Tier 2 Weight Management Services - BNSSG (DRAFT)

Overview

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

These options vary across the region and local pathways are subject to change.

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

NHS Digital Weight Management Programme

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.

For those patients who are eligible to access and who successfully complete it, this 12-week online programme forms part of the Tier 2 Weight Management pathway.

Local Services - Bristol

Beezee Adults is Bristol's weight management programme offered by Maximus UK. They help adults lose weight in a healthy way and keep it off for good. Services available and how to access them are outlined below.

Online Group Sessions

Due to unprecedented demand, there is a significant waiting time for this service. This varies each month so an exact timeframe cannot be given however, this could be anywhere from 3 - 12 months, based on number of referrals received. In the meantime, patients should be encouraged to access Beezee Academy to access the self-led intervention as well as signposted to the Beezee community page that details resources and local activities available.

Beezee Adults Academy

Six months of free access to the online learning platform, the ‘Academy’, where people can learn at their own pace.

Eligibility:

• Available for Bristol residents over 18years.

Referral: 

• Self referral through the online learning platform.

Gutless - men’s online course

A free online weight loss programme just for men. Support includes:

• Online group sessions for one hour every week for 10 weeks.
  • Support from a nutritionist who will check in throughout the programme.
  • A casual, fun, laid-back atmosphere.

Eligibility

• BMI ≥25-40 (adjusted to 23 if of Black African, African-Caribbean and Asian origin).

Exclusions:

• Having a significant health condition or illness (co-morbidity) in the same individual which has a substantial impact on the patient's health and their ability to take part in the programme. This would mean the Tier 2 intervention is unsuitable.
• Having a complex need which requires an elevated level of support or may rely on other services due to a significant health condition, disability or broader life circumstances. This may involve challenges around mental health, communication, behaviour, sensory input or cognitive ability. As the programme is designed for Tier 2, the individuals need to be able to have autonomy over their participation.
• Having a diagnosed eating disorder
• Having had bariatric surgery in the last two years
• Pregnancy

Referral:

Self or Health Professional Referral via website:

• Patient follows the simple steps here: Gutless - Free Healthy Lifestyle Services
• Health professional referral using: Referrers - Free Healthy Lifestyle Services

Or email:

hellobristol@maximusuk.co.uk providing as much detail as possible including name, DOB, gender, home address (including post code), and BMI. A contact phone number for the patient/parent/carer is required as this is the key contact method. Consent is needed for us to contact them with this.

Beezee Families

If the adult is part of a family with young children aged between 4-15 years old they can also learn at their own pace on the Families Academy by signing up to the online learning platform

Community resources and activities

Explore free resources for adult, children and families on mental health and getting active in their area. Community resources and activities - Free Healthy Lifestyle Services | Bristol

Local Services - North Somerset

Slimming World

Free 12 weeks access via GP referral 

Eligibility:

• Aged 16 years or more and resident in North Somerset AND
• Has not attended a slimming club in the 12 months prior to referral (self-funded or referred by health professional)
• 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.

Exclusions:

• Diagnosed eating disorder
• 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

Referral

GP should print/email the North Somerset Slimming World Referral Letter (also available as an EMIS template) and give to the patient.

Patient should then call or use the link / QR code provided to complete the online registration. Once they have registered, Slimming World will double check their eligibility and book them on to their preferred group for the first 12 weeks, free of charge.

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 Better Health North Somerset for additional information, including how patients can self-refer and 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)

Postnatal HEN 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.

The course is designed as a rolling programme so that mums can join at any time and it is expected that participants attend at least 9 sessions within 12 weeks.

Eligibility:

• Must live in North Somerset or be registered with a North Somerset GP practice
• Have a baby aged 0-12 months old.

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

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.

This programme is currently available at:

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

Eligibility criteria:

• Adults aged 18 years and above, living in North Somerset (or registered with a North Somerset GP practice)
• 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

Referral:

Self refer via Healthy You | Better Health North Somerset

or contact Legacy Leisure:

Email: kylie.taylor@legacyleisure.org.uk

Call: 01934 425900 (ask for Kylie Taylor)

Additional local resources

The Lose Weight webpage lists all of the weight management support available in North Somerset

Also see the Better Health North Somerset page

Local Services - South Glos

Please consult the South Gloucestershire Healthy Weight Pathway below to determine the most appropriate service for the patient and follow the relevant referral process outlined.

Further information and how to refer is provided below.

Healthy Weight Programme

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)
• 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:

Please complete the ‘South Glos Weight Management on Referral Form’ on EMIS.

Patients can also self-refer by completing the One You Contact Form. 

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

Healthy Weight Programme for families

Adults that meet the Healthy Weight criteria will also have the option to attend the family programme, depending on their child's circumstances.

Further information can be found on Weight Management for children (tier 1 and 2) 

Additional local resources

Health & Happiness Hubs are a collaboration between South Gloucestershire Council, GP surgeries, South Gloucestershire Locality Partnership and Southern Brooks, for people with a long-term health condition who want to make positive changes to improve their health and happiness.

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.