Wilsnip
New Member
Hello All
I thought this might be useful for some. I know about this for my job, I know this is the status for the South of England, but not sure about the rest of the country but the basic principals are the same.
To qualify you need to follow these rules:
be BMI of 40 or more or 35-40 with co-morbidities these could include diabetes, sleep apnoea, orthopaedic issues, high blood pressure (there are others but this depends on the area.
A patient must have attempted the following:
Tier 1 - intervention by the patient, dietary changes, exercise
Tier 2 - GP intervention with drugs, dietary advice, weigh in clinic
Tier 3 - this is commissioned by either your local authority (public health) or your local CCG. I know in some areas the Tier 3 doesnt exist and this makes it difficult as the commissioner of Tier 4 is NHS England and their policy states the patient must have done Tier 3. It can last for 6-12 months, and this again is dependant on area. tier 3 usually exists of a person to provide you support, guidance on portion control and weigh you, psychological support, exercise guidance
Tier 4 - Bariatric surgery from an NHS provider.
Bariatric surgery is commissioned by NHS England, but usually only when the bits above have been followed. For those with a BMI 50+ the Tier 3 can be shortened.
The reason for the Tier 3 is that in the past lots of people have had bariatric surgery and not learnt the lessons of a healthy diet, portion control, or have had psychological issues which needed to be sorted out. I know some hopsitals had this in place but not all, hence they introduced this. However this puts in place difficulties now as not everyone has access to Tier 3 and I think some hospitals are trying to sort out their own as they are fed up of waiting for local authorities to sort it out.
Again it depends on the area you live in, but basically if your GP is stating that they dont know what to do ask them to contact NHS England who fund the surgery for advice. I think someone else on here as put the link to the policy that covers it.
I thought this might be useful for some. I know about this for my job, I know this is the status for the South of England, but not sure about the rest of the country but the basic principals are the same.
To qualify you need to follow these rules:
be BMI of 40 or more or 35-40 with co-morbidities these could include diabetes, sleep apnoea, orthopaedic issues, high blood pressure (there are others but this depends on the area.
A patient must have attempted the following:
Tier 1 - intervention by the patient, dietary changes, exercise
Tier 2 - GP intervention with drugs, dietary advice, weigh in clinic
Tier 3 - this is commissioned by either your local authority (public health) or your local CCG. I know in some areas the Tier 3 doesnt exist and this makes it difficult as the commissioner of Tier 4 is NHS England and their policy states the patient must have done Tier 3. It can last for 6-12 months, and this again is dependant on area. tier 3 usually exists of a person to provide you support, guidance on portion control and weigh you, psychological support, exercise guidance
Tier 4 - Bariatric surgery from an NHS provider.
Bariatric surgery is commissioned by NHS England, but usually only when the bits above have been followed. For those with a BMI 50+ the Tier 3 can be shortened.
The reason for the Tier 3 is that in the past lots of people have had bariatric surgery and not learnt the lessons of a healthy diet, portion control, or have had psychological issues which needed to be sorted out. I know some hopsitals had this in place but not all, hence they introduced this. However this puts in place difficulties now as not everyone has access to Tier 3 and I think some hospitals are trying to sort out their own as they are fed up of waiting for local authorities to sort it out.
Again it depends on the area you live in, but basically if your GP is stating that they dont know what to do ask them to contact NHS England who fund the surgery for advice. I think someone else on here as put the link to the policy that covers it.
