January 2017 – Message from BOMSS Honorary Secretary
Mr Shaw Somers
BOMSS has continued to mature as a society and we are now ready to embark on a new phase of engagement with our membership. We need to support members in their work with professional advice and data to support interactions with their hospitals and commissioners. It is also necessary to ensure that surgeons are practicing in a comprehensive environment in order to minimise patient risk and comply with guidance in both NHS and independent sectors (IHAS 2014).
Having breathed a sigh of relief at the successful negotiations of tariff increase in 2015, we found ourselves yet again bearing the brunt of a 30% decrease in NHS tariffs for bariatric procedures because of a fundamental misunderstanding of bariatric surgical work. Our negotiating team swung into action, armed with NBSR data to defend our previous tariff levels. I think the deal we have reached is as much as we could hope for in these difficult times for the NHS.
We look forward to our forthcoming 8th Scientific meeting in Alton Towers, which Mr Chandra Cheruvu has organised. The venue promises to be excellent (even though the rides are closed!) and the programme should fuel much discussion.
Back by popular demand is the BOMSS ski meeting in Corvara, Italian Dolomites 25-29 March 2017. Last year’s meeting was lively and popular. Places are limited, so book now to avoid disappointment.
This will be my final message as BOMSS secretary. I have enjoyed the challenge in helping my colleagues Roger Ackroyd and Vinod Menon keep the society on an even keel in these difficult times. I look forward to continuing the work with the latter colleague as secretary, while I take up the Presidential baton.
June 2016 – Message from BOMSS Honorary Secretary
Mr Shaw Somers
The summer report from BOMSS comes with a more upbeat tone than recent times. Thanks to the patient efforts of Mr Byrne and Mr Kerrigan on behalf of BOMSS council, negotiations with Monitor have led to a significant increase in tariff for the new bariatric procedure codes. This should significantly ease the financial pressure on our NHS services over the coming financial year. There is still work to do, as sleeve gastrectomy is still classed as ‘restrictive surgery’ and grouped with gastric banding. Negotiations continue, and we are being heard.
The Annual Scientific meeting in Cardiff was a great success. Our thanks go to Mr Jon Barry for organising a great venue and hosting us so well. Our guest speakers from France, Prof J-M Chevalier and Dr David Nocca were most impressed with the multi-disciplinary nature of our meeting and the level of the debate during sessions. They gave thought-provoking talks on one-anastomosis bypass and the future evolution of sleeve gastrectomy. Feedback was very positive, and ideas are already coming together for sessions at our next meeting in January 2017 at Alton Towers.
Plans are now rapidly progressing for IFSO 2017 in London. Mr Richard Welbourn and Ms Cynthia Borg continue to work hard leading the organisation, whilst grappling with the intricacies of IFSO politics and bureaucracy. We look forward to hosting the congress in late August 2017, and the pre-congress courses which should be of significant interest to UK and European delegates.
The work of the NBSR committee in securing our position within the NHS continues to grow. As government agencies continue to struggle with accuracy of clinical data and outcomes, we are able to clearly demonstrate these from our own registry. The role of NBSR in helping “to get our house in order” cannot be overstated and has placed us very much in NHS England’s good books. Time will tell if this translates into any concessions regarding patient access and tariff increase. The proposed publication of private patient data in April 2017 has been discussed with FIPO chairman, Mr Glazer. He has offered to collate the responses to the data request, and will be negotiating with PHIN on behalf of all the specialities involved. BOMSS and the NBSR committee remain in close discussion with FIPO on this, and have outlined the difficulty in meaningful patient reported outcomes (one of PHIN’s requirements) from bariatric patients.
Finally, your honorary secretary has just returned from a lecture tour of Australia and New Zealand, and has learned much which could help promote bariatric surgery in the UK. I look forward to working on this over the coming months.
Best wishes for a good summer
January 2016 – Message from BOMSS Honorary Secretary
Mr Shaw Somers
Bariatric surgery has faced significant challenges over the last year, principally following a fiasco centred around the new NHS tariff system for bariatric surgery. With the introduction of new procedure codes for
primary gastric bypass, sleeve gastrectomy and gastric banding, Monitor was tasked with pricing up an appropriate HRG tariff. Unfortunately, the new tariffs were not only almost half the previous tariff value, but sleeve gastrectomy was reclassified with gastric banding! Most bariatric services found themselves working at a significant financial loss for 2015-16. BOMSS council has been active in negotiating with the various NHS bodies involved in tariff setting and we hope that common sense will prevail and a higher tariff will be agreed.
The importance of correct coding of procedure and comorbidities on NHS discharge summaries cannot be over emphasised. I would advise all upper GI services re-examine and confirm their coding procedures to be sure their service remains financially viable in these difficult times.
Publication of the second NBSR report in November 2014 was successful and further underlines the good work done in bariatric centres across the country. The NBSR subcommittee has been very busy negotiating with HQIP on behalf of our BOMSS members. The increasing demand for more detailed surgeons’ outcome data is being deftly managed. However, the proposed publication of outcome and pricing data from the private sector will throw further work to this important group over the coming year. BOMSS will be working with PHIN, the agency responsible for this initiative, to ensure BOMSS member’s interests are best served.
BOMSS continues to prepare for hosting IFSO 2017. This promises to be a significant meeting in the world surgical calendar and we anticipate a turnout of over 2000 delegates from around the world. The QEII conference centre has been booked for the end of August 2017, and venues are being selected for the various associated social functions. Any suggestions or offers of help will be gratefully received.
