About the service
The tier 3 Change4Life weight management service is a specialist weight management service to support obese residence in Barnsley to achieve a healthier weight. This includes medical assessment of clients, treatments and lifestyle changes such as improved diet, increased physical activity, behavioural interventions, low and very low-calorie diets, pharmacological treatments, psychological support and the consideration of referral for bariatric surgery if clinically appropriate.
The aim of the service is to reduce health risks, improve co-morbidity and encourage a healthy and active lifestyle with an overall improvement in health and wellbeing.
We provide one-to-one community clinics across the borough and offer an out-of-hours clinic once a week. We provide an information session on bariatric surgery for patients interested in learning more about bariatric surgery as an option to lose weight.
Why would someone choose the service?
Results from our patient and public involvement survey, October 2016, showed the following:
- 100% of clients felt that the dietitian was knowledgeable about weight management.
- 100% of clients told us that they were given enough time to discuss their concerns.
- 99% of clients felt involved in their treatment plan to lose weight
- 100% of clients felt the dietitian gave them a clear focus on changed needed to lose weight
- 98% of clients felt that the wait to see the dietitian was about right.
Staff you may meet
- Administrative staff provide essential support to doctors, nurses and other healthcare professionals. This can be in a variety of different settings, with administrators working as a receptionist in a clinic or a clerk on a ward. They may also be working closely with a consultant as a medical secretary.
- A care navigator provides advice and support to individuals their families or carers during their care. They often make home visits and support hospital discharges. Care navigators can also signpost and refer individuals to the appropriate services or help arrange care based on the individual’s needs.
- Dietitians use the science of food to help people to make good choices about food and lifestyle. Nutrition is an important part of recovery and wellbeing. All service users admitted to a Trust ward have their nutritional state assessed.
- There are more than 60 different specialities that doctors work within the NHS. Each is unique but there are many characteristics which are common. Roles range from working in a hospital to being based in the community as a GP.
- There are many people who work behind the scenes to keep services running and you may meet them in hospital or community settings. They include porters, cleaners, plumbers, electricians, decorators receptionists and secretaries who all work to make sure healthcare settings are kept clean, tidy and safe.
- Nurses who choose to specialise in the mental health branch of nursing work with GPs, psychiatrists, psychologists, and others, to help care for patients. Increasingly, care is given in the community, with mental health nurses visiting patients and their families at home, in residential centres, in prisons or in specialist clinics or units.
- Nursing or healthcare assistants work in hospital or community settings under the guidance of a qualified healthcare professional. They help doctors, nurses and therapists give people the care and treatment they need.
- Occupational therapy is the assessment and treatment of physical and psychiatric conditions using specific, purposeful activity to prevent disability and promote independent function in all aspects of daily life.
- The NHS employs a wide range of clinical staff, it wouldn’t be possible to list them all on this website! All our clinical staff are skilled, dedicated professionals who adhere to high standards of training and work-place practice.
- Physiotherapists help people to improve their range of movement in order to promote health and well being. This can help people to live more independently.
- Receptionists are the first link for many patients and visitors. They often work on their own or with one or two other receptionists, greeting patients as they arrive and check them in. They might also collect patient notes and ensure that these vital records go to the right healthcare professional. In a clinic, they may make appointments and arrange patient transport.
- We have a range of specialist advisors working in our Trust – they give advice on a wide range of different things, depending on what service they work in. So it could be, for example, mental health, stopping smoking, healthy eating or diabetes.
- Telephonists (also known as switchboard operators) are employed throughout the health service. They may work on a busy switchboard in a hospital or the Trust headquarters. Like receptionists, they are an important first point of contact for patients and their families and are a vital link between a caller and the person who can help.
Why a professional should choose the service
- The Change4Life service provides a client-led, best practice-based service to help people achieve weight loss and maintain their weight loss long term.
- The service offer support in the bariatric surgery pathway which includes referrals onwards for bariatric surgery at the appropriate time.
- We ensure that staff are appropriately trained to deliver a high-quality service. This includes nutritional training, training in facilitating behaviour skills and motivational interviewing
- Staff are offered support from clinical professionals including specialist adult and paediatric consultants based at Barnsley hospital
- We work alongside other services including the Tier 2 weight management service called Be Well Barnsley, primary and secondary care healthcare professionals and specialist services i.e. diabetes teams
- We can deliver ad-hoc brief intervention training to health care professionals
The service delivers the following:
- Referral criteria include:
- Children from the age of 4 years old
- BMI above the 98th centile
- Direct referral pathway to the Family and Childrens programme delivered by the Be Well Barnsley team
- Paediatric clinics – a one-to-one clinic with the specialist weight management dietitian
- Specialist paediatric MDT clinic – a one-to-one clinic with the paediatric consultant and specialist weight management dietitian for children with complex needs / co-morbidities
- Weight loss
- Maintenance of weight loss
- Relapse prevention
- Self-management skills
- Improved physical health including long-term conditions
- Improved functional capacity
- Improved activity levels
- Positive behaviour changes
Referrals accepted from:
AHPs, Carers/family, CMHTs, Consultants, Drug/alcohol agencies, GP staff, GPs, Health visitors, Hospital staff, Housing associations, Local authority staff, Midwives, Other NHS services, Other Trust services, Patients(self-referral), Schools, Voluntary services, Youth centres
Referrals also accepted from:
Any other healthcare professionals
- Ante-natal ladies with a BMI above 30 kg/m2 at the initial midwife appointment
Referral criteria for adults and young people over 16:
- Patients will only be considered for referral to the Tier 3 Change4Life WMS if they have tried Tier 1 and 2 community interventions i.e. slimming clubs
- BMI above 40
- Individuals with a BMI > 30, not wishing to receive bariatric surgery, with at least 3 co-morbidities.
- Individuals referred for bariatric surgery that meet the Tier 4 referral criteria and therefore require assessment and preparation:
NICE guidance recommends bariatric surgery as a treatment option for adults with obesity on fulfilment of the following criteria:
- BMI of 50+. The client will have to spend a minimum of 6 months in the Tier 3 Change4Life WMS before referral to the Tier 4 service.
- BMI>40 with co-morbidity specifically of pharmacologically treated type 2 diabetes that could be improved if the client lost weight. The client will have to spend a minimum of 9-12 months in the Tier 3 Change4Life WMS before referral to the Tier 4 service.
- Type 2 diabetes within 10 years of onset and BMI>30 in some circumstances
- All appropriate non-surgical measures have been tried but have failed to achieve or maintain adequate, clinically beneficial weight loss for at least 6 months
- The person has been receiving or will receive intensive management in a specialist obesity service.
- The person is generally fit for anaesthesia and surgery and commits to the need for long-term lifestyle change and follow-up care.
- Type 2 diabetes within 10 years of onset and BMI > 30, in some circumstances
Referral Criteria for Children and Young people:
- Between 3 – 15 year old
- BMI adjusted for height and gender above the 98th centile
- BMI adjusted for height and gender above the 91th centile with significant comorbidities and complex needs for example learning disabilities and or other additional support needed for instance safeguarding issued directly related to obesity
Services not specifically stated as part of this specification are excluded from this schedule. Any services provided outside the terms of the Agreement shall have the CCG’s specific consent in advance. Excluded are:
- Clients who do not satisfy the referral criteria
- Clients with unstable or severe mental or physical illness beyond the expertise of Primary Care
- Clients with severe active eating disorders
How to refer:
- Phone number 01226 644364 and choose option 1 Fax number 01226 299782
- In writing to the Tier 3 Change4Life service, 2nd Floor Oaks Building, Kendray, Doncaster Road, Barnsley, S70 3RD