It is the responsibility of individual integrated care boards to determine policies for their local area, including that of Body Mass Index (BMI) threshold criteria for joint replacement surgery. As with all surgery, BMI should be considered as one part of a holistic, personalised perioperative evaluation of the risks versus clinical need for joint replacement surgery of an individual patient.

The National Health Service and local government provide a range of services to help people living with overweight and obesity to manage their weight, which may include individuals waiting for joint replacement surgery, where they meet other eligibility criteria. These range from multi-component behavioural programmes, such as the NHS Digital Weight Management Programme, to specialist services for those living with severe obesity and associated co-morbidities.

The Department has made no specific assessment of the potential impact of body mass index (BMI) based restrictions on health inequalities.

It is the responsibility of individual integrated care boards to determine policies for their local area, including that of the BMI threshold criteria for joint replacement surgery. 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.

While National Institute for Health and Care Excellence guidelines are not mandatory, they do represent best practice and National Health Service organisations are expected to take them fully into account in ensuring that local services meet the needs of their populations.

The NHS and local government provide a range of services to help people living with overweight and obesity to manage their weight, which may include individuals waiting for joint replacement surgery, where they meet other eligibility criteria. These range from multi-component behavioural programmes, such as the NHS Digital Weight Management Programme, to specialist services for those living with severe obesity and associated co-morbidities.

The Department has made no specific assessment of the potential impact of body mass index (BMI) based restrictions on health inequalities.

It is the responsibility of individual integrated care boards to determine policies for their local area, including that of the BMI threshold criteria for joint replacement surgery. 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.

While National Institute for Health and Care Excellence guidelines are not mandatory, they do represent best practice and National Health Service organisations are expected to take them fully into account in ensuring that local services meet the needs of their populations.

The NHS and local government provide a range of services to help people living with overweight and obesity to manage their weight, which may include individuals waiting for joint replacement surgery, where they meet other eligibility criteria. These range from multi-component behavioural programmes, such as the NHS Digital Weight Management Programme, to specialist services for those living with severe obesity and associated co-morbidities.

The Department has made no specific assessment of the potential impact of body mass index (BMI) based restrictions on health inequalities.

It is the responsibility of individual integrated care boards to determine policies for their local area, including that of the BMI threshold criteria for joint replacement surgery. 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.

While National Institute for Health and Care Excellence guidelines are not mandatory, they do represent best practice and National Health Service organisations are expected to take them fully into account in ensuring that local services meet the needs of their populations.

The NHS and local government provide a range of services to help people living with overweight and obesity to manage their weight, which may include individuals waiting for joint replacement surgery, where they meet other eligibility criteria. These range from multi-component behavioural programmes, such as the NHS Digital Weight Management Programme, to specialist services for those living with severe obesity and associated co-morbidities.

It is the responsibility of individual integrated care boards (ICBs) to determine policies for their local area, including that of the body mass index (BMI) threshold criteria for joint replacement surgery.

The National Institute for Health and Care Excellence has developed guidelines for BMI thresholds by experts based on a thorough assessment of the available evidence and through extensive engagement with interested parties. They are not mandatory but represent best practice and National Health Service organisations are expected to take them fully into account in ensuring that local services meet the needs of their populations.

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.

No specific assessment has been made of the impact of BMI based restrictions on waiting times, pain, mobility, and disease progression among patients awaiting joint replacement surgery, and there are no current plans for the Department to issue guidance to ICBs on this matter.

It is the responsibility of individual integrated care boards (ICBs) to determine policies for their local area, including that of the body mass index (BMI) threshold criteria for joint replacement surgery.

The National Institute for Health and Care Excellence has developed guidelines for BMI thresholds by experts based on a thorough assessment of the available evidence and through extensive engagement with interested parties. They are not mandatory but represent best practice and National Health Service organisations are expected to take them fully into account in ensuring that local services meet the needs of their populations.

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.

No specific assessment has been made of the impact of BMI based restrictions on waiting times, pain, mobility, and disease progression among patients awaiting joint replacement surgery, and there are no current plans for the Department to issue guidance to ICBs on this matter.

It is the responsibility of individual integrated care boards (ICBs) to determine policies for their local area, including that of the body mass index (BMI) threshold criteria for joint replacement surgery.

The National Institute for Health and Care Excellence has developed guidelines for BMI thresholds by experts based on a thorough assessment of the available evidence and through extensive engagement with interested parties. They are not mandatory but represent best practice and National Health Service organisations are expected to take them fully into account in ensuring that local services meet the needs of their populations.

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.

No specific assessment has been made of the impact of BMI based restrictions on waiting times, pain, mobility, and disease progression among patients awaiting joint replacement surgery, and there are no current plans for the Department to issue guidance to ICBs on this matter.

