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<p>There is no national requirement for clinical commissioning groups (CCGs) to go
through an individual funding request process before each patient is able to access
bariatric surgery. The implementation and operation of CCG commissioning policies
is a matter for individual CCGs to determine.</p><p> </p><p>NHS England has therefore
made no formal assessment of this proposed requirement on CCGs.</p><p> </p><p>The
National Institute for Health and Care Excellence Clinical Guidelines 43 (updated
November 2014) is clear about which groups of individuals bariatric surgery can benefit,
with both clinical and cost effectiveness demonstrated, and attendance at Tier 3 services
required first. Tier 3 covers multidisciplinary weight management services which are
normally commissioned by CCGs.</p>
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