If your doctor thinks you need an operation then you may be given help to stop smoking or reduce your weight before you go to hospital.

From 1st November 2016, patients who are obese or smoke will be asked to spend six months getting fitter before being referred for routine (non-urgent) surgery.

What if I am being referred to the hospital for tests or an opinion rather than an operation?

If you have a BMI greater or equal to 30 or smoke and are being referred to a surgical speciality for diagnostic tests, you will be advised by your GP that if non-urgent routine surgery is planned after being seen by the hospital, you will still need to complete the 6 month health optimisation period. You can access the lifestyle support services yourself or see your GP. The hospital will write to your GP who will still need to assess you at the end of the 6 month health optimisation period.

What happens once I have completed my health optimisation period?

At the end of your 6 month Health Optimisation Period or when you have stopped smoking for more than 4 weeks and/or reduced your BMI measurement to under 30, you should make a follow up appointment with your GP to discuss your health and your referral.

What if my health changes during the 6 month health optimisation period?

If you are concerned that your health has deteriorated during the 6 month health optimisation period, you should discuss your concerns with your GP who will reassess the situation.

How do I access the support services?

Referral to the service will be made by your GP, with your consent. Alternatively you may contact the service directly (self-referral).

For more information about the NHS in the Harrogate and Rural District area please visit the CCG’s website: www.harrogateandruraldistrictccg.nhs.uk

If you would like this document in a different format or language please contact 01423 799300.

HELPING YOU GET FIT FOR YOUR OPERATION

Fitter patients recover more quickly after operations and stay healthier for longer too.

Read this leaflet to find out more.

Are you a smoker?Are you overweight?

Adult Weight Management ServicesTier 2 Weight Management"Fit4Life" delivered by Harrogate Borough Council, funded by North Yorkshire County CouncilReferrals:Tel: 01942 404799Email: ihl.wigan@nhs.net

Programme Enquiries:Web: www.harrogate.gov.uk/fit4lifeTel: 01423 500600 ext 58206

Stop Smoking Service Enquiries: Delivered by LivingWell Smokefree Tel: 01609 797272Email: stopsmoking@northyorks.gov.uk Web: www.northyorks.gov.uk/stopping-smoking

Other lifestyle support services available through self-referral:Drug/Alcohol Services:Web: www.nyhorizons.org.uk/ Tel: Single Point of Contact - 01723 330730 Email: info@nyhorizons.org.uk Facebook: www.facebook.com/ NorthYorkshireHorizons/Twitter: @NYHorizons

Voluntary Services:Harrogate and Ripon Centres for Voluntary Service have a fully searchable “Where to Turn” Community Directory which gives access information for hundreds of community activities and services to support good health and well-being.

Web: harcvs.org.uk/WheretoTurnTel: 01423 504074Email: cvs@harcvs.org.uk

Health optimisation before routine surgery

Harrogate and Rural District CCG have approved a range of measures to improve the health and wellbeing of patients. Healthy lifestyle behaviours have a positive effect on your health. Patients who have a BMI greater or equal to 30 or people who smoke will be offered a referral to either a weight management programme or stop smoking services for a 6 month period of health optimisation before being considered for a non-urgent routine operation.

BMI (body mass index) is a measure of whether you are a healthy weight for your height. For more information on how to calculate your BMI please visit:

nhs.uk/tools/pages/healthyweightcalculator.aspx

We know that patients in good health recover better after an operation and have fewer complications. By taking care of yourself beforehand, you can reduce the risk of complications (such as Increased risk of blood clots; lower oxygen levels during surgery; increased risk of wound infection; and increased breathing problems) and help you heal as quickly as possible. Harms caused by smoking and obesity are potentially preventable and referral to support services prior to surgery offers an opportunity for you to improve your health and reduce the risks of surgical complications. There are other lifestyle behaviours which are good for your health like being active and reducing your alcohol intake.

What does a referral to a lifestyle support service mean?

You can access free support to help you lose weight or stop smoking through Harrogate Borough Council’s ‘Fit4Life’ programme or Smokefree Life North Yorkshire. The contact details are at the end of this leaflet.

The first step for weight management will be a telephone conversation with an instructor to discuss the best option for you based on your medical condition and recommendations from your health professional. You will then be invited for an assessment of your current activity levels, diet, past experiences, lifestyle goals and interests. You will also be able to find out more about the programme which takes place over 12 weeks. It supports you to make positive changes to your diet and increase your physical activity levels. Sessions are held in a wide range of venues, at varied times, across the Harrogate district.

There is a range of support available to suit you through stop smoking services, including drop-in clinics, group sessions, online support, telephone support or weekly one-to-one appointments with a free supply of medication, such as Nicotine Replacement Therapy (NRT). If you have problems with mobility and would prefer face-to-face support, home visits are available too.

What are the benefits of losing weight and quitting smoking?

Studies show the benefits of losing weight and quitting smoking include:

• Decreased complications from surgery

• Long-term health benefits, including lowered risk of heart disease, high blood pressure and diabetes

• Having more energy• Sleeping better and waking up

feeling rested and in a good mood• Having fewer aches and pains and

improved ability to move and get around

• Finding it easier to breathe and decreased risk of lung cancer

• Improved immune system (ability to fight off illness)

Are there any exclusions to this policy?

The exclusions to needing to complete the 6 month health optimisation period are:

• Any urgent or non-routine procedures

• Patients undergoing referral or surgery for cancer

• Patients with a BMI of 30 or greater but who have waist measurement less than 94cm in males or 80cm in females

• Patients with severe mental health illness, Learning Disability or significant cognitive impairment

• Referrals for interventions of a diagnostic nature e.g. endoscopy

• Children under 18 years• Frail Elderly• The policy does not currently apply

to eye conditions or dentistry/oral surgery

If an exclusion applies to you, you will still be given lifestyle advice, however your referral will progress as normal.

If you don’t meet any of the exclusions but your doctor feels a period of health optimisation may be detrimental to you, you may be considered through the CCG’s Individual Funding Request panel – your doctor will apply on your behalf.

Patients who only use electronic cigarettes will be classified as a non-smoker.