title: Experiences of accessing obesity surgery on the NHS: a qualitative study.
abstract: Although surgical treatment is recommended for morbid obesity where other interventions have failed, there is evidence that access to NHS surgery is heavily rationed. This study aimed to investigate how patients experienced accessing referrals for obesity surgery.
  
  
  
  Data collection was undertaken using in-depth interviews with patients and clinicians working in a specialist secondary care facility, and analysis took a constant comparative approach.
  
  
  
  Twenty-two participants with morbid obesity were followed up for a period of up to 3 years. All participants had made multiple attempts to lose weight prior to consulting their GPs yet felt this was rarely acknowledged by clinicians. Participants were frustrated when they received insufficient support to comply with primary care interventions, and when it came to obtaining a referral to secondary care, most had to raise this issue with GPs themselves.
  
  
  
  There is an urgent need for interventions for morbid obesity in primary care that are accessible to patients to facilitate weight loss and prevent weight re-gain. For those at very high weights, better integration between primary and secondary care is required to ensure appropriate and timely referral for those who need assessment for surgery.
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol BS8 2PS, UK.
authors.forename: Amanda
authors.initials: A
authors.lastname: Owen-Smith
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol BS8 2PS, UK.
authors.forename: Jenny
authors.initials: J
authors.lastname: Donovan
authors.affiliation: Health Economics Unit, School of Health and Population Sciences, University of Birmingham, Public Health Building, University of Birmingham, Birmingham B15 2TT, UK.
authors.forename: Joanna
authors.initials: J
authors.lastname: Coast
mesh_terms: D000328:Adult; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011320:Primary Health Care; D036301:Qualitative Research; D013222:State Medicine; D006113:United Kingdom; D055815:Young Adult
keywords: GPs; morbid obesity; obesity; primary care; qualitative