The British Obesity and Metabolic Surgery Society (BOMSS) has published Commissioning guide: weight assessment and management (tier 3).

Of all adults in the UK, approximately two-thirds are overweight and one in three children aged 10–11 years are overweight or obese. As excess weight is a significant risk factor for many diseases like type 2 diabetes, cancer, and cardiovascular disease, there is a considerable need to be prepared to treat patients who have diseases likely caused by their weight. Despite the amount of data supporting the use of bariatric surgery for weight management, the rate of bariatric surgery in England fell by 31% between 2011–2012 and 2014–2015, and continues to see little use in Scotland or Wales, and no use in Northern Ireland.

This guide, which is supported by 22 professional organisations, describes in detail the infrastructure needed to set up or commission weight assessment and management clinics (WAMCs) (or ‘tier 3’ clinics, that employ a multidisciplinary team for specialist assessment), including the necessary staffing. These tier 3 clinics should link tier 1 and 2 population-wide lifestyle services to tier 4 specialist bariatric surgical services.

The contents of the guide include:

  • a high value care pathway for WAMCs, including comprehensive guidance for GPs
  • procedures for WAMCs
  • quality dashboard for WAMCs
  • levers for implementation
  • benefits and risks of implementing the guide.