Where to refer patients for weight management support?

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First line for patients with HTN or T2DM should be referral to:

12 weeks online access to tailored support.

You must be 18 or over.
You must have a BMI greater than 30. The BMI threshold will be lowered to 27.5 for people from black, Asian, and ethnic minority backgrounds, as we know people from these ethnic backgrounds are at an increased risk of conditions such as Type 2 diabetes at a lower BMI.
You must have diabetes, high blood pressure, or both.
You must have a smartphone, tablet, or computer with internet access.

9 month F2F/Digital programme.

Patient must be aged 18 years and over.
Patient must not be pregnant.
Patient must have had a blood test in the last 12 months that has revealed they are hyperglycaemic and are not diabetic – this is indicated by the patients HbA1c results between 42 and 47 or a fasting plasma glucose (FPG) of 5.5 – 6.9 mmol/l.

For patients with existing diagnosis of T2DM.

3 month total diet replacement including soups and shakes, followed by healthy lifestyle support.

Aged 18 to 65 years (inclusive).
Diagnosed with Type 2 diabetes within the last 6 years.
BMI ≥ 27kg/m² in people from White ethnic groups (adjusted to ≥ 25kg/m² in people from Black, Asian and other ethnic groups).

HbA1c measurement taken within the last 12 months, in line with the following:

If on diabetes medication, HbA1c 43-87 mmol/mol.
If not on diabetes medication, HbA1c 48-87 mmol/mol.
Must have attended for monitoring and diabetes review when last offered, including retinal screening, and commit to continue attending annual reviews, even if remission is achieved (no need to wait for retinal screening to take place if newly diagnosed).
Patient must not be pregnant, breastfeeding, an insulin user, had previous bariatric surgery, been on the programme in the last 12 months or have a significant co-morbidity.

12 weeks structured healthy eating and physical activity (on line and in person options) or 12 weeks Slimming World or Weight Watchers vouchers.

Staffordshire residents (excluding Stoke on Trent) aged 18 or over and who have:

A BMI of 27.5+ with a long-term medical condition or people with Black African, African-Caribbean and Asian family background.

Not yet available in Staffordshire (SWITCH scheme still in pilot stages).

UHNM Bariatric team: Complex obesity, usually BMI of 40 or higher, or a BMI of 35-40 with significant co-morbidities.