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A pensioner suffering with a swollen knee to has been told to go on an eight month "weight reduction lifestyle" course before a doctor will see her.

Pauline Jones says she was referred to the Wrexham Maleor Hospital orthopaedic department by her local GP a couple of months ago to assess her painful knee.

However Ms Jones of Yale Street, Johnstown, was shocked when a letter arrived this month signed by Betsi Cadwaldar University Health Board's "Lifestyle Adminstrators" telling her to go on a weight loss "lifestyle" course, before a consultant would see her.

The 74-year-old fears without a proper assessment by a doctor, her knee could be damaged further, but health chiefs say a "Lifestyle Management Programme is a widely accepted, nationally recognised model of care."

(Image: Ian Cooper/North Wales Live)

She said she'd had open heart surgery two years ago to replace valves and now struggles to walk any distance or breathe properly.

Ms Jones - a former charity worker and political assistant - claimed it could be a way of keeping down waiting lists and fears her knee could suffer more damage if its not assessed properly.

"I was fuming, I telephoned my doctor and they knew nothing about it. I phoned the orthopaedics and they didn't know anything about it," said Ms Jones.

"Then I phoned these people and that's when they told me that if I didn't do this course, I would not go on the waiting list to see a doctor."

She added: "Two years ago I had open heart surgery and had my valves replaced I find it hard to walk very far, I find it difficult to breathe and get so out of breath.

"They don't know what is the matter with my knee - I have had no assessment and it could be doing more damage, because they don't even know what's wrong."

The letter said: "A review of your Body Mass Index (BMI) ie your weight and height is part of the assessment.

"Anyone who has a BMI of 35 or above is directed to our weight reduction 'Life style programme'."

(Image: Ian Cooper/North Wales Live)

The letter added: "It is essential to your treatment and all patients are carefully assessed and directed to attend this programme, where appropriate, before considering further orthopaedic intervention.

"After completion of the 32 week programme, if surgical intervention is still needed, you will receive your first out-patient appointment for assessment by an orthopaedic consultant, joining the waiting list at the point you completed the program, not week zero."

A BCUHB spokesman said: "Referring people with orthopaedic complaints and a BMI greater than 35 to a Lifestyle Management Programme is a widely accepted, nationally recognised model of care.

“The Lifestyle Programme is designed to help patients improve their general health, improve exercise tolerance and where possible reduce or lose weight. The key benefits of this programme include reduced joint pain symptoms associated with obesity and improved exercise tolerance.

“When patients complete the Lifestyles Management Programme, a referral to the Orthopaedic Department may still be required and if so you will join the Orthopaedic waiting list at week 32 so will not be disadvantaged.

"Often patients find that their joint pain reduces significantly following weight reduction and they no longer require an Orthopaedic opinion and therefore surgery may no longer be required or indicated.

“The Lifestyle Management Programme is an essential part of preparing a patient for any potential surgery, as obesity increases the health risks and complications associated with an anaesthetic or surgery.

"Patients who are deemed to be at high risk, are required to undergo and attend a lifestyle programme so as to improve and reduce the potential risks.”

A Welsh Government spokesperson, said: “We can’t comment on individual cases. We expect all patients to be seen and treated in a timely manner and in order of their clinical priority, which is a decision for the relevant consultant to make.”

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