Tier 2 Weight Management Services

General Principals

Patients who have not been able to lose weight through advice and self care may be eligible for Tier 2 Weight Management Services.

These services currently vary across the BNSSG area but are summarised in the following BNSSG Policy (this policy is the CBA policy for tier 3 & 4 services but also summarises tier 1 - 4 services for Bristol, South Gloucestershire and North Somerset)

We have tried to summarise the local options below. Please be aware that local pathways may be subject to change.

Please also see the Digital Weight Management page on Remedy.

Patients should complete at Tier 2 Weight Management process before consideration of referral to Tier 3 & 4 Weight Management service unless BMI is 50 or over in which case direct referral to Tier 3 & 4 Service is allowable.

Referral Guidance - Bristol

The NHS Digital Weight Management Programme supports adults living with obesity who also have a diagnosis of diabetes or hypertension or both, to manage their weight and improve their health. This 12-week online programme forms part of the Tier 2 Weight Management pathway for those patients who are eligible to access and who successfully complete this programme.

BeeZee Bodies 

BeeZee Bodies will continue to run the Bristol tier 2 weight management service until at least March 2026. They accept referrals from all Bristol-based GP surgeries for online adults’ and families’ programmes, with a face-to-face, community-based, and co-produced offer to come in the next year.

They run free 12-week virtual programmes which involve a weekly, hour-long webinar with groups of families or adults. In addition, they offer the opportunity for 1-1 chats with nutritionists at the beginning, middle, and end of the programmes.

Referrals are accepted from all Bristol-based GP surgeries.

Eligibility criteria include BMI ≥25-40 (adjusted to 23 if of Black African, African-Caribbean and Asian origin) for adults. For families, they accept families with children aged 4-12 with a BMI centile >95th (the whole family unit is welcome and encouraged to attend if just 1 child fits this criteria).

Exclusion criteria - having a significant comorbidity or complex needs that may need specialist weight management, being pregnant, having a diagnosed eating disorder or bariatric surgery in the last 2 years.

Unsure if your patient falls under our inclusion or exclusion criteria? Please still refer and the team will contact the referrer or the patient to explore how they might be able to support them.

How to refer:

Website, follow the simple procedure here: https://beezeebodies.com/refer-a-client/

OR Email at beezee.bodies@nhs.net, including:

• Patient’s name
• Patient’s DOB
• Patient’s home address
• Patient/parent/carer and contact details
• Patient/parent/carer consent for us to contact them

Update July 2024 from BeeZee Bodies - Waiting times

We are currently experiencing longer waiting times for patients seeking our services, due to such a high demand. BZ Live is currently our adult programme running in Bristol, please find the link here: 
https://beezeebodies.com/programs/beezee-live/ . 

The demand has surpassed our expectations (which is exciting!), so we have recently increased the amount of people beyond our commissioned targets. 

Family Programs Availability: 

On a positive note, we still have ample spaces available in our family programs. Please find the link here: Healthy Lifestyles and Weight Management Support for Children (beezeebodies.com)
This presents an excellent opportunity for General Practitioners to refer their younger patients to our services, ensuring they receive the care they need in a timely manner. 

PLUS: our self-directed online courses are available through our BZ Academy programme: https://beezeebodies.com/programs/families-academy/ 

Gutless Program for Male Patients: 

Additionally, there are potentially available spaces in the current rotation for male patients under the Gutless program. We encourage GPs to consider referring eligible male patients to take advantage of these openings.
https://beezeebodies.com/programs/gutless/ 

Physical activity on referral 

Please see Exercise on Referral page in the self care section of Remedy

Referral Guidance - South Glos

UPDATE: From 31 March 2022, all tier 2 adult weight management support for South Gloucestershire residents will be offered through the One You SG service. For further information please refer to the services listed below. 

To refer a patient for weight management support please complete the ‘South Glos Weight Management on Referral Form’ via EMIS. A patient can also self-refer by completing the One You Contact Form

If you have any questions related to this update, please contact Sarah Amos - Sarah.Amos@southglos.gov.uk 

Healthy Weight Programme (adults)

Eligible South Gloucestershire patients can access a free 14-week programme delivered by the Active Lifestyle Centres. This includes an in-person 1:1 consultation followed by 5 group support sessions and access to all leisure facilities throughout the 14-week period. 

Eligibility 

• Aged 18 years or more
• Has a BMI ≥30 with no co-morbidities (adjusted to BMI ≥28 with co-morbidities or BMI ≥27.5 in people of Black African, African-Caribbean, and Asian origin) 
• A South Gloucestershire resident or registered with a South Gloucestershire GP
• Is clinically stable
• Is not pregnant
• Does not have a history of or an ongoing eating disorder 

Referral  

Patients can be referred to the programme by the One You team, to refer a patient use the ‘South Glos Weight Management on Referral Form’ via EMIS.

If you have any questions relating to the Healthy Weight Programme (adults) please call 01454 865337 or email oneyou@southglos.gov.uk 

An adult that meets the above criteria will also have the option to attend the Healthy Weight Programme for families, depending on their child's circumstances. Further information can be found on the Children's Remedy Weight Management page here 

Referral Guidance - North Somerset

Also see the Better Health North Somerset page on Remedy.

