Obesity, to state the obvious, is a growing problem - and the medical equipment to deal with larger patients is growing, too.

Recent reports of bigger beds, extra-strong hoists and reinforced ambulances are likely to raise an eyebrow, even a snigger. For instance, the Welsh Ambulance Service hit the headlines recently when it bought eight extra-wide ambulances, each with a reinforced stretcher and a winch for lifting extra-heavy patients into the vehicle. But though many might joke about them, purchases are significant in terms of NHS costs.

A quarter of British adults are obese. Although there are no specific figures on the number of obese patients, it is fair to estimate that of the 13 million hospital admissions every year, thousands of patients require special equipment because of their size.

Obesity costs the NHS £9 billion a year, but the Department of Health does not break down figures to show what proportion relates to bespoke equipment. However, Norman Lamb MP, the Liberal Democrat health spokesman, conducted an investigation into the problem last year. He questioned 150 trusts and found, on average, that they treated 371 obese patients a year each and spent £60,000 on specialist equipment, a figure that had doubled in three years. This would equate to more than £10 million a year if all of the 172 acute hospital trusts in England and Wales were spending the same. Trusts in more deprived areas showed the highest costs, with the Dudley Hospital Group in the West Midlands spending £295,000 on equipment for obese patients over three years and Royal Cornwall Hospitals Trust spending £212,000 in the same period.

Lamb says: “We were gobsmacked when some of the answers came back. It was quite shocking but fairly inevitable given the changes we are experiencing. Hospitals have no option but to make the investment because they have to respond to the healthcare needs of those who are presented to them. The brutal truth is that those needs are changing and this is putting significant financial pressure on our hospitals.”

But what, exactly, is being being supersized in the NHS?

BEDS AND CHAIRS

Hospitals have found that standard hydraulic foot-operated beds, which can lift 25st (160kg), are not robust enough to take seriously obese patients. Manufacturers are now supplying electric reclining beds, which can take up to 39st as the new standard. Even so, higher capacity is sometimes needed. The 950-bed Aintree University Hospitals Trust has three beds with integral scales that can take up to 70st, and has just ordered another. They cost almost £9,000 each.

Bedside chairs also need to be wider, with a higher capacity. Vinyl static chairs that can take up to 60st cost £400.

Standard wheelchairs are 17in (43cm) wide, but larger ones at 28in or 30in with a capacity of 60st are being introduced. These cost £1,500 compared with £300 to £400 for the traditional version. Southend University Hospital Foundation Trust has recently bought two lectric wheelchairs for obese patients.

SCANS AND X-RAYS

Obese patients are difficult to scan. First, it is hard for them to get into tube-shaped CT and MRI scanners where they can become wedged; and, secondly, ultrasound and X-rays take longer and are more difficult to read because of the layers of fat the waves have to pass through. Reading them is “like shining a torch into fog”, according to one radiologist. Obese people are harder to examine clinically; it's more difficult to feel abnormal lumps and bumps, so scans are very important. The platforms they lie on need to be stronger, too.

As a result, technology companies are inventing alternatives. Philips has developed a £10,000 ultrasound scanner called the C5-1 PureWave transducer, which can “see through” fat. It has been used at the Freeman Hospital in Newcastle as part of a trial since April 2007 and is now in 25 NHS hospitals. Dr Simon Elliott, a consultant radiologist, says it has cut examination times by a third and reduced the need for additional CT or MRI scans because of poor-quality results by almost 20 per cent.

Enclosed MRI scanners are being built with higher platform capacity and wider tube aperture, while Open MRIs have been developed more recently. A Philips version allows three times more space and takes a weight of 39st, but it comes with a price tag of £1 million.

SURGICAL EQUIPMENT

Surgical instruments including scissors, graspers (which hold tissue out of the way) and needle-holders for suturing are no longer long enough for keyhole surgery on some obese patients. As a result, UK companies such as Surgical Instruments Group Holdings, which distributes the instruments to the NHS, are providing longer versions. The standard size is 12in, and they cost £700 each, but the new ones measure almost 18in and cost £800 to £900 each. David Peddy, the managing director, says: “It's only a handful of hospitals needing this, but it is going to be increasing in demand.”

Operating tables, too, are getting stronger, with Swindon and Marlborough NHS Trust having bought ones taking 35st while the new University College Hospital in London has one that takes 47st and costs more than £20,000.

HOISTS AND 'HOVERMATTS'

Hoists and slings are commonplace in hospitals to lift patients, and mobile floor-based hoists costing £2,000 to £3,000 can take up to 47st. However, these are hard to move with an obese patient. As a result, more overhead gantry systems, which cost £5,000 to £6,000, are needed. These slide on a beam, making it possible to move a very heavy patient from bed to chair.

The “HoverMatt Air Transfer Mattresses” uses the hovercraft principle to help transfer patients from, for example, a trolley to an operating table. A deflated mattress with hundreds of holes on the underside is placed under the patient, which is then inflated. A cushion of air is created below the patient, which makes it easier to push them across on to another surface. There is no weight limit. Aintree Hospital Trust has just purchased ten, at a cost of £2,700 each.

MATERNITY

A recent study of 16 maternity units in the North East of England into the effects of obesity found the need for specialist equipment was one of the main concerns of midwives and other staff. Larger delivery beds in labour suites, bigger blood-pressure cuffs for monitoring and longer needles for epidurals were needed.

When husbands wanted to accompany their wives into theatre, many were as obese as their wives, so sterile “pyjamas” in much larger sizes were required, too.

Obesity in numbers

2050 By this year half the adult population of the UK could be obese

30% of children are obese or overweight

54,000 is the drop in the number of gym memberships from 2006 to 2007

£4.89 million how much the Scots spent on anti-obesity drugs last year

Source: Times database

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