I AM writing to clarify the details of decisions taken by NEW Devon Clinical Commissioning Group (CCG) to prioritise urgent health services as well as those laid out in the NHS constitution. Last month we announced that demand for services was outstripping what we in the NEW Devon CCG area can afford. We could not allow this to continue and therefore had to take urgent measures to curb healthcare expenditure and protect priority services. GPs who work for the CCG reviewed a number of potential measures and all were considered against clinical criteria and clinical evidence. We then decided on a series of measures to implement, including, as has been widely reported, asking people to lose weight and give up smoking before routine surgery. We did this because it is widely recognised that patients who are overweight with what is known as a high body mass index (BMI) should aim to lose weight and smokers should stop smoking to improve their general health. There is also clear evidence of better results for patients where they lose weight or quit smoking before undergoing surgery and this is the basis of our decision-making. Where people have lost weight or given up smoking they will have a greater chance of an effective outcome from their operation. We consider that this is a reasonable way for us to carry out the duties of the CCG to most effectively, efficiently and economically provide health services for local people. In all cases decisions are currently interim or temporary commissioning positions based on current clinical evidence and we will go on to consult further with local people, local specialists and local GPs in 2015 before making any longer term decisions. We consider that this process has been applied fairly and transparently. Regrettably, in some instances, we have been inaccurately reported and criticised for introducing a 'blanket ban'on surgery for these groups. This is not and never has been the case. Wherever a patient or GP believes there to be exceptional circumstances, each case will be considered on its individual clinical merit. No patient will be denied treatment on the basis of finances. Information on the measures is available from our website http://www.newdevonccg.nhs">www.newdevonccg.nhs. uk Thank you for taking the time to read this letter and please do all you can to use your NHS wisely. Dr Tim Burke Chair NEW Devon CCG