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<p>Public health is primarily a matter for local authorities, which includes preventative
services around obesity and smoking cessation.</p><p> </p><p>Clinical commissioning
groups (CCGs) are responsible for working with local authorities to understand and
meet the needs of their local populations, and making decisions on how to best commission
services which meet that population’s health needs.</p><p> </p><p>NHS England does
not have a formal process in place to ensure that CCGs provide obese patients and
smokers with access to appropriate treatment before operations. However, CCGs are
encouraged to obtain the advice of NHS England regional teams before putting forward
proposals which would affect access to services.</p><p> </p><p>CCGs also have a legal
duty to have due regard to National Institute for Health and Care Excellence guidelines.</p><p>
</p><p>CCGs have a statutory duty to meet the reasonable health requirements of their
local population. As part of their duty to seek continuous improvement in the quality
of services they commission, CCGs must act with a view to securing continuous improvement
in the outcomes of services. NHS England can exercise its formal powers of direction
if it is satisfied that a CCG is failing or is at risk of failing to discharge this
duty.</p>
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