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.


Congratulations to the BOMSS 2017 prizewinners

The Council Prize Award was awarded to Waleed Al-Khyatt
Roux en-Y gastric bypass as a revisional procedure for a failed gastric band: A review of 125 consecutive cases.
(A6)

Best DVD Award was awarded to Mr Charalampos Markakis
Refashioning of gastrojejunal anastomosis and partial excision of gastric remnant in a patient presenting with haematemesis 3 years after banded gastric bypass
(D07)

Best Poster Awarded to Anna Kamocka
Bariatric surgery makes obese patients healthier; analysis of the National Bariatric Surgery Registry
(PoD3)


Join us in Italy

 

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The second BOMSS Expert Meeting  will be held in the beautiful Italian Dolomites in March 2017, from March 25-29 in Corvara.

  • Registration for the meeting is from £150 for BOMSS members and £250 for non-members.
  • Half board accommodation (for 4 nights) is £625 based on 2 people sharing.

Sessions will include discussions on issues surrounding the Laparoscopic Roux en Y gastric bypass and the Laparoscopic Sleeve Gastrectomy in the UK and include technical controversies and current practices.

Places are limited to 30 delegates. Please register your interest by email to Sarvjit@augis.org  along with a payment of £150 (member) registration and £624 for accommodation by 30 November 2016.  Please note the all fees are non-refundable.

To find out more or register for the meeting, please contact: nichola@augis.org or sarvjit@augis.org


Looking ahead to IFSO 2017 in London

BOMSS will host the 2017 IFSO Annual Conference from August 29 – September 2, 2017.

The Congress will be held in central London at the Queen Elizabeth II Conference Centre – with its excellent transport links as well as the attraction that the capital city holds for many overseas visitors. This is a great opportunity for BOMSS to make an impression on the world stage of bariatrics. We have already declared ourselves as a Society that promotes high quality in bariatric surgery thanks to the work on constitutional issues, practice standards and data collection by our past and current president. Now we can demonstrate how to run a high quality scientific congress too.

The venue – the Queen Elizabeth II conference centre in the heart of London and in the shadow of Big Ben and Westminster Abbey – will certainly prove a big draw.

http://www.ifso2017.com


Can you host BOMSS in 2018 or 2019?

We are looking for expressions of interest from anyone wishing to host our Annual Scientific Meetings in January 2018 and January 2019.  This is what we are looking for:

The Meeting takes place in the third week of January and runs from Wednesday to Friday.

The current formula is that all delegates and industry are able to stay in same hotel and we want to continue and 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. We will  look for a range of alternative hotel accommodation (if necessary) within walking distance of main HQ Hotel.  

 The Venue
Hotel conference venue
Total number of hotel bedrooms: 350 

Trade Exhibition
Minimum Trade Exhibition space of 400sqm² 
Catering should be confined to the Trade exhibition area
Set up on Wednesday

Poster area for 90 poster sides

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 more than 100 Training Day delegates

The Scientific Programme
Main conference: Plenary room for 400 
3 x Breakout rooms to hold: 150/100/150delegates
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 
Good links by train, road and air

If you are interested in hosting this event, please email Sarvjit in the BOMSS office with any expressions of interest by Friday, 29 July.  We will invite you to present your chosen venue to BOMSS Council on Wednesday, 21 September in Leeds.


BOMSS welcomes call for surgery to resolve diabetes

Experts in diabetes have called for surgery to be considered a standard treatment in people with high BMIs – http://care.diabetesjournals.org/content/current

Roger Ackroyd, president of BOMSS, said: “ We welcome the call for surgery to be recognised as a standard treatment option for Type 2 diabetes, based on a wide body of evidence, including 11 randomised trials. Economic studies also show that the treatment can be cost-effective. This supports the day-today experience of bariatric surgeons and nurses across the UK in recent years that surgery is cost-effective and gives people back their health.

“Type 2 diabetes is a serious health condition so it is essential that all effective treatment options are available – and this includes surgery. Poorly controlled diabetes can lead to serious complications such as blindness, amputations and stroke, complications which rob people of their health and are very expensive to treat.

“The National Institute for Health and Care Excellence (NICE) must now make it explicit in its Type 2 diabetes guidelines that those with Type 2 diabetes who meet the recommended criteria for obesity surgery should be referred for early assessment for surgery. These recommendations are currently stated in the NICE obesity guidelines (2014) but are not fully incorporated in current NICE Type 2 diabetes guidelines (2015).”

The new guidelines state that surgery should be recommended to treat people with Type 2 diabetes who have a BMI of 40 or more, regardless of their blood glucose control, as well as people with a BMI of 30 and over whose blood glucose levels are inadequately controlled by lifestyle changes and blood glucose lowering medication. It is also recommended that the BMI thresholds in Asian people with Type 2 diabetes should be lower as they develop Type 2 diabetes at a lower BMI compared to other populations.

The full articles, joint statement and commentary can be seen here: http://care.diabetesjournals.org/content/current