The local Primary Care Trust (PCT) and NHS Trust hospital jointly handles the funding for all bariatric surgery. There is a contractual agreement between them in which they allocate various funding amounts to a large range of programs. The problem is that there are competing demands for this funding which, in turn, results in there being losers and winners when it comes time to pay for treatment.
NICE has published some recommended guidelines for bariatric surgery to be made available to all PCTs. If, for whatever reason the PCT does not provide funding for this type of surgery the patient may then ask to be referred to a hospital which does offer this service, in another location. Should this be the case, the GP will have to ask for permission to refer you out of the location. The patient then has to check with the PCT in that location exactly what their funding criteria are.
The patient does not normally have a choice with regard to the type of surgeon and hospital. Should the GP find a hospital and surgeon who can undertake this surgery then the patient has to go there for treatment. Should the location be out of the local area then it is again a case for that area's PCT.
What usually causes a problem with this is that obesity treatment is not a high priority for most PCTs and therefore does not usually attract much in the way of funding. Many people do not qualify for bariatric surgery and then they must ask for a referral. However, it almost always comes down to funding and if the PCT does not have money allocated for bariatric surgery then the patient you will have to look elsewhere.
Another problem with the PCT is that they only have having a set amount of funding for the treatment of obesity. Once the funding has run out is not likely that there will be any more until the start of a new financial year. The funding is there for all bariatric surgery patients but unfortunately it can't provide funding for everyone and you may be the one patient who finds them self without sufficient funding.
Another problem with NHS surgery the long waiting lists. Bariatric surgery patients can find themselves waiting for as long as eighteen months for surgery.