Obesity Resources

The following reports are recommended to add to a batch reporting process (Automated Reporting) to go to the relevant admin team members for ongoing optimisation. 

Report Location	Report Name	Action
3-6 Monthly Batch
CDRC Quality > Weight	? Digital Weight Management – 1.13 Consider Invitation (excluding those unsuitable or invited/referred/declined/started in the last 12m)	Consider inviting these patients by electronic or paper invite.
Monthly Batch
CDRC Contracting >Weight Management	? QC Weight Management 1.0 – All potential referral codes without weight management referral (current year)	Review records and add the ES payment code using the QOF and Contracting template  More details
CDRC Contracting >Weight Management	? Payment Count 1: Weight Management – Referrals	Run search, breakdown and submit monthly numbers to CCG
CDRC Contracting >Weight Management	? Payment Count 2a: Weight Management – BMI >30 (not BAME) ? Payment Count 2b: Weight Management – BMI >=27.5 (BAME)	Run search, breakdown, add the two numbers together and submit monthly numbers to CCG

There are two main templates for day-to-day management of weight issues 

Core Data Entry – CDRC Template 

Allows recording of key data; displays most recent information; flags potential referral options (which supports the Weight Management Enhanced Service); has a link to the template showing more detailed information; has links to patient resources and patient referral pathways. 

The most recent information about measurements and interventions is shown. 

Eligibility for various referral pathways is displayed. These include: 

• NDPP (GP referral for NDH and GDM, self referral if DMUK Score >=16) 
• The NHS Digital Weight Management programme (GP referral for most patients and self referral for NHS staff) 
• Tier 3 /4/ Bariatric Surgery referral 
• Local tier 2 services (if these have been set up for your area – contact NECSU.cdrc@nhs.net to arrange setup) 

Weight Detailed – CDRC Template 

How to Access

With a patient’s record retrieved in the lower left hand corner use the search bar, type in ‘Weight Detailed – CDRC’ and select the following template:

Alternatively, press F12 and search for ‘Weight Detailed – CDRC’, this will return the aforementioned template.

This template shows more detailed information as well as a section to help with motivational interviewing for weight management. 

How to Access

With a patient open, n the lower left hand corner use the search bar, type in ‘Patinfo Weight Management – CDRC’ and select the following template:

Alternatively, press F12 and search for ‘Patinfo Weight Management – CDRC’, this will return the aforementioned template.

The patient information template shows , local and national resources to help patients with weight management.  When opened from the weight templates, it should open directly on information for your local area.  (Contact NECSU.CDRC@nhs.net to add local information) 

Hyperlinks from the first column can be sent to patients (via email, text or Airmid) using the Comms Annexe.  Paper versions can be printed from the second column. 

When this template is closed, you will be prompted to add a code above weight management advice if it hasn’t already been added. 

How to Access

With a patient’s record retrieved, in the lower left hand corner there is a search bar, type in ‘Weight Management Referral – CDRC’ and select the following template:

Alternatively, press F12 and type in ‘Weight Management Referral – CDRC’ in the search bar, this will return the aforementioned template.

When the Weight Management Referral template is opened it will show options for your local area.  (Contact NECSU.CDRC@nhs.net to add more local pathways). 

How to Access

With a patient’s record retrieved, in the lower left hand corner there is a search bar, type in ‘Orlistat – CDRC’ and select the following template:

Alternatively, press F12 and type in ‘Orlistat – CDRC’ in the search bar, this will return the aforementioned template.

Orlistat Template

The Orlistat template allows effective use of orlistat 

Column 1	Column 2	Column 3
Indications for orlistat use	Recent weights and BMI – trends can be followed
Safety considerations	Relevant information from the record such as interacting medication, renal function and gallstone information	Link to more detailed information about gallstones and cholecystectomy Link to current repeat medication
Weight and BMI data entry	Last issue of orlistat is shown	Link to view showing all issues of orlistat with weight so effectiveness can be seen
Weight advice data entry	Previous advice is shown	Link to see all advice given
Orlistat checklist – runs a safety check on orlistat use and allows user to record a checklist for use. Link to patient information that can be printed or sent electronically	Last checklist entry	All previous checklist entries

Checklist 

Prompts user to enter the start date, weight and target weight loss at 3 months (which is then shown on the template). Side effects, recommendations and patient information provision is also covered. 