National Institute for Health and Care Excellence guidelines are developed by experts based on a thorough assessment of the available evidence and through extensive engagement with interested parties. They are not mandatory but represent best practice, and National Health Service organisations are expected to take them fully into account in ensuring that local services meet the needs of their populations.

It is the responsibility of individual integrated care boards to determine policies for their local area. As with all surgery, Body Mass Index (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.

I refer the Hon. Member to the answer I gave to the Hon. Member for Rushcliffe on 20 November 2025 to Question 89688.

It is the responsibility of individual integrated care boards (ICBs) to determine clinical commissioning policies, such as eligibility for joint replacement surgery, for their local areas, including when an ICB is the result of a merger.

As with all surgery, body mass index (BMI) should be considered as part of a holistic, personalised perioperative evaluation of the risks versus the clinical need for joint replacement surgery of an individual patient. As per National Institute for Health and Care Excellence guidance, BMI should not be considered in isolation as a barrier to surgery.

As part of the National Health Service Elective Reform Plan, the Government has committed to expanding access to the NHS Digital Weight Management Programme for patients waiting for hip and knee replacements. This will help optimise patients for their surgery, potentially leading to a reduced length of hospital stay and minimising their risk of post-operative complications.

It is the responsibility of individual integrated care boards to determine clinical commissioning policies for their local areas, including eligibility for joint replacement surgery.

As with all surgery, body mass index (BMI) should be considered as part of a holistic, personalised perioperative evaluation of the risks versus the clinical need for joint replacement surgery of an individual patient. BMI should not be considered in isolation as a barrier to surgery.

As part of the NHS Elective Reform Plan, the Government has committed to expanding access to the NHS Digital Weight Management Programme for patients waiting for hip and knee replacements. This will help optimise patients for their surgery, potentially leading to a reduced length of hospital stay and minimising their risk of post-operative complications.

I refer the Hon. Member to the answer I gave to the Hon. Member for Rushcliffe on 20 November 2025 to Question 89688.

I refer the Hon. Member to the answer I gave to the hon. Member for Rushcliffe on 20 November 2025 to Question 89688.

I refer the Hon. Member to the answer I gave on 20 November 2025 to Question 89688.

The Government is committed to putting patients first, nationally and in North Herefordshire. That is why, in the Elective Reform Plan, we committed to returning by March 2029 to the National Health Service constitutional standard that 92% of patients wait no longer than 18 weeks from referral to consultant-led treatment. Having delivered 5.2 million extra appointments, we have more than doubled our pledge to deliver an extra two million during our first year in office.

Thanks to our modernisation and record investment, waiting lists have been falling for the first time in over a decade. Since the Government came into office it has decreased by over 230,000, despite over 26.4 million referrals onto the waiting list.

North Herefordshire is predominantly served by the Wye Valley NHS Trust, which has seen recent performance improvement in the trauma and orthopaedic (TO) waiting list. Between July 2024 and September 2025, the proportion of waits within 18 weeks for patients on the TO list increased by 5.7%, to 51.8%. The number waiting more than 52 weeks has also fallen by nearly 40%. Since November, high volume weekend lists for joint replacement procedures have also commenced at the Wye Valley Trust.

Nationally, the number of patients on TO waiting lists waiting within 18 weeks has improved by 3.7% and the number waiting more than 52 weeks has fallen by almost 16,000 over the same period.

We know there is more to do to tackle elective waiting lists including for joint replacement surgery. That is why we have invested £1.65 billion in capital funding in 2025/26 to expand and enhance surgical capacity, which includes funding for surgical hubs, the majority of which offer joint replacement surgeries.

As of December 2025, 123 surgical hubs are operational across England including three in the Herefordshire and Worcestershire Integrated Care System, the most recent being the Wye Valley Elective Surgical Hub which opened in July 2024. These dedicated and protected surgical hubs focus on high volume low complexity surgeries and protect elective care from winter and emergency pressures by using ring-fenced staff and facilities, reducing cancellations and improving efficiency.

The Government is committed to putting patients first, nationally and in the South Bolton and Walkden Constituency. This means making sure that patients, including those waiting for joint replacement surgery, are seen on time and ensuring that people have the best possible experience during their care.

The South Bolton area is predominantly served by the Bolton NHS Foundation Trust (FT), whilst the wider region including Walkden is served by the Manchester University NHS FT.

At the Bolton NHS FT, over half, or 55.6%, of waits on the trauma and orthopaedics (T&O) waiting list, which includes joint replacement surgery, were waiting within 18 weeks, an improvement of 8.8% since the start of July 2024. The number of long waits of more than 52 weeks has also reduced by 67% over the same period, down to 83.

At the Manchester University NHS FT, 45% of T&O waits were within 18 weeks, an improvement of 3.7%. The number of long waits of over 52 weeks has also reduced by 6% over the same period, down to 893.

