Procedures with limited clinical value (FOI)

Request

Under the Freedom of Information Act, please could you provide answers to the following?

A

Do you have a list of procedures of limited clinical value? 

If yes, does this currently include either a multidisciplinary Tier 3 or a Tier 4 weight management service?

When were each of these added to the list of procedures of limited clinical value?

B

How many multidisciplinary Tier 3 and Tier 4 weight management services have you decommissioned in each of the past five calendar years? Please provide details.

C

Please list all the multidisciplinary Tier 3 and Tier 4 obesity services that you have commissioned in the past calendar five years.

D

How many patients have received either a multidisciplinary Tier 3 or a Tier 4 weight management service in each of the past five calendar years in your CCG area?

Response

A

Health and Community Services (HCS) has a ‘Procedures with Restrictions and Thresholds Policy (2017)’. This Policy specifies whether a procedure is excluded or restricted. HCS policy on the surgical management of obesity is classified as a restricted procedure. This means it is not funded unless an exemption criteria is met. HCS works to NICE Obesity guidance but all cases are considered on a case-by-case basis.

The Procedures with Restrictions and Thresholds Policy (2017) is available through the following link:

Procedures with Restrictions and Thresholds Policy (2017)

The list currently includes Tier 4 Weight Management Service.

The policy was developed several years ago. The policy was updated in 2017 however no change was made to Weight Management.

B

HCS has not decommissioned any Tier 3 or Tier 4 services in the last five years.

C

Tier 3 and Tier 4 services have been operational since at least 2004. There have been no new services commissioned.

D

Tier 3 – At present 1:1 consultations are only offered for overweight patients if they have co-morbidities and thereafter they are given the option to attend a monthly drop-in clinic for monitoring. Those who are overweight and have diabetes will be seen within the Diabetes Service. Data is not collected in relation to this.

Tier 4 – HCS is not a Clinical Commissioning Group (CCG) as care is provided for a whole Island population. Since 2014, 89 patients have been in receipt of a Tier 4 Weight Management Service.

Disclosure control has been applied to numbers fewer than ten under Article 25 (Personal information) of the Freedom of Information (Jersey) Law 2011.

Article applied

Article 25 Personal information

(1) Information is absolutely exempt information if it constitutes personal data of which the applicant is the data subject as defined in the Data Protection (Jersey) Law 2018.

(2) Information is absolutely exempt information if –

(a) it constitutes personal data of which the applicant is not the data subject as defined in the Data Protection (Jersey) Law 2018; and

(b) its supply to a member of the public would contravene any of the data protection principles, as defined in that Law.