PCT Surgery Funding Criteria

Name of PCT Criteria for patient funding of bariatric surgery. (Information provided by PCT Nov 2007 – Jan 2008)
Ashton, Leigh and Wigan  NICE Guideline criteria
Barking and Dagenham NICE Guideline criteria. Patient must also have previously attended an obesity clinic.
Barnet NICE Guideline criteria.
Barnsley BMI over 50 or between 45-50 with severe comorbidities.
Bassetlaw  BMI over 50 or between 45-50 with severe comorbidities.
Bath and North East Somerset  Information awaited
Bedfordshire  BMI over 40 with type 2 diabetes and/or severe sleep apnoea (hypertension is not an allowable comorbidity for surgery), are aged 18-60 and who have been receiving intensive obesity management of at least 6 months.
Berkshire East BMI over 50 with diabetes or severe dismobility due to obesity sufficient to affect essential activities of daily living and who have been receiving treatment which has included diet and exercise support, pharmacological therapy and counselling in a specialist obesity management service and failed to respond adequately. Access to surgery is only via specialist obesity management service.
Berkshire West BMI over 50 with diabetes or severe dismobility due to obesity sufficient to affect essential activities of daily living and who have been receiving treatment which has included diet and exercise support, pharmacological therapy and counselling in a specialist obesity management service and failed to respond adequately. Access to surgery is only via specialist obesity management service.
Bexley NICE guidelines criteria supplemented by criteria of dietetic department.
Birmingham East and North NICE Guidelines criteria but will not fund second procedure (e.g. if band fails, will not fund bypass)
Blackburn with Darwen Information awaited
Blackpool Local criteria but further information awaited
Bolton NICE Guideline criteria
Bournemouth and Poole Evidence recorded that all non surgical options have been exhausted. NICE Guideline criteria plus evidence that the patient has been actively supported by their GP in the community for at least 3 years.
Bradford and Airedale BMI over 40.
Brent Information awaited.
Brighton and Hove NICE Guideline criteria plus at least 12 months dietary or pharmacotherapy.
Bristol NICE Guidelines criteria with priority given to patients with BMI over 35 with type 2 diabetes in age range 18-45.
Bromley NICE Guideline criteria
Buckinghamshire BMI over 50 with diabetes or severe dismobility due to obesity sufficient to affect essential activities of daily living and who have been receiving treatment which has included diet and exercise support, pharmacological therapy and counselling in a specialist obesity management service and failed to respond adequately. Access to surgery is only via specialist obesity management service.
Bury NICE Guideline criteria
Calderdale NICE Guideline criteria plus patient must have been severely obese for 5 years or more and actively involved in a non-surgical weight reduction programme for that time. Priority will be given to patients with symptomatic coronary heart or peripheral vascular disease and non-insulin dependent diabetes. 
Cambridgeshire BMI over 40 with type 2 diabetes and/or severe sleep apnoea (hypertension is not an allowable comorbidity for surgery), are aged 18-60 and who have been receiving intensive obesity management of at least 6 months.
Camden NICE Guideline criteria
Central and Eastern Cheshire Information awaited.
Central Lancashire NICE Guidelines criteria
City and Hackney NICE Guidelines criteria
Cornwall and Isles of Scilly NICE Guidelines criteria
County Durham NICE Guidelines criteria plus demonstration that medication has been used and the reasons it has not been successful, participation in a lifestyle programme (exercise and weight management), dietitian input and evidence of commitment to change diet/lifestyle and motivation.
Coventry BMI over 45 with type 2 diabetes or BMI over 50 with comorbidities which are likely to be improved with weight loss or BMI over 65 without comorbidities. Patients must have failed to achieve or maintain weight loss after one years intensive management in a specialist obesity clinic setting.
Croydon NICE Guideline criteria
Cumbria NICE Guideline criteria
Darlington NICE Guidelines criteria plus demonstration that medication has been used and the reasons it has not been successful, participation in a lifestyle programme (exercise and weight management), dietitian input and evidence of commitment to change diet/lifestyle and motivation.
Derby City NICE Guideline criteria
Derbyshire County BMI over 45 with comorbidities or BMI over 50 without.
Devon NICE Guideline criteria
Doncaster BMI over 50 or between 45-50 with severe comorbidities.
Dorset Evidence recorded that all non surgical options have been exhausted. NICE Guideline criteria plus evidence that the patient has been actively supported by their GP in the community for at least 3 years.
Dudley BMI over 60 or over 50 with serious comorbidities (ischemic heart disease, type 2 diabetes on oral medication or insulin, life-threatening sleep apnoea, severe uncontrolled hypertension, benign intracranial hypertension, transient ischemic attacks or stroke, severe lower limb major joint disease requiring orthopaedic intervention which is precluded on safety grounds due to patient’s BMI, severe dismobility due to obesity sufficient to affect essential activities of daily living). For Chinese and South East Asian patients, BMI levels as per NICE Guidelines.
