Tier three weight management services are a specialised form of weight management, typically offered through NHS services, that provide intensive support for individuals struggling with obesity. These services often involve a multi-disciplinary team (MDT) approach, incorporating expertise from dieticians, psychologists, physical activity specialists and other healthcare professionals. The goal is to help individuals achieve sustainable weight loss and improve their overall health through lifestyle changes, behavioural modifications and in some cases with the aid of weight-loss medications.
Tier three services are a step below the more extreme tier four, which involves patients undergoing bariatric surgery. Typically, a patient will only access tier four having demonstrated a genuine attempt to manage their weight under a tier three service.
In Lancashire and South Cumbria, services are delivered in a non-uniform way based on historical commissioning arrangements inherited by the ICB, which replaced the former eight clinical commissioning groups (CCGS) in Lancashire and South Cumbria. Access to services can be further complicated by providers being awarded contracts in other areas of the country and thus obtaining a ‘qualifying contract’ under the NHS’s patient choice framework.
The ICB has committed to looking at ways to standardise tier three weight management services across Lancashire and South Cumbria to reduce inequity and postcode lotteries and to ensure best value for money both for the NHS and for taxpayers living in the region. As part of this review, the views of patients who have experienced the current tier three weight management services in Lancashire and South Cumbria were sought.