What’s happening in Tier 3 weight management services?

Challenges for Tier 3 Weight Management commissioning

Workforce pressures, staff vacancies, extensive waiting lists and barriers to equitable care are challenges that put increasing strain on the NHS.

The latest NHS reorganisation seeks to join up healthcare services on a regional level, but this reshuffle brings its own challenges.

But what exactly is the issue?

9 in 10 NHS leaders say their efforts to reduce the size of the waiting list are hindered by lack of investment in buildings and estate

Two thirds say they do not have enough capital funding to meet ‘digital ambitions’

9 in 10 say they cannot transform patient services to meet current NHS England Long Term Plan targets without further capital

Cost of provision

With growing pressure to do and achieve more with less funding, finding ways to drive efficiency is always high on the agenda. The new ICSs have four overarching objectives, one of which is to enhance productivity and value for money.

The Department of Health and Social Care recently announced a £20 million research boost to develop new obesity medicines and digital technologies, aiming to help people lose 20% of their body weight.

The treatment of obesity is very important in improving the health of the nation, and increasing the funding for research in this area is much needed. However costs of treatment in NHS budgets are massively increasing, and with this comes a tidal wave of cost pressure from new drugs such as GLP-1s.

Psychological input and population health

Studies have shown evidence of a relationship between weight loss and an improvement in mental health and quality of life in an obese population. When commissioning a service it is important to take into consideration:

  • behavioural change science
  • ease of access
  • appropriate psyche and medicines management support

This will support achieving the desired outcomes across the population, and not exclude anyone from accessing the appropriate care for them.

Despite this evidence there is a lack of guidance and agreement about what specific components of behaviour change an effective weight management service should include.

The impact on quality of life is important when evaluating weight management interventions, whether weight loss is achieved or not.

This should be considered when delivering such services.

By looking at a quality of life score, you can understand from a behavioural perspective what aspects of the intervention are meaningful to the participant.

There appears to be a bi-directional link between depression and obesity, so it is important to consider the broader, holistic benefits programmes can have for participants.

Our data shows that PHQ-9 scores are decreased as participants progress through our Tier 3 Weight Management programme, with 48% of participants moving to a less severe depression category after 6 months.

Read our service evaluation

Health inequalities

Nearly two-thirds of adults in England are overweight or living with obesity. Inequalities in the prevalence of obesity exist in relation to deprivation, ethnicity, gender, geography and mental illness.

Average female life expectancy is 83 years but only 63 years will be spent in good health

Men in the most affluent areas of the country live nearly 10 years longer than those in the more deprived on average

Women in the most affluent areas spend 15 years in poor health, those in the most deprived spend 27 years in poor health (one third of life)

Tackling health inequalities is top of the NHS agenda, in particular the lack of access to care in areas with high levels of deprivation, for people with disabilities, and from ethnic minority backgrounds. The recent CQC annual report on the state of health and care in England said this needed to be addressed as a matter of urgency.

More flexible ways to access support for weight management are needed, one route to consider is through tapping into the potential offered by a range of digital services, where evidence of effectiveness is still emerging.

Get in touch

Over seven million people are currently on NHS waiting lists for elective care in England, placing a huge strain on NHS staff and services left with poor communication systems to manage the elective backlog.

One way we’re supporting Trusts to manage this is via Oviva Way to Wellness, our Tier 3 Weight Management service.

Oviva works closely with commissioners and local health professionals to understand the needs of the local population to address inequalities, rising costs and lengthy waiting lists.

Get in touch below to find out more.