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<p>Clinical commissioning groups (CCGs) are responsible for commissioning services
to meet the requirements of their population, including obese patients and smokers.
In doing so, CCGs need to ensure that the services they provide are fit for purpose,
reflect the needs of the local population, and are based on the available evidence
and take into account national guidelines.</p><p> </p><p>Major surgery poses much
higher risks for severely overweight patients and those who smoke. So local general
practitioner-led CCGs are entirely right to ensure these patients first get support
to lose weight and try and stop smoking before their operation. Reducing obesity and
cutting smoking not only benefits patients but saves the National Health Service and
taxpayers millions of pounds.</p><p> </p><p>This does not and cannot mean blanket
bans on particular patients, such as smokers, getting operations, which would be inconsistent
with the NHS Constitution.</p>
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