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Written question asked by Gideon Amos (Liberal Democrat) on Tuesday, 30 June 2026, in the House of Commons. It was due for an answer on Thursday, 2 July 2026. It was answered by Karin Smyth (Labour) on Thursday, 9 July 2026 on behalf of the Department of Health and Social Care.

Orthopaedics

Question

To ask the Secretary of State for Health and Social Care, what assessment he has made of the impact of (a) commissioning thresholds, (b) referral management systems, and (c) the application of NICE guidance, including body mass index criteria, on patient access to musculoskeletal and orthopaedic treatments within the NHS; and if he will take steps to ensure that such policies do not (i) delay and (ii) restrict access to clinically indicated care.

Answer

Decisions on eligibility for procedures are a matter for local National Health Service commissioners and clinicians, taking account of relevant National Institute for Health and Care Excellence (NICE) guidance and the individual needs of the patient. The Department expects access to NHS services to be based on clinical need and informed clinical judgement.

NICE has produced a guideline on joint replacement that covers care before, during, and after a planned knee, hip, or shoulder replacement. The guideline does not make any recommendations on the use of body mass index (BMI) thresholds in determining eligibility for orthopaedic procedures.

As with all surgery, BMI should be considered as part of a holistic, personalised perioperative evaluation of the risks versus clinical need for joint replacement surgery of an individual patient. However, BMI should not be considered in isolation and in and of itself should not act as a barrier to surgery.

As part of the Elective Reform Plan, we expanded Advice and Guidance services, which enable general practitioners and other clinicians to get quick specialist advice from consultants about non-urgent patient care, helping decide on treatment plans, test results, or if a hospital referral is needed. From October 2026, providers are expected to ensure that all appropriate requests and referrals, excluding urgent suspect cancer, flow through a Single Point of Access model, acting as a single ‘front door’ to support clinical triage to the most appropriate service or outcome, supporting faster specialist assessment and meaning clearer next steps for patients.

All providers of healthcare, including independent sector providers, are regulated by the Care Quality Commission and follow a set of fundamental standards of safety and quality, below which care should never fall. The safety of all patients, whether they are treated in the NHS or the independent sector, is a top priority for the Government.

Secondary information

Type
Written question
Reference
14710
Session
2026-27
Grouped for answer
Yes
Subjects
Eligibility Orthopaedics Obesity
Link
View this Written question on www.parliament.uk