Obesity Poorly Served By NHS, Survey Finds

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Obese patients receive inadequate NHS care, a new analysis of patient safety records has suggested.

To identify mistakes in the system, nearly 400 cases submitted to the National Patient Safety Agency were reviewed by researchers from the Central Manchester University Hospitals NHS Trust.

The team highlighted a range of issues, including problems with drug doses, ventilation and surgery, adding that better training and more specialist equipment was needed.

Defined as a body mass index of 30 or over, clinical obesity affects one in seven children and nearly a quarter of adults, costing the NHS more than £4bn a year. However, the team's review of 389 reports to the NPSA's voluntary reporting system between January 2005 and August 2008 suggests that the NHS is struggling to cope with specific needs.

Obese patients receiving poor medical care

The study, published in the Postgraduate Medical Journal, said the health service has focused more on preventing obesity than dealing with the implications of seeing obese patients.

The report highlighted a number of serious cases, including 3 deaths, involving related complications such as heart disease and ventilation problems. But the overwhelming number involved less serious issues such as pressure sores and treatment delays and cancellations. 86% of cases were judged of little or no harm.

In over half the cases, the most common problem was lack of specialist equipment, such as heavy-duty wheelchairs, beds and operating tables. Also underlined were incorrect drug dosages, ventilation problems and staff with inadequate knowledge of caring for obese patients.

For patients undergoing surgery, poor planning was common, leading to issues such as listing patients for day cases when their weights indicated the need for overnights.

The report's co-author Dr Chris Booth noted the rise of obesity over the last 15 to 20 years and how the NHS has struggled to keep up. "Obese patients need specialist equipment and there are physiological and anatomical differences that staff need to be aware of," he said.

Mike Farrar, chief executive of the NHS Confederation, agreed the importance of the issue, but stressed the health service's increased investment in equipment.

"Ambulance trusts have had to invest significant amounts in bariatric ambulances in recent years," he observed, "and hospitals are increasing the number of extra-wide, reinforced beds as the demands of larger patients put greater pressure on the system and its staff."

A Department of Health spokeswoman insisted that unsafe care would not be tolerated, adding: "We would encourage the NHS to review these findings and make sure that appropriate procedures and equipment are in place to provide safe care at all times."

Natalie Rodgers in the Medical Negligence Team of Simpson Millar LLP said the report signalled shortcomings in the NHS which could be extremely costly in the long term. "The health service needs to establish obesity specialists at every GP practice. With the government's own Foresight report estimating that weight problems already cost the wider economy some £16 billion, which unchecked will rise to £50 billion a year by 2050, a coherent and effective response is long overdue."


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