Transcript NHS Leicester, Leicestershire and Rutland Obesity Model

Draft NHS Leicester, Leicestershire and Rutland Adult Obesity Pathway
Risk Level
Is the patient ready
to lose weight?
Interventions
Intervention Descriptor
City
County
IDENTIFICATION
ASSESSMENT ( NICE Guidance NICE CG43
Surgery Policy
High Risk
-Patients presenting with
A BMI ≥30-39 with
co-morbidities
-Patients with a BMI >40
-South Asian with a
BMI ≥25 with
co-morbidities
Medium Risk
Patients presenting with
a BMI ≥ 25-29.9 or
Patients presenting with
A BMI ≥ 30-39.9 without
co- morbidities
Low Risk
Patients presenting with
a BMI ≤ 25 and have no
co-morbidities
TIER 3
Surgical
Intervention
If Yes,
after brief
intervention
refer to
appropriate
intervention
T1,T2 or T3
NB: All patients
should be
encouraged to
use TIER 0
interventions
TIER 2
Specialist Community Weight Management
Services
Intensive behavioural change service for
individuals suffering with complex comorbidities and/or long term weight issues
DHAL
(Referral form hyperlink)
ALS
FAB
Community Weight Management Services
First line weight intervention service
LEAP
1:1 Dietetic
Appointments (*LNDS)
TIER 1
ALS
CounterWeight
(link)
ALS Criteria
Provides basic nutrition and exercise support to reduce weight
and improve quality of life
If patient NOT
ready, Signpost
to
TIER 0
And encourage
patient to
utilise
TIER 0
Universal ‘Healthy Weight’ Activity
Population Wide intervention and services
(Open Access e.g. Leisure Centres, Green Spaces, Active Travel,
Workplace Health, Community Physical Activity Sessions)
RE-ASSESS
Refer for Bariatric
Assessment/Surgery
RELAPSE RE-ASSESSMENT NEEDED
* If patient has specific condition refer to specific condition charts for in depth assessment/ intervention
-Health Trainers Leicester Health Trainers
-Change 4 Life (C4Life hyperlink)
-Physical Activity Groups
-Leisure Centre/ Community
Based Classes
(3 x 30 Pledge) Active Together
Self referral to
other suitable commercial
groups that have multicomponent approach and follow
NICE Guidance
EXIT STRATEGY
Patients presenting with
a BMI of ≥ 50
or ≥ 45 with significant
co- morbidities (local)
*East Midlands
Commissioning
Guidance Bariatric
Post intervention lifestyle change should be self sustained to achieve/maintain healthy weight
Very High Risk