Public health is primarily a matter for local authorities, which includes preventative services around obesity and smoking cessation.
Clinical commissioning groups (CCGs) are responsible for working with local authorities to understand and meet the needs of their local populations, and making decisions on how to best commission services which meet that population’s health needs.
NHS England does not have a formal process in place to ensure that CCGs provide obese patients and smokers with access to appropriate treatment before operations. However, CCGs are encouraged to obtain the advice of NHS England regional teams before putting forward proposals which would affect access to services.
CCGs also have a legal duty to have due regard to National Institute for Health and Care Excellence guidelines.
CCGs have a statutory duty to meet the reasonable health requirements of their local population. As part of their duty to seek continuous improvement in the quality of services they commission, CCGs must act with a view to securing continuous improvement in the outcomes of services. NHS England can exercise its formal powers of direction if it is satisfied that a CCG is failing or is at risk of failing to discharge this duty.