August 2015 -Message from the BOMSS Honorary Secretary
Mr Shaw Somers
BOMSS members continue to enjoy the successful annual meeting. Earlier this year members met in Gosforth in the North-east for three days of education and social discourse. The meeting was well attended with over 300 delegates. This was a truly multidisciplinary event, with a significant proportion of allied health professionals and trainees amongst the attendees. The lectures were packed and the venue proved ideal. Thanks to Sean Woodcock and Peter Small for the organisation.
Next year the meeting is in Cardiff (January 27-29). Mr Roger Ackroyd took office as BOMSS president following the AGM, and thanks were given to Richard Welbourn for his wholehearted commitment during his tenure.
Spring and summer 2015 has seen some radical changes in the UK Bariatric scene. The second NBSR report was published in the autumn. BOMSS acknowledges the significant effort he has put into this work and into his leadership of the NBSR committee. Dealing with HQIP on our behalf is frustrating and time-consuming, but BOMSS is well represented by Richard and the NBSR committee.
Revised NICE guidance for the management of severe and complex obesity (CG189) has been published and is strongly supportive of surgical intervention as an effective and cost-efficient way of managing this disease. One would think that given the evidence NHS England would invest in these services in order to save in the long run. However, we were to discover quite the opposite.
Most AUGIS and BOMSS members will be aware of the “squeeze” on NHS HRG tariffs from April 2015. This continues to put pressure on complex surgical services and affects us all. At some point, the profession will have to stand up, denounce this mendacious process and propose an alternative way of reimbursing hospitals for complex surgical work. Bariatric surgery has been given three specific new codes which, when applied, results in a 40-60% decrease in reimbursement compared with existing tariffs. For all Bariatric units this will make primary bariatric surgery a loss-making enterprise. BOMSS is aware that some units have negotiated a package tariff for primary bariatric surgery, but the pressure to adhere to PbR will make any attempts to negotiate these very difficult.
BOMSS Council is hard at work trying to discover creative ways of circumventing these tariff changes without breaking rules. We will keep members informed of developments and keep negotiating with the relevant authorities.
The attempted transfer of commissioning from NHS England to CCGs was strongly resisted by BOMSS and the CCGs who did not feel ready to adopt commissioning for this complex field. A one-year deferral period has been agreed, and we await further plans from NHS England as the new financial year progresses.
Finally, plans are progressing well for IFSO 2017 in central London. The venue will be the Queen Elizabeth II conference centre in Westminster, opposite the Houses of Parliament. This promises to be one of IFSO’s more popular meetings with over 2,000 delegates expected. We look forward to seeing all BOMSS members there at the end of August 2017.
Message from BOMSS Honorary Secretary
Preparations continue for the organisation of the world congress of IFSO 2017 in London. This will be hosted by BOMSS and should be a landmark meeting for us. We are shortly to formulate the organising committee and will be contacting those members interested in helping.
We have completed the first round of guidance and position statements which can be seen here. I would encourage all BOMSS members to read these, comment to us and quote them whenever necessary to support their own service development.
BOMSS also undertook representation on the new NICE CG43 guidance which further stengthens the case for bariatric surgery provision in the NHS.
Those who ventured to IFSO Montreal experienced a great meeting with over 2,000 delegates. Whilst the various techniques continue to mature and their place in bariatric management become better defined, the basic science sessions reinforced our lack of understanding for the mechanisms of action of our most common procedures!
The BOMSS session at the annual AUGIS meeting in Brighton was well attended, and its appeal to the general upper GI surgeon well received.
The latest issue to hit the headlines for bariatric surgery is the proposed change in NHS tariff. Three new codes have been proposed for primary bariatric interventions. Taken broadly, they equate to approximately 40% reduction in the reimbursements to hospitals per procedure. By RM calculations, this is unsustainable. We have made representations to Monitor, which is responsible for advising NHS England. Whilst bariatric surgery seems unfairly penalised, the general reduction in tariff can only spell more misery for trust finance managers. Sooner rather than later, the professional associations ought to group together and start to push back on this issue.
We look forward to our 2015 meeting in Gosforth, Newcastle, which has been organised by Mr Sean Woodcock and Mr Peter Small. It promises to be a worthy gathering, both academic and social. I look forward to seeing you there.
Mr Shaw Somers
BOMSS Honorary Secretary
Message from BOMSS Honorary Secretary
BOMSS continues to grow as a society. Numerically, we are attracting more AHP and consultant numbers, but we are also maturing into a society which is responsible for the promotion of bariatric surgery to government and also for the assistance of members with service development.
The continued challenges of counter-intuitive commissioning and Tier 3 service issues is a vexed problem. Only by engaging with policymakers are we likely to make progress away from unproven and unhelpful strategies. This takes much time and discussion but I am happy to say that we are making progress and can now count many prior sceptics as allies.
Our Fifth Annual Scientific Congress – held at Chesford Grange Hotel in Leamington Spa in January 2014 – was an outstanding success. The Training Day was well attended and uniformly well-received. I congratulate Mr Vinod Menon, BOMSS Treasurer and the local organising committee for organising the event and Ms Sally Norton and the scientific programme committee for lining up such an interesting and stimulating scientific programme.
BOMSS Council continues to discuss and publish guidance for surgeons, AHPs and commissioners. I would reiterate Mr Roger Ackroyd’s invitation to browse the website from time to time to keep updated with news and views. As always, comments and questions from members are welcome.
I look forward to seeing colleagues at the BOMSS Session of AUGIS 2014 in Brighton (September 18 – 19).
Mr Shaw Somers
BOMSS Honorary Secretary