In writing to the Tier 3 Change4Life service, 2nd Floor Oaks Building, Kendray, Doncaster Road, Barnsley, S70 3RD
Contact name
Twane Celliers
Who should be referred
Ante-natal ladies with a BMI above 30 kg/m2 at the initial midwife appointment
Referral criteria for adults and young people over 16:
Patients will only be considered for referral to the Tier 3 Change4Life WMS if they have tried Tier 1 and 2 community interventions i.e. slimming clubs
BMI above 40
Individuals with a BMI > 30, not wishing to receive bariatric surgery, with at least 3 co-morbidities.
Individuals referred for bariatric surgery that meet the Tier 4 referral criteria and therefore require assessment and preparation:
NICE guidance recommends bariatric surgery as a treatment option for adults with obesity on fulfilment of the following criteria:
BMI of 50+. The client will have to spend a minimum of 6 months in the Tier 3 Change4Life WMS before referral to the Tier 4 service.
BMI>40 with co-morbidity specifically of pharmacologically treated type 2 diabetes that could be improved if the client lost weight. The client will have to spend a minimum of 9-12 months in the Tier 3 Change4Life WMS before referral to the Tier 4 service.
Type 2 diabetes within 10 years of onset and BMI>30 in some circumstances
All appropriate non-surgical measures have been tried but have failed to achieve or maintain adequate, clinically beneficial weight loss for at least 6 months
The person has been receiving or will receive intensive management in a specialist obesity service.
The person is generally fit for anaesthesia and surgery and commits to the need for long-term lifestyle change and follow-up care.
Type 2 diabetes within 10 years of onset and BMI > 30, in some circumstances
Referral Criteria for Children and Young people:
Between 3 – 15 year old
BMI adjusted for height and gender above the 98th centile
BMI adjusted for height and gender above the 91th centile with significant comorbidities and complex needs for example learning disabilities and or other additional support needed for instance safeguarding issued directly related to obesity
Exclusion criteria: Services not specifically stated as part of this specification are excluded from this schedule. Any services provided outside the terms of the Agreement shall have the CCG’s specific consent in advance. Excluded are:
Clients who do not satisfy the referral criteria
Clients with unstable or severe mental or physical illness beyond the expertise of Primary Care