Table 1 Prevalence and content of hip and knee arthroplasty policies for body mass index and smoking (106 clinical commissioning groups in England 2021)

Policy situation unknown

0

0.0

1

0.9

Policy introduced but now inactive

11

10.4

4

3.8

No policy

23

21.7

21

19.8

Policy introduced and still active of which:

72

67.9

80

75.5

1 advice given only—no added service or extra wait

10

13.9

18

22.5

2 extra service provision—advised to use but no requirements

12

16.7

31

38.8

3 extra service provision—mandatory referral but no requirement to engage

6

8.3

19

23.8

4 extra waiting time to surgery, but no penalty for engagement or outcome

6

8.3

1

1.3

5 extra service provision—access to surgery delayed until engagement/outcome attempted

18

25.0

7

8.8

6 extra service provision—access to surgery denied until BMI threshold or smoking status is met

20

27.8

4

5.0