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Surrey Heartlands
Tier 1:
(universal services): are freely available via the Better Health website. Commissioned by NHS England this resource is for adults only and includes the NHS Weight Loss app.
In addition, the NHS Adult Digital Weight Management Programme is available to adults who have been diagnosed with hypertension and/or diabetes. Primary Care are paid via an enhanced service to refer into this programme.
Tier 2:
Surrey County Council commission Tier 2, adult weight management service.
The service is called One You Surrey, anyone with a BMI equal or greater than 30kg2 can access the service. The pathway for the Tier 2 services includes the National Diabetes Prevention Programme. Primary Care are also paid via the enhanced service to refer into these programmes.
Tier 3: Specialised obesity services
Surrey currently has a Tier 3 service running out of Ashford and St. Peter’s.
Weight Management Service (ashfordstpeters.nhs.uk) - Introduction to the Tier 3 Service – Weight Management Program – Specialist Weight Management Services (ashfordstpeters.net)
Clinical criteria are currently under review.
Tier 4: Bariatric Service
Bariatric surgery (provided by Ashford St. Peter’s
Assessment for Surgery (ashfordstpeters.nhs.uk)
The current policy thresholds (TNRF2 041) for Tier 4 Bariatric Surgery (primary and revision surgery) are as below:
The ICB will routinely fund Primary Bariatric Surgery for patients to meet all of the following criteria.
Patient is 18 years or over
Patient has a BMI of 40kg/m2 or more
OR
A BMI between 35 kg/m2 and 40kg/m2 in the presence of other significant diseases.
Patient has undergone a formalised MDT led processes for the screening of comorbidities and the detection of other significant diseases.
Morbid/severe obesity has been present for at least five years.
The individual has attended a local bariatric surgery information session prior to referral
The individual has followed dietary, and exercise advise for at least 12 months
For patients with BMI > 50 attending a specialist bariatric service, this period may include the stabilisation and assessment period prior to bariatric surgery. The minimum acceptable period is six months.
Medicines Management team responses:
Primary Care Obesity guidance is available on the Surrey Heartlands Prescribing Advisory Database here: https://surreyccg.res-systems.net/PAD/Guidelines/Detail/4400