TY - JOUR
AU - N. Finer
AU - N. Fragkas
AU - A. D. Miras
AU - S. Le Brocq
AU - D. J. Pournaras
AU - J. Wass
AU - C. Pyper
A1 - 
AB - This research surveyed Tier 3 (specialist, multidisciplinary) adult weight management services in England commissioned for the National Health Service (NHS) by Integrated Care Boards (ICBs) across England in financial year 2022-2023. A survey of public health services commissioned by ICBs gathered via freedom of information requests. All 42 ICBs in England surveyed between September and December 2023. Outcome measures were: whether or not there was Tier 3 provision, the type of Tier 3 services provided, the estimated number of patients referred and treated, and the relation of referral rates to measures of deprivation. We had a 100% response rate; five reported no Tier 3 provision. Using regional data and estimates of eligibility for referral to Tier 3 management, only 0%-1.1% of those eligible were referred. Referral rates exclusively to Tier 3 services showed no correlation with the Index of Multiple Deprivation IMD (R (2) = 0.27; p = 0.21). Four services commissioned appeared not to meet the definition of a Tier 3 service. Provision of Tier 3 services in England is inadequate and variable and currently fails to meet the needs of the population. Many areas with high levels of deprivation provide the most limited access. Even where commissioned, some services do not meet commissioning guidelines. Action is required to implement Health Service Policy and to ensure obesity services conform with clinical need and national guidelines.
AD - Public Health Action Support Team CIC (PHAST), London, UK.; Medical Affairs, Pfizer Ltd, London, UK.; School of Medicine, Ulster University, Londonderry, UK.; All About Obesity CIC, Harrogate, UK.; Department of Bariatric and Metabolic Surgery, North Bristol NHS Trust, Southmead Hospital, Bristol, UK.; University of Oxford-Oxford Centre for Diabetes, Endocrinology & Metabolism (OCDEM) Churchill Hospital, Oxford, UK.
AN - 40810393
BT - Clin Obes
C5 - Education & Workforce
CP - 6
DA - Dec
DO - 10.1111/cob.70038
DP - NLM
ET - 20250814
IS - 6
JF - Clin Obes
LA - eng
N2 - This research surveyed Tier 3 (specialist, multidisciplinary) adult weight management services in England commissioned for the National Health Service (NHS) by Integrated Care Boards (ICBs) across England in financial year 2022-2023. A survey of public health services commissioned by ICBs gathered via freedom of information requests. All 42 ICBs in England surveyed between September and December 2023. Outcome measures were: whether or not there was Tier 3 provision, the type of Tier 3 services provided, the estimated number of patients referred and treated, and the relation of referral rates to measures of deprivation. We had a 100% response rate; five reported no Tier 3 provision. Using regional data and estimates of eligibility for referral to Tier 3 management, only 0%-1.1% of those eligible were referred. Referral rates exclusively to Tier 3 services showed no correlation with the Index of Multiple Deprivation IMD (R (2) = 0.27; p = 0.21). Four services commissioned appeared not to meet the definition of a Tier 3 service. Provision of Tier 3 services in England is inadequate and variable and currently fails to meet the needs of the population. Many areas with high levels of deprivation provide the most limited access. Even where commissioned, some services do not meet commissioning guidelines. Action is required to implement Health Service Policy and to ensure obesity services conform with clinical need and national guidelines.
PY - 2025
SN - 1758-8103
SP - e70038
ST - Commissioning of Tier 3 Obesity Services by Integrated Care Boards in England: An Analysis of Responses to Freedom of Information Requests
T1 - Commissioning of Tier 3 Obesity Services by Integrated Care Boards in England: An Analysis of Responses to Freedom of Information Requests
T2 - Clin Obes
TI - Commissioning of Tier 3 Obesity Services by Integrated Care Boards in England: An Analysis of Responses to Freedom of Information Requests
U1 - Education & Workforce
U3 - 10.1111/cob.70038
VL - 15
VO - 1758-8103
Y1 - 2025
ER -