Ealing NICE Guideline criteria
East and North Hertfordshire BMI over 40 with type 2 diabetes and/or severe sleep apnoea, are aged 18-60 and who have been receiving intensive obesity management of at least 6 months.
East Lancashire NICE Guidelines criteria
East Riding of Yorkshire NICE Guidelines criteria
East Sussex Downs and Weald NICE Guidelines criteria
Eastern and Coastal Kent NICE Guidelines criteria
Enfield Information awaited.
Gateshead (South of Tyne & Wear) NICE Guidelines criteria
Gloucestershire NICE Guidelines criteria
Great Yarmouth & Waveney BMI over 40 with type 2 diabetes and/or severe sleep apnoea (hypertension is not an allowable comorbidity for surgery), are aged 18-60 and who have been receiving intensive obesity management of at least 6 months
Greenwich NICE Guidelines criteria
Halton and St Helens Priority given to those with BMI over 50 or BMI 45-50 with serious comorbidity. Must also have received and complied with weight management support in a specialised hospital obesity clinic.
Hammersmith and Fulham Information awaited
Hampshire BMI over 60 or over 45 with serious comorbidities such as established ischaemic heart disease, type 2 diabetes requiring oral medication or insulin, life-threatening sleep apnoea, severe uncontrolled hypertension, benign intracranial hypertension, history of transient ischaemic attacks or stroke, severe lower limb major joint disease requiring orthopaedic intervention which is precluded on safety grounds due to the patient’s BMI.
Haringey NICE Guidelines criteria
Harrow Information awaited
Hartlepool NICE Guidelines criteria
Hastings and Rother Information awaited
Havering NICE Guidelines criteria
Heart of Birmingham BMI over 45 with type 2 diabetes or BMI over 50 with comorbidities which are likely to be improved with weight loss or BMI over 65 without comorbidities. Patients must have failed to achieve or maintain weight loss after one years intensive management in a specialist obesity clinic setting.
Herefordshire NICE Guidelines criteria
Heywood, Middleton & Rochdale NICE Guidelines criteria
Hillingdon NICE Guidelines criteria but priority given to those with life-threatening comorbidities such as high blood pressure and cardiac-related problems
Hounslow NICE Guidelines criteria
Hull Information awaited
Isle of Wight NICE Guidelines criteria
Islington NICE Guidelines criteria
Kensington and Chelsea NICE Guidelines criteria
Kingston NICE Guidelines criteria
Kirklees NICE Guidelines criteria
Knowsley NICE Guidelines criteria
Lambeth Information awaited
Leeds Information awaited
Leicester City Information awaited
Leicestershire County & Rutland Information awaited
Lewisham NICE Guidelines criteria
Lincolnshire Information awaited
Liverpool Information awaited
Luton Information awaited
Manchester NICE Guidelines criteria
Medway Information awaited
Mid Essex BMI over 40 with type 2 diabetes and/or severe sleep apnoea (hypertension is not an allowable comorbidity for surgery), are aged 18-60 and who have been receiving intensive obesity management of at least 6 months
Middlesborough NICE Guidelines criteria
Milton Keynes BMI over 50 with diabetes or severe dismobility due to obesity sufficient to affect essential activities of daily living and who have been receiving treatment which has included diet and exercise support, pharmacological therapy and counselling in a specialist obesity management service and failed to respond adequately. Access to surgery is only via specialist obesity management service.
Newcastle NICE Guidelines criteria
Newham NICE Guidelines criteria
Norfolk BMI over 40 with type 2 diabetes and/or severe sleep apnoea (hypertension is not an allowable comorbidity for surgery), are aged 18-60 and who have been receiving intensive obesity management of at least 6 months
North Essex BMI over 40 with type 2 diabetes and/or severe sleep apnoea (hypertension is not an allowable comorbidity for surgery), are aged 18-60 and who have been receiving intensive obesity management of at least 6 months
North East Lincolnshire Information awaited
North Lancashire NICE Guidelines criteria
North Lincolnshire NICE Guidelines criteria plus other local criteria not provided.
North Somerset NICE Guidelines criteria with priority given to patients with BMI over 35 with type 2 diabetes in age range 18-45.
North Staffordshire BMI over 40
North Tees Information awaited
North Tyneside Information awaited
North Yorkshire and York NICE Guidelines criteria with automatic approval if BMI over 50
Northamptonshire NICE Guidelines criteria
Northumberland Information awaited
Nottingham City Information awaited
Nottinghamshire County Information awaited
Oldham Information awaited
Oxfordshire BMI over 50 with diabetes or other severe comorbidity
Peterborough BMI over 40 with type 2 diabetes and/or severe sleep apnoea (hypertension is not an allowable comorbidity for surgery), are aged 18-60 and who have been receiving intensive obesity management of at least 6 months.
