Clinical commissioning groups must do more to implement national guidelines for body contouring surgery following massive weight loss

25 November 2015

New research presented at this year’s BAPRAS Winter Scientific Meeting (November 25-27) shows that many clinical commissioning groups in England have yet to implement national guidelines for reconstructive body contouring surgery following massive weight loss. 

More than 70 per cent of massive weight loss patients (defined as the loss of 50 per cent or more of the excess body weight) seek reconstructive body contouring surgery to improve functional and social wellbeing. 
In March 2014, BAPRAS produced NICE accredited national commissioning guidelines for body contouring surgery to standardise referral pathways and eliminate the postcode lottery. However, a new national commissioning survey to determine uptake of the guidelines by clinical commissioning groups in England suggests that implementation is not widespread.

BAPRAS research found that 61 per cent of the CGCs surveyed fund body contouring surgery after massive weight loss, while 35 per cent were aware of the new guidelines. Only 7 per cent had implemented the guidelines, with 75 per cent identifying local funding guidelines. 

To improve patient access to body contouring surgery, 75 per cent of respondents thought patient-reported outcome measures were key. 89 per cent stated cost-effectiveness, while 70 per cent wanted the development of a national standardised obesity surgery framework (CQUIN), with body contouring surgery assessment as an incentivised performance outcome. 

These results are being presented at the BAPRAS Winter Scientific Meeting today by Jonathan Dunne, Reshma Ghedia and Mark Soldin. They conclude that the independent development of guidelines throughout NHS England is wasteful and unnecessarily replicates work. 

Wider dissemination of best available evidence with body contouring guidelines is imperative to inform patients, GPs and CCGs, and would allow patients a real chance to re-integrate into society as healthy contributing individuals. 

The British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) Winter Scientific Meeting brings together consultants, trainees, nurses and clinicians working in the field of Plastic Surgery. Attracting over 400 delegates, the Meeting features guest lecture sessions throughout the programme, including talks on head, breast, cleft lip and palate and limb reconstruction. This year the three-day event takes place at the Vox Conference Centre, Birmingham. 


BAPRAS, the British Association of Plastic, Reconstructive and Aesthetic Surgeons, is the voice of Plastic Surgery in the UK. It aims to increase the understanding of the professional specialty and scope of Plastic Surgery, promoting innovation in teaching, learning and research.

Founded in 1946 (originally as the British Association of Plastic Surgeons), today BAPRAS has over 800 members and is the professional representative body for reconstructive and aesthetic Plastic Surgeons providing services to patients on the NHS and privately in the UK. Members of the public can find a member Plastic Surgeon in their area by logging on to Anyone can check the GMC to find out if a surgeon is on the Plastic Surgery specialist register;