Post-Bariatric Follow up Care

Introduction

This document outlines the policy for managing requests for follow-up care and prescribing for patients who have undergone bariatric surgery (e.g., Sleeve Gastrectomy, Gastric Bypass, Gastric Band) privately or overseas. It aims to provide clear guidance for both practice staff and patients, ensuring safe and consistent care while protecting NHS resources.

The policy is based on guidance from BOMSS and NICE and adheres to the principle that private and NHS care must be kept separate to prevent the NHS from subsidising private treatment.

This structured process ensures patient safety, clinical responsibility, and minimal administrative burden while clarifying responsibilities for both patients and practice staff.

Practice Implementation: Post-Bariatric Surgery Care

Overview

Follow-up care within the first two years after private or overseas bariatric surgery is considered specialist care. The responsibility for this care remains with the operating private provider. This process is designed to ensure consistent handling of related requests while maintaining clear boundaries between private and NHS responsibilities.

Key Practice Considerations

  • The first two years of post-operative follow-up is specialist care and is the responsibility of the private provider.
  • We do not enter shared care agreements with private providers.
  • We do not accept workload transfers(e.g., requests to arrange tests or prescribe specialist supplements) from private providers.
  • Patients can request a transfer to NHS care, but acceptance is subject to NHS service criteria and capacity.

Patient Information: Follow-up Care After Private or Overseas Bariatric Surgery

What is the policy on follow-up care?

If you choose to have bariatric surgery privately (in the UK or abroad), you are responsible for arranging and funding your post-operative follow-up care. The first two years after surgery require specialist monitoring, which is not a routine service provided by your GP.

Your private surgical provider is responsible for your care, including:

  • Blood tests and monitoring.
  • Nutritional supplementation plans and prescriptions.
  • Management of any surgery-related complications.

Arranging Your Private Follow-up Care

Before undergoing surgery, you must ensure you have a full, funded follow-up package with your private provider for at least two years. You should clarify with them who is responsible for:

  • All necessary blood tests and scans.
  • Prescriptions for specialist supplements and medications.
  • Managing any complications.
  • The process and criteria for discharge from their care.

Transferring to NHS Care

You have the right to request a transfer to NHS care in line with the NHS Constitution. However, please be aware:

  • If your follow-up needs are still specialist in nature(typically within the first two years), we will refer you to an NHS-commissioned bariatric service.
  • Acceptance by an NHS service is not guaranteed and depends on their specific criteria and capacity.
  • If a referral is rejected, you may need to escalate this formally to the local NHS commissioner.

Once you are formally accepted by an NHS specialist service, your GP will provide elements of care that normally fall within general practice, guided by the advice from the NHS specialists.

Prescriptions and Monitoring

  • Specialist supplements/medications required after bariatric surgery are not routinely prescribed by GPs if you are under private care.
  • Your private provider is responsible for all prescribing and monitoring until an NHS service accepts the transfer of your care.
  • We cannot arrange tests or complete forms solely to support your private follow-up care.

Summary: Key Points to Consider Before Private or Overseas Bariatric Surgery

Topic Key Information
Follow-up Responsibility The private surgical provider is responsible for the first two years of specialist follow-up care, including monitoring and complication management.
Prescriptions & Tests Your private provider must organise and fund all related prescriptions (e.g., vitamins, minerals) and blood tests. GPs cannot undertake this for private care.
Transfer to NHS A transfer to NHS care is possible but requires referral to and acceptance by an NHS specialist service, which is not guaranteed.
GP Role GPs will not provide routine specialist follow-up but will support care that normally falls within general practice only after a patient is accepted by an NHS specialist service.
Shared Care Agreements We DO NOT enter into shared care agreements with private providers due to the need to keep private and NHS care separate.

College Road Surgery
Version 1, September 2025
MS