2017 and successful authors will be notified by the Wednesday, 6 December 2017.

To find out more and to submit an abstract, please visit the BOMSS 2018 website at: http://www.bomss.org.uk/2018conference/abstracts/

The BOMSS Training will be taking place on Wednesday, 24 January 2018,and registration for BOMSS 2018 will open shortly so please look out for updates on the BOMSS 2018 website. 

 


Experts publish updated guide to providing services for overweight and obese patients

Guidance on commissioning weight assessment services and management clinics, first published in 2014, has been updated and now includes guidelines on children and young people.

The guidance is sponsored by and represents the views of 22 professional organisations including nine medical Royal Colleges directly concerned with patient care.

Commissioning Guidance: Weight Assessment and management clinics (Tier 3) says about two-thirds of adults in the UK are overweight, 1 in 4 are clinically obese, and 1 in 3 children aged 10-11 are overweight or obese. Both conditions predispose to diseases such as type 2 diabetes, high blood pressure, strokes, heart attacks, cancer and general ill-health.

But it says most hospitals do not have services for these patients and, even if clinics do exist, patients and many GPs may not be aware of them, so patients who need and could benefit from expert assessment and management are not referred in a timely manner including children and young people.

As the treatment is often complex, a wide range of professionals, including medical and surgical doctors, nurses, psychologists and anaesthetists may need to be involved.

The Guidance – released on World Obesity Day – calls for the NHS to prioritise and develop services to allow patients with severe diseases caused by obesity to have access to treatment and describes the infrastructure needed to set up or commission Weight Assessment and Management Clinics (Tier 3 Clinics) in the NHS in England.

The document describes in detail which patients may most benefit from being referred for assessment for surgery (bariatric surgery) and includes a section on specialist Children’s and Adolescent Weight Assessment and Management Clinics.

It recommends that a multi-disciplinary team for children and young people should contain at least a paediatrician with a special interest in obesity, a children’s / adolescent dietitian, a specialist children’s or adolescent nurse, a clinical psychologist with expertise in paediatrics and with access to a social worker, a physical therapist and a liaison child and adolescent psychiatrist.

A minimum of six months of comprehensive assessment and management is recommended as appropriate for children and young people and says they should only be referred for surgery when all other options have been tried.

Lead author Mr Richard Welbourn, a consultant bariatric surgeon and a past-President of the British Obesity & Metabolic Surgery Society (BOMSS) said: “There is an urgent need for services to help people of all ages who have severe weight problems which address their needs and find ways to lead more fulfilling and productive lives.

“The new Guidance offers a blueprint for the NHS to provide better care, starting in primary care with suggested pathways for General Practitioners depending on the patient’s history and current health. It offers suggestions for the care of children and adolescents with the most severe obesity and gives several options for people with diabetes.

“Looking at secondary care, the challenge of managing the epidemic of patients with severe and complex obesity disease is largely unmet despite repeated guidelines from NICE. The updated Guidance describes in detail how services can be provided by multi-disciplinary teams in weight assessment and management clinics. This includes advice on setting up services for children and young people who unfortunately suffer the same problems as adults and are just as much in need of treatment for weight loss and management.

“These services have been developed in several parts of the UK but there are many areas where there is nothing available – an unfair postcode lottery of care. The models for setting up weight assessment and management clinics should be urgently adopted across the NHS to provide the services so many people need.”

Other additions to the updated guide include recommendations on anaesthetic assessment and ongoing shared care with general practitioners.

Professor Russell Viner, Officer for Health Promotion at the Royal College of Paediatrics and Child Health, said: “Obesity is affecting more children at a younger age – and it’s only going to be tackled through robust policies that focus on prevention.  Medical intervention and particularly surgery should always be a last resort. But it’s crucial that children and young people who are currently severely overweight get the right help through weight advice and management clinics which are designed to cater specifically for their needs. This guidance is much needed and I urge all CCGs to adopt it.”

