Weight Management (Kirklees) Care Pathway

Review in progress

Disclaimer: The guidance contains helpful primary care information for management of referrals and up to date referral criteria. These guidelines are locality specific to best reflect local services. This guidance does not override or replace the individual responsibility of healthcare and social care professionals involved in the delivery of care to make informed professional judgements appropriate to the circumstances of the individual.

Scope

This guidance refers to:

  • Referrals to the Interim Weight Management Provision for tier 2 and tier 3 services
  • Patients 16 + years
  • Patients living in the Kirklees district (North Kirklees & Greater Huddersfield).

This guidance does not cover:

  • Patients who live outside the Kirklees district (non-Kirklees Council Tax Payers).
  • Tier 1 (universal) service.
  • Tier 4 (bariatric) service.
  • Patients under 16 years.
  • Pregnant Ladies.
  • People with a diagnosed eating disorder.

Commissioning Statement:

  • See commissioning policy for further information - UNDER DEVELOPMENT

Assessment

Ensure patient is ready to make behaviour change

Signs and Symptoms

  • Patients with BMI 30+ for tier 2
  • For patients with co-morbidities or who are of South Asian, Black African or Japanese ethnicity, lower BMI thresholds of 2.5kg/m2 should be applied. Eg. BMI 30 is equivalent to 27.5.

History and Examination – Tier 2

  • Weight
  • Height
  • BMI
  • Blood pressure
  • Alcohol units per week

Indicate if the patient has any of the following co-morbidities:

  • Eating disorder (please describe)
  • Type 1 diabetes
  • Obstructive Sleep Apnoea (OSA)
  • Coronary Heart Disease / Vascular / Disease includes angina / arrhythmias, tachycardia; recent episode
  • Pulmonary disease / asthma
  • Hypertension
  • Type 2 diabetes
  • Polycystic Ovarian Syndrome (PCOS)
  • Back pain / osteoarthritis / rheumatoid arthritis
  • Impaired mobility
  • Cancer (any form)
  • Mental Health concerns – on medication and stable for 12 months
  • Personality disorders – on medication and stable for 12 months

Investigations

Undertake the following to aid diagnosis, inform management or prior to referral:

For BMI 45+ or BMI 40+ with complex co-morbidities please supply:

Full medical history

Blood results (within the last 6 months) for:

  • Total Cholesterol
  • Haemoglobin
  • HbA1C
  • HB
  • Creatinine
  • LFTs
  • TSH
  • T4

Referral

Referral Criteria

  • Patients 16+
  • BMI 30+ or 27.5+ with co-morbidities or of South Asian, Chinese or Japanese ethnicity for tier 2
  • Patients who have not previously attended self-funded session in the last 6 months prior to referral
  • Please provide information about any comorbidities
  • Patients with unstable mental health concerns should not be referred
  • Be committed to achieving and maintaining a healthy weight.
  • Score medium to high on the confidence and motivation to change.
  • Be committed to attending regular appointments within the service.

Commissioning Statement:

  • Referral to Weight Management Services is the only route for NHS funded surgery in our locality
  • See commissioning policy for further information - Under Development

Referral Instructions

  • Patient and Health professional to complete referral form

Required forms

Supporting Information

Shared Decision Making

  • Patients have a right to make decisions about their care and should be fully informed about the options they face. They should be provided with reliable evidence-based information on the likely benefits and harms of interventions or actions, including any uncertainties and risks, eliciting their preferences and supporting implementation. If relevant patients should be signposted to Obesity decision aid which can be printed off for the patient if required

Patient information/Public Health/Self Care

Evidence/Additional information

Assurance & Governance

  • This guidance was developed on: 02.2017
  • This Care Pathway was ratified by: The OSCAR Assurance Group
  • Date ratified: 03.2017
  • Publication Date: 05.2017
  • Last Updated: 12.2017
  • Review Date: 12.2020
  • Ref No: LW5 - 02.2017
Any feedback or suggestions to improve this guidance should be sent to:oscaradmin@this.nhs.uk
Only the electronic version is maintained, once printed this is no longer a controlled document

 

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