Question 1

Yes. Tier 3 weight management services are commissioned to provide non-consultant lead specialist intensive input where patients requiring effective management cannot be managed in primary care alone.

Referral to tier 3 weight management services must meet the clinical criteria set out below:

1. Be over 18 years and over and registered with a HNY GP and referred by a GP

2. Have a BMI ≥35kg/m2 with any one of the comorbidities listed:

• Hypertension

• Hyperinsulinaemia

• Dyslipidaemia

• Type 2 diabetes

• Psychosocial dysfunction

• Exacerbation of conditions such as asthma or a BMI ≥40kg/m2 without comorbidities. These BMIs are reduced by 2.5kg/m2 for people from a South-Asian, Chinese, Black African or Caribbean family background.

3. Have demonstrated that they have maximised primary care and community conservative management which must as a minimum include: · Receipt of healthy weight and lifestyle advice in primary care AND evidence of active participation in modification to exercise AND diet, which is patient- or GP-led, or delivered by an independent commercial service or Tier 2 service.

4. Patients with a BMI ≥50kg/m2 may be referred directly without evidence of compliance with Tier 2 if they meet the other requirements and have been offered a trial of pharmacological interventions where there are no contra-indications.

5. Have an understanding of the commitment required for a Tier 3 programme. This should include nutritional advice, exercise and lifestyle support AND are willing and able to engage and participate in ALL of these aspects of a Tier 3 programme.

6. Weight loss goals must be met at 6 months to continue treatment into months 7 to 12.

Question 2

The ICB does not hold the information requested, as the information the ICB receives from providers does not include the level of detail requested.

Question 3

The ICB can confirm weight management services are not delivered in or planned for Neighbourhood Health Centres or equivalent in the Integrated Care System (ICS).

Question 4

The ICB can confirm the current funding per provider for adult weight management services as below.

Provider and Annual Cost £

South Tees Hospitals NHS Foundation Trust - 263,334

York and Scarborough Teaching Hospitals NHS Foundation Trust - 85,695

ABL Health - 411,815

City Health Care Partnership (CHCP) - The ICB can confirm it does not hold this information, as this is a block contract.

The ICB can confirm there is no change to funding flow or commissioning responsibilities expected to change under the Neighbourhood Health Model.