Beyond BMI: evidence of ICBs rationing surgery using BMI

We are pleased to share that we have launched a briefing in response to Integrated Care Boards (ICBs) implementing policies that ration joint replacement surgery based on a patient’s body mass index.

Beyond BMI: Removing harmful barriers to Joint replacement surgery sets out the evidence and impact of ICBs in England using BMI thresholds as a way of rationing joint replacement surgery.  While we recognise the pressures that ICBs face to cut costs, these policies are unfair.  They can lead to delays in surgery, leaving people with arthritis in pain for longer.  This significantly affects their quality of life.  Arthritis UK is calling for all ICBs to stop using these policies and stop rationing surgery based on a person’s BMI alone.  

Here are the key findings:

• 1 in 5 ICBs in England ration access to joint replacement surgery based on patients’ BMI.
• BMI thresholds policies differ between ICBs with some refusing to perform surgeries on patients with a BMI above 35, while others set thresholds as high as 45.
• Delays caused by BMI based rationing policiies can lead to prolonged pain and further deterioration of the joints.  As symptoms worsen, individuals may struggle with daily activities and work, triggering a compound cycle of declining physical health, financial strain and mental wellbeing.
• There is limited access to weight management services and provision varies between ICBs, often leaving patients without alternatives or support.  We would appreciate if you were able to support and share the briefing on your social media platforms, within your organisation and external contacts. If you require any resources to support your dissemination, please get in touch at policy@arthritis-uk.org

As some ICBs have newly merged this month, with others to follow, we see this as the optimum time to review all policies and ensure that NICE guidelines are adhered to.    

Please note: due to elections taking place in Scotland and Wales we are in a regulated period and so this report focuses specifically on England for that reason.  The accompanying data table does include data for all nations.

Beyond BMI: Removing Harmful Barriers to Joint Replacement Surgery | Arthritis UK