The Royal College of Physicians’ obesity spokesperson, Professor John Wass, said: “There are currently significant differences in coverage when it comes to Tier 3 services and, as such, many do not have ready access to help. This guidance is helpful, because it puts in clear advice and support for the future and provides a framework for better care for people who have an obesity or weight problem.”

Professor Helen Stokes-Lampard, Chair of the Royal College of GPs, said: “Obesity is a serious health issue for patients regardless of their age, but that one in four children are now thought to be overweight or obese in the UK is a serious cause for concern given that it condemns our next generation for a lifetime of other potentially serious and debilitating health conditions, such as diabetes, cardiovascular disease and cancer.

“The College is proud to endorse this updated guidance, which should give CCGs the advice and support they need to commission the most appropriate services to allow GPs – and other healthcare professionals across the NHS – to deliver the care our young patients who are struggling to maintain a healthy weight need.”

 

Notes to editors
The 2017 Commissioning Guide: Weight assessment and management clinics (Tier 3)
http://www.bomss.org.uk/commissioning-guide-2017

Obesity Review article http://onlinelibrary.wiley.com/doi/10.1111/obr.12601/full

BOMSS is the sponsoring organisation for the guide. Joint-sponsoring organisations are:

Associations of British Clinical Diabetologists
Association for Clinical Biochemistry & Laboratory Medicine Association of Physicians Specialising in Obesity Association for the Study of Obesity
British Association of Paediatric Surgeons
British Dietetic Association
British Psychological Society
Diabetes UK
Faculty of Public Health
Royal College of Anaesthetists
Royal College of General Practitioners
Royal College of Nursing
Royal College of Obstetrics and Gynaecology
Royal College of Paediatrics and Child Health
Royal College of Physicians (London)
Royal College of Pathologists
Royal College of Psychiatrists
Society for Endocrinology
Society for Obesity and Bariatric Anaesthesia
Weight Loss Surgery Info (WLSInfo)


Third IFSO Global Registry Report released

The Third IFSO Global Registry Report (2017) has been released. Published by Dendrite Clinical Systems, under the auspices of the IFSO, the publication reports data from more than 40 countries on more than 196,000 operations, including baseline obesity related disease, operation types, operative outcomes and disease status after bariatric surgery.

This latest report includes 196,188 operation records from 42 countries from five continents, and has detailed information on 106,219 gastric bypass operations (54.1% of all the records submitted), 58,885 sleeve gastrectomy procedures (30.0%) and 19,101 gastric banding operations (9.7%). The publication has some interesting county-to-country analysis and notes a wide variation of BMI pre-surgery between different contributor countries, ranging from 36.7kg m2 in Peru to 51.1kgm2 in Egypt (43.1 kgm2). The highest proportions of gastric bypass surgery were reported in Venezuela (100.0%) and Sweden (95.6%), compared with Kuwait (100.0%), Australia (100.0%) and Saudi Arabia (100.0%), who reported the highest rates of sleeve gastrectomy operations.

Prior to surgery, 21.8% of patients were on medication for type 2 diabetes, 31.4% of patients were treated for hypertension, 15.3% of patients were on medication for depression, 20.2% of patients required treatment for musculo-skeletal pain, 20.3% of patients had sleep apnoea and 24.8% of patients had gastro-esophageal reflux disorder.

Other highlights of the report show:

  • 86.7% of patients who had a gastric band inserted were discharged within one day of their operation after gastric bypass n 63.7% of patients were discharged within two days of surgery;
  • 79.4% of sleeve gastrectomy patients went home within three days of their operation n Unsurprisingly, 98.8% of all operations were performed laparoscopically
  • The Obesity Surgery Mortality Risk Score (OSMRS) varied widely by country with Georgia, Hong Kong and Argentina reporting the highest-risk patient populations (OSMRS groups B & C: 88.2%. 75.0% and 62.0% respectively) and Kuwait, Colombia and the Netherlands reporting the least risk patient populations (OSMRS groups B & C: 17.9%, 20.4% and 23.9% respectively).

