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Draft NHS Leicester, Leicestershire and Rutland Adult Obesity Pathway. Interventions City County. Risk Level. Is the patient ready to lose weight?. Intervention Descriptor. Very High Risk Patients presenting with a BMI of ≥ 50 or ≥ 45 with significant
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Draft NHS Leicester, Leicestershire and Rutland Adult Obesity Pathway Interventions City County Risk Level Is the patient ready to lose weight? Intervention Descriptor Very High Risk Patients presenting with a BMI of ≥ 50 or ≥ 45 with significant co- morbidities (local) *East Midlands Commissioning Guidance Bariatric Surgery Policy If Yes, after brief intervention refer to appropriate intervention T1,T2 or T3 NB: All patients should be encouraged to use TIER 0 interventions Refer for Bariatric Assessment/Surgery ASSESSMENT ( NICE Guidance NICE CG43 EXIT STRATEGY Post intervention lifestyle change should be self sustained to achieve/maintain healthy weight IDENTIFICATION TIER 3 Surgical Intervention 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 TIER 2 Specialist Community Weight Management Services Intensive behavioural change service for individuals suffering with complex co-morbidities and/or long term weight issues DHALLEAP 1:1 Dietetic Appointments (*LNDS) (Referral form hyperlink) ALS Medium Risk Patients presenting with a BMI ≥ 25-29.9 or Patients presenting with A BMI ≥ 30-39.9 without co- morbidities TIER 1 Community Weight Management Services First line weight intervention service Provides basic nutrition and exercise support to reduce weight and improve quality of life FAB Counter- Weight ALS(link) ALS Criteria Low Risk Patients presenting with a BMI ≤ 25 and have no co-morbidities -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 multi- component approach and follow NICE Guidance 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 RELAPSE RE-ASSESSMENT NEEDED * If patient has specific condition refer to specific condition charts for in depth assessment/ intervention