Service Details 

Details of the Digital Weight Management Programme for professionals and patients can be found here 

The 2021/22 enhanced service can be found here 

Eligibility Criteria 

Patient Group	Inclusion	Exclusion
All patients	BMI >=30 OR BMI >=27.5 if BAME AND Hypertension OR Diabetes	Under 18 Bariatric procedure in last 2 years Active eating disorder Moderate or severe frailty Benefits likely to outweigh risks
NHS Staff (not part of the ES)	BMI >=30 OR BMI >=27.5 if BAME	As above

Identifying/Inviting Patients 

1. Opportunistic invitation or LTC review.  The Core Data Entry template will indicate if the patient is likely to be eligible for the Digital Weight Management Programme.  If the patient satisfies the weight criteria but does not have hypertension or diabetes,  it will indicate the patient is eligible if they are NHS staff.  From the Weight Management – patient information link you can print a flyer or send a weblink to the patient. 

2. Systematic Identification. The following searches in the CDRC Quality > Weight folder will identify patients to consider for invitation 

1.10	All patients eligible for invitation
1.11	As for 1.10 excluding those who have a code for ‘unsuitable’ in the past 12 months*
1.12	As for 1.11 excluding those who have a code as having started/declined/been referred in the past 12 months*
1.13	As for 1.12 excluding those who have been invited in the last 12 months *
1.2	All patients eligible for invitation who has a history of an eating disorder – will need manual screening to check if eating disorder still active.

*NB it is not possible to distinguish between the codes for declined/unsuitable/referred etc for the NHS Digital Weight Management Programme and other programmes. 

From the searches above, select some or all of the relevant patients.  The easiest way to send invitations is via the Communications Annexe. Some suggested text for an invite is shown below – this can be copied and pasted into your presets.  Ensure the person who will action the replies is the person who sends the communication. Replies will come to their inbox. 

<forename> <surname> 

You are eligible for the NHS Digital Weight Loss Programme. More information at bit.ly/NHSDigitalWeightLoss. Reply for referral 

Leadgate Surgery 

You can find more information about Sending Electronic Messages here 

Use the code Referral to weight management service offered for all patients invited. 

Reporting and Payment 

The relevant searches for payment under the weight management ES are in CDRC Contracting > Weight Management 

For each of the three searches, right click on the search, select Breakdown and tick the option below, then click Refresh (this will only need to be done once) 

A monthly count for claims will be shown. For Payment 2 add the non-BAME and BAME figures 

This report will change to the new financial year at the end of April each year.  You will need to run the report for the March submission before the end of April. 

Maximising Payments 

There are two systems to maximise payments 

1. Quality control searches to identify missed coding 
2. Protocols to automatically code referrals which are part of the Opt-In Resources 

Quality Control Searches 

The following searches will identify people who have had an uncoded weight management referral that might be eligible for payment if coded (consider adding this to a batch reporting process). The payment trigger code for the ES is: 

Referral to weight management service 

Search
1.0	All patients in searches 1.1, 1.2 and 1.3
1.1	Patients with a code for a referral to a lifestyle management programme without the ES code
1.2	Patients with a non-ES code for a referral to a weight management programme without the ES code
1.3	Patients with an NDPP referral without the ES code

Referrals which are eligible for the ES are: 

• Tier 2 local authority weight management referrals – often the local lifestyle referral pathway 
• NDPP referrals 
• NHS Digital Weight Management Programme 
• Tier 3 / 4 / bariatric referrals 

Add the ES code to the record on the same date as the original referral. The QoF and Contracting template can help with this. It shows eligible or potentially eligible referrals and allows entry of the ES code. 

Local weight management services and referral pathways can be included. 

Oviva (Newcastle)

Oviva’s Tier 2 Weight Management Programme offers patient support for 12w led by a team of weight management specialists. They offer app-based coaching, combined with specialist content, in addition to peer support opportunities and self tracking on the Oviva app.  

The programme provides a flexible, digital model incorporating human coaching to support and motivate patients to change behaviours and lose weight. 

Eligibility 

Inclusion criteria 

• Aged eighteen years or above  
• Registered with a GP practice in Newcastle  
• BMI ≥ 25kg/m²   

Exclusion criteria 

• An individual who does not meet the eligibility criteria above 
• Severe/moderate frailty as recorded on a frailty register 
• Is pregnant 
• Has a diagnosed eating disorder 

or practices who have recently joined the DCS group on SystmOne, PSAs and Protocols will not be automatically active. You can choose the level of activation you would like; opt-in to all or resource specific CDRC resource PSAs and Protocols. Alternatively you can choose not to opt-in and only use the Reports and Templates.

If you would like to activate that following, or all, CDRC PSAs and Protocols, please email contact-cdrc@healthinnovationnenc.org.uk

The Obesity Bundle of opt-in resources includes: 

Automatic Protocols: 

To maximise ES payments, A protocol will trigger if one of the non-ES weight management referral codes is added, if there hasn’t already been an ES code in the current financial year.  For codes that definitely count, such as NDPP, the ES code will be added automatically.  For codes which are equivocal, such as Referral to healthy lifestyle programme, the user will be prompted to consider adding the ES code.