Plymouth NICE Guidelines criteria
Portsmouth City BMI over 60 or over 45 with serious comorbidities such as established ischaemic heart disease, type 2 diabetes requiring oral medication or insulin, life-threatening sleep apnoea, severe uncontrolled hypertension, benign intracranial hypertension, history of transient ischaemic attacks or stroke, severe lower limb major joint disease requiring orthopaedic intervention which is precluded on safety grounds due to the patient’s BMI.
Redbridge Information awaited
Redcar and Cleveland Information awaited
Richmond and Twickenham Body weight >100% or 45kg above ideal weight, BMI >39 and minimum of 5 years obesity.
Rotherham BMI over 50 or between 45-50 with severe comorbidities.
Salford All patients must attend in-house Weight Management programme for minimum of 6 months prior to surgery consideration.
Sandwell NICE Guidelines criteria
Sefton BMI over 50 or 45 – 50 with comorbidities.
Sheffield BMI over 50 or 45 – 50 with severe comorbidities.
Shropshire County NICE Guidelines criteria
Somerset NICE Guidelines criteria
South Birmingham NICE Guidelines criteria
South East Essex BMI over 40 with type 2 diabetes and/or severe sleep apnoea (hypertension is not an allowable comorbidity for surgery), are aged 18-60 and who have been receiving intensive obesity management of at least 6 months
South Gloucestershire NICE Guidelines criteria with priority given to patients with BMI over 35 with type 2 diabetes in age range 18-45.
South Staffordshire BMI over 50 or between 35-50 with comorbidities such as type 2 diabetes or hypertension. Failed to achieve or maintain adequate clinically beneficial weight loss for at least 12 months and exhausted all non-surgical treatments including Orlistat, Sibutramine and had a psychological assessment.
South Tyneside Information awaited
South West Essex Information awaited
Southampton City BMI over 60 or over 45 with serious comorbidities such as established ischaemic heart disease, type 2 diabetes requiring oral medication or insulin, life-threatening sleep apnoea, severe uncontrolled hypertension, benign intracranial hypertension, history of transient ischaemic attacks or stroke, severe lower limb major joint disease requiring orthopaedic intervention which is precluded on safety grounds due to the patient’s BMI.
Southwark NICE Guidelines criteria
Stockport BMI over 50 or over 40 with severe comorbidities (type 2 diabetes on oral medication or insulin, severe obstructive sleep apnoea or obesity hypoventilation syndrome, obesity related cardiomyopathy, clinically unmanageable hypertension, transient ischaemic attacks or stroke, established coronary heart disease, pulmonary hypertension, a condition that requires surgery at the same time such as cholecystectomy or hernia repair, a condition which needs surgery or complex treatment as soon as possible after bariatric surgery such as hip or knee replacement, the patient is experiencing pain caused by another condition which is aggravated by the patient’s weight, other conditions such as Pickwickian Syndrome). Patients must be over 18.
Stoke on Trent BMI over 40 and lifestyle and pharmacological interventions have been undertaken and failed.
Suffolk NICE Guidelines criteria
Sunderland Two medical options have been tried – dietary trial and exercise regime on prescription
Surrey NICE Guidelines criteria
Sutton and Merton NICE Guidelines criteria
Swindon NICE Guidelines criteria plus documented evidence of 5 years support with dietary, pharmacological, exercise and behavioural modification support followed by 6 months intensive management in the specialist obesity clinic.
Tameside and Glossop NICE Guidelines criteria
Telford and Wrekin NICE Guidelines criteria
Torbay NICE Guidelines criteria
Tower Hamlets NICE Guidelines criteria
Trafford Information awaited
Wakefield District NICE Guidelines criteria
Walsall Teaching NICE Guidelines criteria
Waltham Forest NICE Guidelines with local variations not explained
Wandsworth NICE Guidelines criteria
Warrington BMI Over 50.
Warwickshire One year intensive management in specialist obesity clinic setting. BMI over 45 with type 2 diabetes or over 50 with comorbidities or over 65 without comorbidities.
West Essex BMI over 40 with type 2 diabetes and/or severe sleep apnoea (hypertension is not an allowable comorbidity for surgery), are aged 18-60 and who have been receiving intensive obesity management of at least 6 months
West Hertfordshire BMI over 40 with type 2 diabetes and/or severe sleep apnoea (hypertension is not an allowable comorbidity for surgery), are aged 18-60 and who have been receiving intensive obesity management of at least 6 months
West Kent Information awaited
West Sussex NICE Guidelines criteria
Western Cheshire Information awaited
Westminster NICE Guidelines criteria
Wiltshire NICE Guidelines criteria
Wirral NICE Guidelines criteria plus patient must undertake programme through Lifestyle and Weight Management Service and psychological assessment.
Wolverhampton City NICE Guidelines criteria
Worcestershire BMI over 40 and at least 12 months management in Specialist Weight Management Service with documented evidence demonstrating patients commitment to losing weight, changing lifestyle and improving overall health. Age over 18.