Four brown chairs in a waiting room

Tackling NHS waiting lists: The role of weight management services

How can we reduce NHS waiting lists with weight management services?

At Oviva, we know that backlogs in the NHS are a big and complex problem. We are working in partnership with NHS professionals from across England to advocate a solution.

We are not saying this will solve the backlogs in the NHS, rather that this is one of many solutions that will help cut waiting lists and benefit the millions of people living with obesity and diabetes.

NHS Waiting Lists Google Search Engine Results

NHS Waiting Lists Google Search Engine Results May 2023

Our waiting lists on the NHS are rocketing

A record high of over 7 million people are waiting for treatment. The total number of patients waiting over 18 weeks for treatment now stands at 2.87 million, while the number of patients waiting over a year for treatment has exceeded 401,000. This is around 308 times the 1,305 people waiting over a year pre-pandemic in 2019. [BMA, November 2022].

We can significantly cut our NHS waiting lists by helping the many millions of people living with obesity and diabetes to better manage their conditions.

There are 25.6 million overweight adults in England – 62.3% of the total adult population. Of this, 11.4 million adults (25% of the population) are living with obesity. [Public Health England]. 3.8 million people are living with Type 2 diabetes with a further 12.3m at risk [Diabetes UK].

Obesity and Type 2 diabetes reduce people’s quality of life and life expectancy. They impact on people’s mental health, and lead to serious illnesses such as cancer as well as heart, kidney and liver disease. Furthermore, these conditions are putting immense pressure on our health system, driving up our waiting lists, and costing society many millions through lost productivity.

A new generation of medicines for obesity and Type 2 diabetes (GLP-1 Receptor Agonists), which have recently been approved by NICE, create a financial risk to the NHS. Effective, scaled weight management services are needed to prevent this.

It is estimated that the direct cost to the NHS of treating obesity is £6.5 billion a year1 and a further £11.7bn for treating Type 2 diabetes2. Professor Jonathan Valabhji, Clinical Director for Obesity and Diabetes, stated at Diabetes Professional Care 2022 that we need BMI as a 4th treatment target for Type 2 diabetes, as weight management is critical for its treatment.

What Oviva and industry professionals are asking for

We are asking for just 2% of the total cost to the NHS — £300 million — to be invested in treating obesity to prevent the expensive consequences for the NHS and wider society. We have come together from across the NHS to specifically ask for the following:

1The Government is rightly focusing on building hospitals and recruiting nurses. To complement this, we would like the reinstatement of £70 million of ringfenced funding for ICSs to commission new, localised, and more cost-effective weight management services. This funding was withdrawn in April 2022, just a year after it was first announced.
2We would like the Department of Health and Social Care to reserve £150 million to commission digital therapeutics for weight management for people living with obesity and Type 2 diabetes — helping the UK catch up with European nations funding digital therapeutics such as Germany. These can provide personalised coaching and medical care, including culturally sensitive support in different languages, meaning we can reach those most in need.

Face-to-face weight management will only ever be accessible to a small percentage of people due to barriers like travel, parking, childcare, stigma, time off work and language. Digital therapeutics have a lower delivery cost, supporting more people living with obesity within the same fixed budget.

3We would like £80 million ringfenced for ICSs to commission Specialist Tier 3 Weight Management services (help for people living with more severe obesity and complex needs who need more intensive intervention). These services are not currently nationally funded.

Furthermore, local commissioners are not mandated to ensure that their residents have access to these specialist services, resulting in significant gaps in access and excess NHS costs from treating complications of complex obesity such as Obstructive Sleep Apnoea. Analysis in 2015 suggested that these services were not available to residents in 40% of commissioning areas3. More recent analysis by Oviva suggests commissioning of such services has further declined, and the number of places per ICS is typically less than 0.1% of the eligible population, meaning that the significant unwarranted variation in access to services remains.

This relatively modest investment of £300 million, just 2% of what the NHS spends on treating obesity and Type 2 diabetes, will help clear the backlog in the NHS. It will pay for itself in the next 1-3 years by cutting the number of people needing treatment for obesity and Type 2 diabetes related conditions (which are driving up waiting lists). It will make treatment more accessible for those with disabilities and mobility issues, as well as harder to reach groups such as working men and women and ethnic minorities.

Current backers

Dr Mark Jenkins
Medical and UK Managing Director, Oviva

Dr Tom Milligan
General Practitioner, Clinical Lead for Diabetes Humber and North Yorkshire ICB

Dr Shaw Somers
Specialist Bariatric Surgeon, Council member of the APPG on Obesity

Dr Simon Monkhouse
Consultant Upper Gi & Bariatric Surgeon, Surrey and Sussex Healthcare NHS Trust

Dr Tom Barber
Associate Professor and Honorary Consultant Endocrinologist, University of Warwick and University Hospital Coventry & Warwickshire

Dr Rolan Schreiber
GP Associate Director, City Health Care Partnership, East Riding

Joanne Black
Programme Director for MSc Nutrition and Dietetics, University of Hull

David Stobbs
Senior Public Health Practitioner, Public Health Team, Newcastle Council

James Hobkirk
Lecturer in Physiology & Pathophysiology, University of Hull

Liz Wells
Lecturer in Nutrition and Dietetics, University of Hull

Anne Phillips
Professor in Diabetes Care, Birmingham City University

Julie Schreiber
Dietician, Humber Teaching NHS Trust

Add your support

This statement has been initiated by Oviva, in consultation and partnership with NHS professionals across England. If you would like to add your support for the statement, please enter your details below.