The Global IFSO Registry Project was headed by Kelvin Higa (United States), Jacques Himpens (Belgium), Richard Welbourn (UK), John Dixon (Australia), Peter Walton (Dendrite Clinical Systems) and Robin Kinsman (Dendrite Clinical Systems).

If you are interested in participating in the Fourth IFSO Global Registry Report, please email: ifsoregistry@edendrite.com for more information.

 


Read Prof Batterham’s report on weight management services and health

AHP representative, Prof Rachel Batterham, has produced an important report looking at how weight management services can improve health outcomes and we would encourage everyone to read this important work.

Executive Summary

Improving Health Through The Provision of Weight Management Services.1

It includes suggested steps to establish weight management services in a region 

1. Find out the degree of obesity in the local population. What is the need for and potential uptake of each Tier of the service?

2. Use the NICE local costing template to estimate initial and future expenditure. Enquire about funds available from NHS England and allocate budgets accordingly.

3. See what services are already available in the region and nationally. Many Tier 2 and exercise referral services are well-established and funded. These may contribute to a specialist Tier 3 weight management service with additional input.

4. Look at models for effective commissioning of Tier 3 and Tier 4 services. Work with your acute provider to commission effective services, ensuring appropriate pathways into bariatric surgery, enough theatre time and effective after-care with at least 2 years follow-up.

5. Identify a champion for obesity. This could be a lead physician or a commissioning champion.

6. Produce local primary care guidance to cover how to raise the issue of obesity with patients, what the local referral pathways are and what is required from GPs post-surgery.

7. Implement effective monitoring and evaluation of services, including contributing to national registries.

8. Liaise with other CCG regions. Explore existing commissioning policies and shared needs with regions of similar population demographics. This will be advantageous in achieving the economies of scale, sharing limited specialist resources and adhering to the IFSO guidelines for safety, quality and excellence in bariatric surgery.


Key IFSO date

BOMSS members – surgical teams / surgeons / AHPs – are encouraged to attend the
BOMSS ‘political session’ at IFSO 2017.
Metabolic Surgery: Evolution, Evaluation and Economics: Why is a safe cost-effective therapy for a deadly disease under-utilised?
Friday, 1 September, 8-9.30am
Leading 
politicians and commissioners will attend and engage in the challenge to increase service provision in the NHS in all four home countries.
This is our chance to put the panelists on the spot as we raise the profile of surgery with a new NBSR data release.
Please come and lend your weight to this important session for BOMSS.


Council member fronts BBC programme

BOMSS Council Member Professor Rachel Batterham will present a BBC programme  on Tuesday, April 11, looking at obesity, prejudice and the benefits of bariatric surgery.

Research scientist Prof Batterham, based at University College Hospital, explores whether there is “fat prejudice” against obese patients within parts of the NHS which stops them accessing potentially cost-effective surgery.

Professor Batterham says: “I have met patients who say they were made to feel “not worthy” and were denied life-changing bariatric surgery and other routine operations.”

 

 


NHS commissioning groups restricting weight loss surgery, surgeons warn – at a cost to patients and the public healthcare bill

A freedom of information (FOI) request made to all NHS commissioning groups (CCGs) shows that several have adopted policies which attempt to ration weight loss surgery to the super-obese, and ignore official advice on who should be eligible for surgery.

This has made it more difficult for overweight and obese people to get effective treatment to help them lose weight despite evidence that it is safe, effective and saves healthcare costs, according to the findings of a joint report from The British Obesity and Metabolic Surgery Society (BOMSS) and the Royal College of Surgeons (RCS).

Some CCGs either require patients to stop smoking or for patients to have a Body Mass Index (BMI) of over 50, despite NHS England and the National Institute for Health and Care Excellence (NICE) stating that surgery is cost effective and should be considered for patients with a BMI of over 35 with a co-morbidity (a further medical condition) such as Type II diabetes, or a BMI of 40 without a co-morbidity.

