read in the BMJ that the National Enquiry into Patient Outcome and Death (NCEPOD) commented on patients undergoing bariatric surgery and "found a catalogue of failings in their treatment, with more than two thirds having no psychological counselling before they were referred and only a third being followed up adequately".

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Concerns over care of patients before and after bariatric surgery

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NCEPOD's Clinical Coordinator said that weight loss surgery is seen as a quick fix to obesity problems. However, it is a radical procedure with considerable risk and should not be undertaken without full information about the considerable risks, as well as the benefits; being provided to patients.

I was shocked to read that approximately one third of patients did not receive input from a dietician pre-surgery. Surely this would be one of the first steps. 61% of patients did not have psychological input which is very surprising as it is well known that there are psychological elements to over eating. Those who did receive such input did not have this until after the surgery.

Other concerns related to the consent form, which was often signed on the day of surgery, giving little time for reflection and consideration of options; lack of involvement of dieticians and clinicians in the follow up appointment, and a six week wait to be seen following surgery. Reviewers also noted that 14% of patients did not meet NICE Guidance.

It appears that there is much to be done to ensure that these patients are receiving the care and support that they need both before and after surgery. What is the point of providing funding for such surgery when there is a failure to take all steps to ensure successful outcomes?

Patricia Wakeford


Clinical Negligence team

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