Tier 3 Weight Loss

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The Weigh Ahead Specialist Weight Management Programme

Spire Healthcare

Tier 3 service for potential access to bariatric surgery.
No current access for GLP1 medication. Long waiting times.
Code “referral to weight management service” (£11.50 per referral)
 
Inclusion Criteria:  
 
Patients need to have a BMI greater than 35 with an obesity-related co-morbidity (eg Hypertension, Type 2 Diabetes, high cholesterol, severe arthritis) or BMI greater than 40 without an obesity-related co-morbidity
 
Patients need to have completed a Tier 2 service/intervention in the past two years.
 
This could any of the following:
  • a locally commissioned service (see page 1 for Tier 2 services)
  • prescribed Orlistat by GP
  • referred to an ‘exercise on referral’ scheme
Exclusion Criteria:
  • Patients must not have been enrolled on or completed the Tier 3 programme previously
  • Any patient with serious uncontrolled disease, e.g. angina, asthma, COPD, heart failure, aortic stenosis
  • Recent complicated Myocardial infarction and/or awaiting further investigation
  • Uncontrolled arrhythmia that compromises cardiac function
  • Blood pressure at rest above 180mg Systolic, 120mg Diastolic
  • Clients with an unstable psychiatric disorder
  • Acute infection
  • Pregnancy
Referral Info:
 
Bloods needed within 6 months:
  • Thyroid
  • Lipids
  • U&E’s
  • Liver Function
  • Fasting Blood Glucose
  • HbA1c (if diabetic)
Referral form on Ardens:
Ref – Spire – The Weigh Ahead TIER 3 Specialist Weight Management Programme
 
Attach to e-referral under “Health Promotion”
 
Code “referral to weight management service” (£11.50 per referral)
 
 
 

Portsmouth Hospitals University

Integrated Complex Obesity Service (ICOS) Tier 3 service providing specialist multidisciplinary management of obesity 
 
Code “referral to weight management service” (£11.50 per referral)
 
Inclusion Criteria: 
  • BMI 35+ with 2 or more co-morbidities defined on referral form
  • BMI 50+ no comorbidities
  • Must be smoke free
  • NB PO1-PO6 only
Exclusion Criteria:
 
Must have completed 6 months in a Tier 2 prior to referral
 
Referral Info:
 
GP and Wellbeing Service referral only
 
 
Prediabetes and Type 2 Diabetes Specific Services
 
 
 

Healthier You

NHS Diabetes Prevention Programme
 
Virtual or Face to Face offer for patients at risk of Type 2 Diabetes. Code “referral to weight management service” (£11.50 per referral)
 
Inclusion Criteria: 
  • Prediabetes (HbA1c 42-47) or Fasting Glucose 5.5-6.9 within the last 12 months. 
  • Or History of Gestational Diabetes.
Exclusion Criteria:
 
Diabetes Diagnosis (all types except Gestational)
 
Referral Info:
  • Referral form on Ardens: Ref – NDPP – NHS Diabetes Prevention Programme Referral
  • Email to address on form.
  • Code “referral to weight management service” (£11.50 per referral)

NHS Type 2 Diabetes Path to Remission Programme (Soups and Shakes Diet)

 

 

Xyla

One-to-one in person support; or
One-to-one digital support
 
The programme involves 12 weeks of a low-calorie diet (shakes and soups supplied) followed by the reintroduction of food, focusing on movement and maintaining a new healthy eating lifestyle.
  • An initial one-to-one assessment
  • 20 sessions with a Health & Wellbeing diabetes practitioner
  • 39 online support modules
  • Final one-to-one assessment
Code “referral to weight management service” (£11.50 per referral)
 
Inclusion Criteria: 
  • Aged 18–65 years
  • Diagnosis of Type 2 diabetes within the last 6 years
  • Have a BMI over 27 (or over 25 if you are of Black, Asian or minority ethnic origin)
  • Also need to meet various other eligibility criteria (see referral form) and be willing to commit to the 12-month programme
Exclusion Criteria:
  • Current insulin user
  • Someone who is pregnant or planning a pregnancy in the next 12 months
  • Someone who has had bariatric surgery
  • Someone who has completed the programme in the last 12 months
Referral Info:
  • Needs GP assessment pre referral to check Diabetes and BP medications.
  • HbA1c needed within 12 months.
  • Referral form on Ardens:
  • Ref – Xyla – Type 2 Diabetes Path to Remission Programme
  • Form sent to email on form.
  • Code “referral to weight management service” (£11.50 per referral)
 
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