We set out in the 2025 Elective Reform Plan, the productivity and modernisation efforts needed to reach the National Health Service constitutional standard that 92% of patients wait no longer than 18 weeks from referral to consultant-led treatment by March 2029. The plan outlines actions that will help to ensure care is delivered in the right place. This includes £1.65 billion of capital funding in 2025/26 to increase capacity for elective and emergency care, partly through new surgical hubs. Hubs deliver quicker access to common surgical procedures, including T&O services. In October 2025, capacity in one of two surgical hubs that are part of the Manchester University FT was expanded, namely the Trafford Hospital Elective Surgical Hub. This means more patients can receive treatment faster and begin recovery sooner.

The Government remains committed to continuing to expand the number of hubs over the next three years to increase surgical capacity and deliver faster access to common procedures including T&O procedures.

The Government is committed to putting patients first, nationally and in Bury St Edmunds and Stowmarket. This means making sure that patients, including those waiting for joint replacement surgery, are seen on time and ensuring that people have the best possible experience during their care.

Bury St Edmunds and Stowmarket is predominantly served by the West Suffolk NHS Foundation Trust. Over half, or 50.9%, of patients on the trauma and orthopaedic waiting list, which includes joint replacement surgery, were waiting within 18 weeks, an improvement of 7.9% since July 2024, and the number waiting more than 52 weeks has also fallen by over 70%.

Nationally, the number of patients on trauma and orthopaedic waiting lists waiting within 18 weeks has improved by 3.6% and the number waiting more than 52 weeks has fallen by over 16,000 in the same period.

We set out in the 2025 Elective Reform Plan the productivity and reform efforts needed to reach the National Health Service constitutional standard that 92% of patients wait no longer than 18 weeks from referral to consultant-led treatment by March 2029. The plan outlines actions that will help to ensure care is delivered in the right place, and includes £1.65 billion of capital funding in 2025/26 to deliver new surgical hubs, diagnostic scanners, and beds to increase capacity for elective and emergency care.

Currently, there are 123 surgical hubs operational across England, including two in the Suffolk and North East Essex Integrated Care System, and we are committed to expanding the number of hubs over the next three years to increase surgical capacity and deliver faster access to common procedures, including trauma and orthopaedic procedures.

In December 2024, we opened the Newmarket Community Diagnostic Centre which increased diagnostic capacity, with over 34,000 scans conducted for more than 21,000 patients, and which led to a 53% reduction in the magnetic resonance imaging waiting list between December 2024 and October 2025. As of September 2025, community diagnostic centres are now delivering additional tests and checks in 170 sites. We have also confirmed 13 new state-of-the-art DEXA scanners to support better bone care, delivering on this Government’s commitment in the Elective Reform Plan. These will allow for an extra 29,000 bone scans per year, benefitting tens of thousands of patients.

The Department has made no specific assessment of the potential merits of removing the use of body mass index (BMI) thresholds to determine eligibility for joint replacement surgery. It is the responsibility of individual integrated care boards to determine policies for their local area.

As with all surgery, BMI would 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 NHS Elective Reform Plan there is a commitment to expand access to the NHS Digital Weight Management Programme for patients waiting for hip and knee surgery.

The Government is committed to putting patients first and tackling waiting lists as part of our Health Mission. We exceeded our pledge to deliver an extra two million appointments, tests, and operations in our first year of Government, delivering 5.2 million additional appointments between July 2024 and June 2025. This marks a vital first step to delivering on our commitment to return to the National Health Service constitutional standard that 92% of patients wait no longer than 18 weeks from referral to consultant-led treatment by March 2029.

The Department is taking a range of steps to reduce waiting times for surgery, including joint replacement surgery. There are currently 123 surgical hubs operational across England, and we are committed to expanding the number of hubs over the next three years to increase surgical capacity and deliver faster access to common procedures. Surgical hubs have been shown to deliver approximately 20% increased productivity in the hubs compared to trusts without a dedicated elective hub on site.

The Getting it Right First time (GIRFT) programme published detailed guidance for hip and knee replacements in July 2023 and has been supporting trusts through a multidisciplinary team made up of anaesthetic, surgical, and allied health professional colleagues. Additionally, GIRFT is leading a community musculoskeletal programme, supporting improvements in the early stages of the pathway, to ensure that only those patients who require surgery are referred into secondary care, and that their condition is optimised for surgery as far as possible at the point of referral. Further information on the GIRFT programme is available at the following link:

https://gettingitrightfirsttime.co.uk/

The Department has made no specific assessment of this criterion alone.

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

For example, blanket body mass index thresholds for surgery should not be in place or used as a means of determining eligibility for surgery.

As part of the NHS Elective Reform Plan there is a commitment to expand access to the NHS Digital Weight Management Programme for patients waiting for hip and knee surgery.