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Obesity: Surgery

Volume 487: debated on Tuesday 10 February 2009

To ask the Secretary of State for Health what guidance his Department and its agencies have issued to healthcare professionals on assessing patients for (a) the fitting of gastric bands and (b) other bariatric surgery. (254840)

The National Institute for Health and Clinical Excellence (NICE) has set ‘Guidance on the prevention, identification, assessment and management of overweight and obesity in adults and children’, available at

www.nice.org.uk/CG43.

This guidance is for both health and non-health professionals, and contains guidance on when bariatric surgery may be considered as an option.

It is up to primary care trusts as local commissioners and providers of services to determine the most appropriate methods to deliver health care to their populations, based on clinical need and effectiveness, and following medical advice.

To ask the Secretary of State for Health how many NHS patients have had a gastric band fitted in 2007-08; and how many of them were readmitted to hospital as an emergency within three months of surgery as a result of complications. (254841)

The information is not available in the form requested.

Data are not yet available for 2007-08. Data are provided for 2006-07 which show that there were 706 finished consultant episodes where there was a primary diagnosis of obesity and an insertion of a gastric band as a main operation carried out in England. Gastric bands are only one type of procedure recommended for the treatment of obesity by the National Institute for Health and Clinical Excellence.

Data on emergency readmissions rates are collected by the National Centre for Health Outcomes Development and published at www.nchod.nhs.uk. Analysis from this source for gastric band surgery can be produced only at disproportionate cost.

Notes:

Finished Consultant Episode (FCE)

A finished consultant episode (FCE) is defined as a continuous period of admitted patient care under one consultant within one health care provider. FCEs are counted against the year in which they end. The figures do not represent the number of different patients, as a person may have more than one episode of care within the same stay in hospital or in different stays in the same year.

Number of episodes in which the patient had a (named) primary diagnosis

These figures represent the number of episodes where the diagnosis was recorded in the primary diagnosis field in a Hospital Episode Statistics (HES) record.

The ICD-10 code used to identify obesity is as follows:

E66—Obesity

Main procedure

The main procedure is the first recorded procedure or intervention in the Hospital HES data set and is usually the most resource intensive procedure or intervention performed during the episode. It is appropriate to use main procedure when looking at admission details, (e.g. time waited), but a more complete count of episodes with a particular procedure is obtained by looking at the main and the secondary procedure.

The OPCS code used to identify a gastric band insertion is as follows:

G30.3—Partitioning of stomach using band

Data Quality

HES are compiled from data sent by more than 300 NHS trusts and primary care trusts (PCTs) in England. Data are also received from a number of independent sector organisations for activity commissioned by the English NHS. The NHS Information Centre for health and social care liaises closely with these organisations to encourage submission of complete and valid data and seeks to minimise inaccuracies and the effect of missing and invalid data via HES processes. While this brings about improvement over time, some shortcomings remain.

Source:

Hospital Episode Statistics (HES), The NHS Information Centre for health and social care.