A new report on the commissioning of obesity services in England is hoping to pave the way for more equitable access for patients.

The report - put together by a working group convened by NHS England and Public Health England - seeks to provide greater clarity on the commissioning of services and co-ordinate the clinical elements of care.

This, it is hoped, will go some way to addressing the stark variation in access to services seen across the country. 

In particular, it was evident that, in some areas, no organisations were commissioning multi-disciplinary team interventions - referred to as tier 3 services - leaving some patients unable to access bariatric surgery, for example.

Tier 3 services are a critical intervention under the obesity pathway, and the report has now outlined the preferred approach to commissioning responsibilities across the different tiers to ensure uniform provision across the country.

The working group has concluded that local authorities should retain responsibility for tiers 1 and 2 of services, which basically centre on prevention and reinforcement of healthy eating and physical activity messages and weight management services.

Commissioning of tier 3 services, which are aimed at individuals who have not responded to previous interventions and involve clinician-led multi-disciplinary teams, should fall under the remit of clinical commissioning groups (CCGs).

And NHS England should retain primary commissioning responsibility for tier 4 services, including surgery, it said.

Situation 'not acceptable'

“It is clearly not acceptable that access to obesity services across the country is so variable," noted Professor Jonathan Valabhji, NHS England’s National Clinical Director for Obesity and Diabetes and chair of the working group, and he said the report "is an important first step in providing much needed clarity about the future commissioning arrangements for all obesity care services and ensuring greater equity of access to obesity care wherever patients live in England". 

PHE and NHS England are now collecting comments from national and local stakeholder organisations, primarily on implementation of the plans at a local level and implications for delivery.

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