The lack of both tier 2 and tier 3 weight management services in Leeds has left patients with an ‘unacceptable’ service provision gap, according to the LMC.
Leeds City Council was forced to decommission its tier 2 service in April due to cost pressures, but LMC assistant medical secretary Dr Richard Vautrey said GPs have been unable to refer to the service since October last year.
The ICB-commissioned tier 3 service then stopped accepting referrals last month, which Dr Vautrey said is a ‘consequence’ of tier 2 services ending which resulted in higher demand.
Leeds LMC wrote to all Leeds MPs to say they are ‘seriously concerned’ by the removal of tier 2 and called for support to ‘reinstate this essential service’.
The lack of referral options for GPs could also impact on income, since both tiers form part of the NHS England’s enhanced service specification for weight management.
Dr Vautrey, who was previously chair of the BMA’s GP Committee, told Pulse that the LMC has written to NHS England about this issue but has not yet had a reply.
For both tiers, the LMC has not had an indication from either the local authority or the ICB of when the services may re-open.
Dr Vautey said: ‘Patients with hypertension and diabetes can access the digital weight management service that NHS England have established, but that’s quite limited.
‘Patients can pay to go to organisations like Slimming World or Weight Watchers or similar organisations. But obviously, that’s not a free service, and so we are really concerned that this decision widens health inequalities rather than addressing it.
‘And all it’s doing is storing up problems for the future, not just for individual patients and their own health, but for the NHS as a whole.
‘So we’ve got a massive financial implication of managing obesity, and that’s only going to get worse if we’re not providing preventative services at an early stage.’
The LMC’s recent newsletter told local GPs that it had received a reply on this issue from Tom Riordan, chief executive of Leeds City Council, which said: ‘The challenges facing local government finances have been extremely challenging over recent years, leading to difficult decisions around the best use of limited resources.
‘This resulted in the decision to reduce the budget available from April 2023 onwards for some of our healthy living services, including the weight management element of our One You Leeds service.’
In March, NICE recommended Wegovy, a weight loss drug, for use as part of a patient’s treatment for obesity in an NHS specialist weight management service.
And this week, its manufacturer claimed that the drug could also reduce risk of cardiovascular events by 20%.
I know it’s causes difficulties for practices when services which patients expect are unavailable. But are these services actually effective?
Official outcomes data for Tier 2 in 21-22 (1) shows that 37% of enrolled patients weighed less at the end of the course than at the beginning.
OK, it’s 37% better than zero, but it means almost 2 in 3 attendees fail to lose weight – as an endorsement it’s not overwhelming.
1. https://www.gov.uk/government/statistics/adult-tier-2-weight-management-services-provisional-data-for-quarters-1-to-3-2021-to-2022-experimental-statistics/adult-tier-2-weight-management-services-short-statistical-commentary-april-2022