NHS England is currently delegating the commissioning of bariatric surgery to CCGs although most groups (80%) have yet to decide their own policies. Six CCGs admit they are not complying with the NHS England and NICE guidance. East Riding CCG says patients must have a BMI of at least 50 before they will be considered for surgery. Wolverhampton CCG imposes the same condition but will also consider some patients at a lower BMI who have diabetes. Solihull considers patients at BMI 50 with certain co-morbidities and will consider patients at BMI 45 or higher who have diabetes. Vale of York will look at patients at BMI or 50 or more but will consider patients at a lower BMI with certain co-morbidities. Mid-Essex is restricting treatment to non-smokers at the time of referral and NE Essex says smokers must be referred to a cessation service before they can be considered.

BOMSS and the RCS are warning this could harm patients and are demanding they revise their policies to bring them in line with the official guidelines.

The report showed that most CCGs have not yet adopted their own bariatric surgery policies – but will have to do so by next month under a phased government NHS reform.

Shaw Somers, Consultant surgeon and BOMSS President, said: “Our survey reveals worrying evidence that some CCGs are effectively taking the law into their own hands and defying official guidance on surgical interventions which have been proved to help people with a serious medical condition and also save healthcare costs.

“It typifies the second-class citizen manner in which bariatric patients seem to be viewed by some CCGs.

“We are calling on NHS England and NICE to make it clear to CCGs that they must comply with the guidelines on who is eligible for this safe and effective treatment, not try to ration it in a misguided attempt to save money in the short-term.”

Royal College of Surgeons President Clare Marx said: “Study after study shows bariatric surgery is highly effective, particularly in treating type 2 diabetes associated with obesity. It is therefore astounding that commissioning groups are effectively indicating that obese patients should get even more obese before they will consider surgery. This makes no sense and contradicts our very strong public health messages about the benefits of losing weight. Bariatric surgery is a significant medical innovation which should be made available to those patients who meet criteria which NICE have considered and published.”

BOMSS and the RCS make five recommendations to health bosses.

  • The six CCGs with arbitrary requirements for bariatric surgery should revise their policies in line with national clinical guidance.
  • NHS England should reiterate that access to NHS bariatric surgical treatment should be based on clinical need and uniform across the UK.
  • NICE and NHS England should continue to highlight the benefits of bariatric surgery.
  • NHS England should confirm that all CCGs will be responsible for commissioning bariatric surgery from 1 April to address the confusion over who is responsible.
  • NHS England should provide CCGs with clinical guidance for commissioning bariatric surgery, in advance of the transfer of responsibilities.

As well as calling on the six CCGs to fall in line with guidance the RCS and BOMSS have pledged to review the policies of all CCGS once new commissioning rules are in place.

RCS and BOMSS Bariatric report 2017

 


What they said about #BOMSS2017 on Twitter

Venkatesh Jayanthi ‏@venkarch  Very good talk by Kelvin Higa at #bomss2017

Simon Monkhouse ‏@SurgMonkhouse  Very interesting talks @bariatricBOMSS  – depressing information about NHS funding but leaders from Scandinavia giving hope

Toni Jenkins‏@amnerisuk  @bariatricBOMSS Need GPs here. Can bariatric teams realistically follow up for multiple years? Needs good community surveillance

PortsmouthDietitians @PDietitians Dietitians play key part in bariatric team @BDA_Obesity @bariatricBOMSS

Mary O’Kane @mpMok Mark O’Kane Blaming and shaming people with obesity does not result in weight loss + has adverse effects @EASOobesity @BDA_Obesity @ObesityEmpower

Mary O’Kane @mpMok @bariatricBOMSS byband sleeve trial will help stop the anecdotes and enable evidence-based information to be developed

Kamal Mahawar‏@kmahawar Another successful meeting by @bariatricBOMSS family. Inspired to meet so many good and great people working to improve outcomes for patients.