NHS Fife has been told to reimburse the cost of private hip replacement surgery after focusing on a patient’s weight and not the pain she was in.
The patient, known only as Miss C, had two hip replacements carried out privately after being told by NHS Fife medics she would not be in line for an operation until she reduced her body mass index.
Now the Scottish Ombudsman has told the health board to apologise to the patient and foot her private healthcare bill.
Miss C suffers from chronic osteoarthritis in both of her hips.
She asked her GP to refer her to a consultant orthopaedic surgeon to be considered for hip replacement surgery.
The consultant told Miss C she would not be considered for surgery until her BMI – the measure for estimating human body fat – was reduced to an appropriate level.
Miss C complained to NHS Fife that the consultant wrongly focussed solely on her BMI and did not properly examine her or discuss her pain or mobility issues.
Miss C requested a private referral for surgery from her GP and had both hips replaced.
NHS Fife admitted during the probe that the consultant did not physically examine Miss C as there was no clinical reason to do so.
It pointed out there were considerable risks and increased complication in patients with a BMI of more than 40 who undergo surgery.
The ombudsman found the board’s approach to dealing with referrals of patients with a high BMI for hip replacement surgery was not sufficiently supported by the guidance available and did not allow for treatment tailored to individual patients.
The investigation found NHS Fife failed to carry out a thorough clinical assessment on Miss C.
In addition, the board’s reason for not offering her a second opinion was not in line with guidance.
The ombudsman asked NHS Fife to apologise and reimburse her.
He has also told the board to ensure its approach in such cases was flexible, in line with guidance, and that it adopts a holistic approach when deciding whether to carry out surgery.
It should ensure patients with high BMI are fully assessment.
It has to remind staff of the General Medical Council’s guidance and ensure local GP practices were aware patients can be referred if there’s a deterioration in their condition.
Director of nursing Helen Buchanan said: “The safety of patients in our care is our number one priority.
“While the decisions in this case were made with patient safety in mind, we accept that the care provided was not of the standard our patients should expect.
“We are currently implementing the ombudsman’s recommendations and will be apologising formally to the individual involved.”