The services currently commissioned are:

Slimming World – free 12 weeks via GP referral 

The GP prints/emails the North Somerset Slimming World Referral Letter and gives to patient (Available as an EMIS template). The patient calls telephone number on the letter or uses the link / QR code provided to complete online registration. When the patient registers with Slimming World they will double check their eligibility, book them on to their preferred group for the first 12 weeks free of charge.

Eligibility - patients referred to the service must fulfil the following criteria to enter the scheme:

Person aged 16 years or more and resident in North Somerset with the following:

• Has not attended a slimming club in the 12 months prior to referral (self-funded or referred by health professional)
• Person is ready to lose weight
• BMI equal to or greater than 30 or BMI equal to or greater than 28 with comorbidity, or from Black Caribbean, Black African and Asian ethnic group OR
• BMI > 91th centile on gender appropriate centile BMI charts, if aged 16-17. Those aged 16-17 will need to be accompanied by an adult when they attend

Those not suitable for referral include: person with diagnosed eating disorder, person with significant unmanaged co-morbidity / underlying medical cause for obesity which requires more intensive support, person is pregnant, person has severe/moderate frailty as recorded on a frailty register, person has had bariatric surgery in the last two years. Note: there is no upper BMI limit for the service as per Weight management: lifestyles services for overweight or obese adults NICE guidance

For further information about Slimming World patient referrals please contact the Slimming World referral team Tel: 01773 483247.

Healthy Lifestyles Advisors

This is a free service available those who are over 18, living in North Somerset or registered with a North Somerset GP practice.

The service provides tailored advice to help achieve health goals (weight loss, get active, eat well, liver health) including 1:1 and group support over a duration of 12 weeks.

Please see the www.betterhealthns.co.uk website for additional information including information about how patients can self refer via the Self Refer Form, there is also a Practitioner Referral Form

The team can also be contacted by email on healthylifestyles@n-somerset.gov.uk or telephone 01934 427661.

H.E.N (Health, Exercise, Nutrition in Pregnancy)

HEN takes place at Oldmixon Children’s Centre in Weston-super-Mare, and is delivered by Public Health Lifestyle Advisors and a Registered Midwife.

Eligibility criteria:

• Resident in North Somerset
• Pregnant
• Able to attend a minimum of four sessions

Please see https://www.betterhealthns.co.uk/healthy-families/healthy-pregnancy/h-e-n-in-pregnancy/ for further information.

H.E.N (Health, Exercise, Nutrition Post Natal)

HEN Postnatal is a free healthy lifestyles course for mums who have given birth in the last year.  The course offers weekly support for up to 12 weeks, to help mums feel better about themselves and focusses on:

• participation in physical activity (40 minutes of the session will include taking part in gentle exercise)
• eating well advice
• goal setting
• motivational support and tips to stay on track
• general wellbeing support and signposting
• individuals can also opt in/out of weight check in’s at some of the sessions if weight loss is a goal for them

The course is designed as a rolling programme so that mums can join at any time to start the 12 weeks of support, it is expected that participants attend at least 9 sessions within 12 weeks.

There is no body mass index (BMI) criteria to access the support but participants must live in North Somerset or be registered with a North Somerset GP practice and have a baby aged 0-12 months old.

To find out more email: healthylifestyles@n-somerset.gov.uk or call 01934 426349.

https://www.betterhealthns.co.uk/information/hen-postnatal/

Healthy You (previously called Choose 2 Lose)

12 weeks of free behaviour change support to improve healthy habits, focussed on healthy eating and exercise. Each session is interactive, lasts 90 minutes and covers different topics each week e.g. portion sizes, healthy food swaps, setting goals, taking part in physical activity, local support and signposting.  At each session participants will have the opportunity to take part in 45 minutes of physical activity which will vary each week.

Eligibility criteria

Our target cohort is adults aged 18 years and above, living in North Somerset (or registered with a North Somerset GP practice) with a BMI ≥28 (adjusted to ≥25 in people of Black African, African-Caribbean and Asian origin and those living with comorbidities).

To get the most out of the course it is expected that participants attend at least 9 sessions (to include week 6 and week 12), those attending at least 9 of the 12 sessions will be eligible for two months free Legacy Leisure gym membership worth £88.

The service will focus on reaching higher risk groups, including adults living in areas of deprivation, BME groups, those with a disability and/or long-term health conditions.

Exclusion criteria

• An individual who does not meet the eligibility criteria as defined above
• Severe/moderate frailty as recoded on a frailty register
• Has a diagnosed eating disorder
• Has a significant unmanaged co-morbidity e.g. chronic obstructive pulmonary disease, unmanaged meaning not on medication and/or not subject to regular clinical review or have not completed a current active management programme such as diabetes management or cardiac rehabilitation
• Has had bariatric surgery in the last two years

This programme is currently available at:

• Hutton Moor Leisure Centre, Weston-super-Mare
• Scotch Horn Leisure Centre, Nailsea

For further information visit: Healthy You 

The Lose Weight webpage lists all of the weight management support available in North Somerset, please feel free to share this link with patients. 

Resources

Additional Services

To find additional services within BNSSG please use your MiDoS Login: Login - MiDoS Admin - 2019 (midosweb.co.uk) If you need your password resent, or be issued with one, please contact: Dosteam.southwest@nhs.net

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.