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Lesley Griffiths, Minister for Health and Social Services

First published:
28 February 2013
Last updated:

This was published under the 2011 to 2016 administration of the Welsh Government



In December 2012, I updated Assembly Members on the review of bariatric surgery policy being conducted by the Welsh Health Specialised Services Committee (WHSSC). The review is now complete and will be published on the WHSCC website (External Link). I would like to make you aware of its work.

Bariatric surgery is a specialised service and WHSSC is responsible for the planning and delivery of specialised and tertiary services in Wales.  WHSSC is independent of Welsh Government and is required to advise Health Boards on optimum use of resources for specialised services.

WHSSC has asked LHBs to consider the findings of the review in the context of developing plans for specialised services in 2013/14. This process will be complete by the end of March. It will be for the LHBs to decide which, if any, of the options regarding Bariatric services proposed they will adopt, as part of finalising the WHSSC specialised services annual plan.  

The review advises on how LHBs can develop the obesity pathway, specifically investment options, to increase the provision of bariatric surgery and revision of the bariatric surgery access criteria, in order to optimise resources to address the problem of obesity.

Increasing rates of obesity are an international problem.  The Welsh Health Survey suggests rates of obesity in Wales are high and maybe increasing.  It is estimated one fifth of the population is obese (defined as BMI>30). Individuals with severe or morbid obesity (BMI>35) are at increased risk of obesity related morbidity and may be suitable candidates for bariatric surgery.  The prevalence of severe obesity (BMI>35) in Wales is estimated to be 6%.

Bariatric surgery is currently commissioned in accordance with the WHSSC commissioning policy which dates from 2009.

The Welsh Government launched the All Wales Obesity Pathway in 2010.  The pathway sets out a four tier framework for obesity services through primary prevention and early intervention at level 1, to bariatric surgery at level 4.  The review found the All Wales Obesity Pathway has yet to be fully implemented, particularly at level 3 where intensive, specialist, non-surgical, multi-disciplinary obesity services are required for individuals who are failing to maintain a healthy weight.  It highlights the need to develop the obesity pathway (in particular, level 3 services) as part of local plans to increase provision of weight management services.  

Officials will be reviewing LHBs progress against the minimum service requirements of the All Wales Obesity Pathway.  

I hope you find the detail of the review helpful.