Background.With the increase in bariatric surgery in the UK, there has been a substantial increase in patients undergoing massive\nweight loss (MWL) seeking postbariatric body-contouring (bariplastic) surgery.However, there is a wide variation of availability on\ntheNationalHealth Service (NHS). Aims. To (1) reviewthe funding policies of PrimaryCare Trusts (PCTs) in England for bariplastic\nsurgery and (2) analyse the number of procedures funded in two consecutive financial years. Methods.We sent out questionnaires to\nall PCTs in England regarding their funding policies for bariplastic surgery and requested the number of procedures funded in 2008-\n09 and 2009-10. Findings. 121/147 (82%) PCTs replied to our questionnaires. 73 (60%) excluded all bariplastic procedures. 106/121\n(87.6%) PCTs had referral guidelines for plastic surgery. 46/121 (38%) PCTs provided the total number of funded abdominoplastyapronectomy\n(A-A) in the two financial years: total number of A-A applicants rose from 393 to 531, but approval for funding fell\nfrom 24.2% to 19.6%. Only 3 (2%) PCTs indicated increase in their future spending on bariplastic procedures in the next 5 years,\nwith 67% planning to decrease or unsure about future funding. Conclusion.There exists a postcode lottery for bariplastic surgery\nin England and we feel the need for guidelines on provision of bariplastic procedures following MWL.
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