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This guidance covers referrals into weight management for Adults of 18 years or more and follows NICE guidance.
The Tier 3 service is not a bariatric surgery clinic.
All referrals to Tier 3 will have an initial assessment to ensure the service is the most appropriate placement for them.
Onward referral for bariatric surgery may be made for patients aged 18 or more who have engaged with the Tier 3 service to lose weight over an agreed period. All referrals for bariatric surgery will be assessed by the Joint Tier 3 and Bariatric Service Multi Disciplinary Team (MDT).
This is the only route for NHS funded surgery in Devon.
As there are major implications for both, it is important that the GP and the patient understand what is involved if referral to the Tier 3 and Tier 4 services is accepted.
This is particularly true for Tier 4 (bariatric surgery) treatment which has life long consequences for the patient and long term prescribing and monitoring responsibilities for the GP.
There is a wealth of patient focused information on the MyHealth website which will help support your patient to make the right decisions for them.
Please consider referring them to this MyHealth-Devon: Obesity
Obesity: Investigations and Monitoring
If BMI is more than 35kg/m2 consider the following
The results of these investigations must be included in any referral to Tier 3.
As there are major implications for both, it is important that the GP and the patient understand what is involved if referral to the Tier 3 and Tier 4 services is accepted.
This is particularly true for Tier 4 (bariatric surgery) treatment which has lifelong consequences for the patient and long term prescribing and monitoring responsibilities for the GP.
Please see the links below
There is a wealth of patient focused information on the MyHealth website which will help support your patient to make the right decisions for them.
Please consider referring your patient to MyHealth-Devon: Obesity
The following results must be included in any referral to Tier 3 or the referral will be returned to the practice:
Patients 18 years or more with a BMI greater than 40kg/m
Patients aged 18 years or more with newly diagnosed (within the last 4 years) type 2 diabetes and have a BMI greater than 30kg/m
Patients with BMI greater than 35kg/m and one or more of the following comorbidities:
For South Devon and Torbay, Northern and Eastern and Western Devon patients refer to the national NHS website ‘Better Health’
Referral to Tier 3 Weight Management
e-Referral service selection:
This guideline has been signed off by the Devon Weight Management Group on behalf of NHS Devon.
Publication date: May 2019
Updated: August 2023