OLD IRVINE ROAD SURGERY PRACTICE POLICY ON BARIATRIC SURGERY ABROAD
The practice is aware that some patients who are not eligible for bariatric surgery under Ayrshire and Arran Health Board guidelines are seeking bariatric surgery abroad. The practice advises against having this type of surgery abroad. The practice also wishes to ensure that patients are aware that following bariatric surgery (e.g. sleeve gastrectomy), long term blood monitoring and specialist nutrition advice will be required for the patient to remain well. Referrals of patients who have had surgery abroad are not accepted by the local NHS Bariatric Service. Specialist post-bariatric surgery advice is outside the knowledge and expertise of the practice team.
The Practice therefore declines to engage in monitoring or nutritional advice of patients who have had bariatric surgery abroad. If a patient is unwell or symptomatic, the GP or ANP may decide that some bloods are appropriate (as they would have been done in a patient of similar symptoms who had not had bariatric surgery) but these tests will not cover the full scope of a nutritional assessment as per the bariatric services. The Practice advises that patients in this group contact a private bariatric service or dietetic service for ongoing monitoring. Please see the following link for more information. Surgery abroad without NHS referral | NHS inform
Choosing to pay to travel abroad for surgery is not recommended by NHS Scotland, or by the surgical specialist associations in the UK.
If you still wish to do this, be aware that NHS Scotland is under no obligation to provide pre and post-operative care other than emergency care.
Source: Scottish Government- Opens in new browser window
Last updated:
25 January 2024
Extract from Chief Medical Officer’s letter to Health Boards January 2023
'While the NHS in Scotland will always provide emergency care where necessary, all routine pre and post-operative care should be part of the package of care purchased by the individual patient. There will be no obligation on NHS Boards to provide such routine pre and post-operative care. In the event of a patient advising a healthcare professional of plans to travel overseas for privately arranged and purchased surgery, they should be advised firstly that this is not recommended, and secondly that there will be no obligation on their local NHS Board to provide routine pre and post-operative care. All care required should be provided within the package of care sold by the overseas provider.'
Monitoring a patient after bariatric surgery abroad (themdu.com)
The GMC's 'Good medical practice' is also clear that, "You must recognise and work within the limits of your competence."
A UK-based GP would leave themselves open to criticism by relying on advice from a specialist based overseas. As the provider is based in another country, they are not subject to the same regulatory requirements as doctors in the UK and work to different guidelines. There might also be language barriers that would make shared care inappropriate and unsafe.
Taking the above points into account, a GP without the support of a UK-based bariatric specialist could struggle to justify why they took on monitoring for a complex patient if something went wrong.
Private/NHS interface
Patients entitled to NHS treatment can switch from private treatment to NHS care as long as that treatment is supported by the NHS. However, many patients who opt for surgery abroad do so because they don't meet the criteria for bariatric surgery funded by the NHS, meaning they may not qualify for NHS funded bariatric follow-up care.