This Signal item is about the risk of harm to bariatric patients from delays in treatment.
A sample incident report reads:
“Crew had already phoned ahead saying that this man weighed 35 stone. Patient is unfortunately too heavy to go on our hospital trolley … contacted bed manager who suggested trying XX for a bariatric bed, none available.”
In the context of this report, a bariatric patient can be defined as anyone who has care needs that are complicated by their weight exceeding the safe working load limit and dimensions of a standard support surface (e.g. trolley, bed, chair, wheelchair, toilet or mattress).
A search of the National Reporting and Learning System (NRLS) identified 25 incidents during a 12 month period where delays or limited access to appropriate equipment had the potential to cause harm to bariatric patients.
According to the Health Survey for England, obesity is on the rise in the UK. Obese patients are over-represented in their use of health and social care services and present with particular health needs relating to transport, movement and handling, pressure relief, and access to surgery and diagnostic services (such as CT). Despite the growing demand on services, a 2007 Health Services Executive report found that 40-70 per cent of trusts did not have a policy for managing the needs of bariatric patients.
The report made a number of recommendations:
- strategic policies need to be formulated to equip the NHS for the rapidly growing obese population in England;
operational policies are needed to lead the process
planning, assessment and management of the manual handling risks for
the care and treatment of bariatric patients;
buildings and vehicles need to be designed to accommodate bariatric patients in safety and comfort and with dignity;
equipment needs to be designed to ‘fit’ a range of bariatric shapes and sizes (using population data);
- training is needed to support the assessment of
bariatric patients and the use of specialist manual handling and
Please contact us with information about your initiatives to reduce risks in any of these areas.
Signals are notifications of key risks emerging from review of serious incidents reported to the NRLS and shared by the NPSA.