Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps her Department is taking to ensure that Tier 2 weight management services are sufficiently (a) resourced and (b) integrated with (i) primary care networks, (ii) community health hubs and (iii) other relevant providers to offer comprehensive support for people living with obesity.

Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)

The National Health Service and local government provide a range of free tier two weight management services (WMS), to help eligible people living with obesity to lose weight. These are multi-component programmes, including dietary approaches and physical activity, with behaviour change support. The length of support can vary, but guidance from the National Institute of Health and Care Excellence suggests these should last at least three months.

The NHS offers the NHS Digital Weight Management Programme, which is a tier two service aimed at adults living with obesity, who also have type 2 diabetes or hypertension, or both, as well as NHS staff living with obesity. The 12-week programme is directly commissioned and managed by NHS England nationally, and is available via direct referral from any general practice or Community Pharmacy

Local authorities are able to spend funding from the Public Health Grant on weight management services in line with local population need. They may be delivered as a standalone service or as part of an integrated service, for example with smoking cessation support. Where local authorities commission these services, they are responsible for determining the required resourcing and interaction with other services, along with weight management service providers

Local authorities are part of integrated care systems (ICSs), which are partnerships of organisations that come together to plan and deliver joined up health and care services, and to improve the lives of people who live and work in their area. ICS membership also includes the NHS, social care providers, charities, and other organisations. Being a member of the ICS will help local authorities to work more closely with partner organisations and offer integrated support for people living with obesity.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps her Department is taking to ensure adequate oversight of how primary care settings deliver equitable access to weight management services in line with NICE Guidance.

Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)

Local authorities and the National Health Service provide a range of Weight Management Services (WMS) to support their communities to achieve and maintain a healthier weight. Generally, WMS delivered in the community are behavioural services provided by local authorities or the NHS Digital Weight Management Programme, rather than in primary care.

Local commissioners and WMS providers are expected to take National Institute for Health and Care Excellence (NICE) guidelines into account, alongside the individual needs, preferences, and values of their patients or service users. The NICE’s guidelines provide recommendations on best practice in terms of both the effectiveness and cost-effectiveness of interventions and services. It is not mandatory to apply the recommendations, although health and care commissioners are expected to take them fully into account.

Although primary care services are not a main provider of WMS, general practice (GP) is an important source of referrals to WMS. The Department funds the GP Weight Management Enhanced Service, which incentivises GPs to develop and implement a proactive approach to identifying and engaging with patients living with obesity, including the referral to WMS where appropriate. The service delivery specification for this enhanced service includes minimum standards such as undertaking training to have sensitive conversations about weight, and the review and restoration of the practice obesity register.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps her Department is taking to improve access to weight management services in areas of socioeconomic deprivation.

Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)

Local authorities and the National Health Service provide weight management services to support their communities to achieve and maintain a healthier weight. These range from behavioural weight management programmes to specialist services for those living with obesity and associated co-morbidities.

Local authorities are able to spend funding from the Public Health Grant on behavioural weight management services in line with local population need, including in areas of socioeconomic deprivation. Integrated care boards are responsible for commissioning NHS specialist weight management services in line with local population need, as well as determining the criteria for access to these services in line with relevant guidance.

NHS England commissions the Digital Weight Management Programme nationally for people living with obesity and an existing comorbidity of either diabetes, or hypertension, or both. The 12-week programme is available via direct referral from any general practice or Community Pharmacy.

The programme provides three levels of intervention at varying intensities, and patients less likely to complete a behavioural programme of this nature, for instance those of a younger age, from ethnic minority backgrounds, from a more deprived area, or who are male, are offered a higher level of intervention and support to retain their engagement on the programme. Approximately 50% of total referrals are from the two most deprived socioeconomic quintiles.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what progress NHS England has made on integrating Wegovy to existing weight management structures within primary care settings.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

The National Institute for Health and Care Excellence’s guidance on semaglutide, the active ingredient in wegovy, for managing overweight and obesity was published in March 2023, and updated in September 2023. It recommends semaglutide as a treatment option for patients that meet specified eligibility criteria, and recommends that the treatment is provided within specialist weight management services. These services are typically provided in secondary rather than primary care settings. The Government is committed to the safe introduction of new weight loss drugs into the National Health Service, and is exploring ways to increase access to more people, who meet the relevant eligibility criteria.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment she has made of the adequacy of the accessibility of tier 3 weight management services for patients; and in which (a) Integrated Care Board areas and (b) NHS trusts those services are available.

Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)

Integrated care boards (ICBs) are responsible for commissioning tier three specialist weight management services (SWMS). These services are generally aimed at those living with severe obesity and associated co-morbidities. They provide support through a tailored programme of care from multidisciplinary teams able to assess and work with patients to establish the most suitable care, considering psychological, behavioural, dietary drivers, as well as underlying disordered eating or compulsions. These tier three SWMS are primarily delivered in secondary care, with occasional specialist primary and community-based provision.

In 2021, during the pandemic, NHS England oversaw a SWMS mapping exercise, via voluntary ICB and trust submission, to inform the COVID-19 recovery plan. Overall findings at the time suggested 37 out of 42 ICBs were commissioning provision of tier three SWMS, with approximately 35,000 patients in England accessing services. However, capacity constraints indicated an estimated 12,000 patients waiting to access services, with an average waiting time of six months nationally. ICBs who participated in the voluntary mapping exercise did not consent to the publication of identifiable information. NHS England does not routinely capture specific data on waiting times to access tier three SWMS.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, if she will publish a breakdown of the number of people on waiting lists for tier 3 weight management services by (a) Integrated Care Board area and (b) NHS trust.

Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)

Integrated care boards (ICBs) are responsible for commissioning tier three specialist weight management services (SWMS). These services are generally aimed at those living with severe obesity and associated co-morbidities. They provide support through a tailored programme of care from multidisciplinary teams able to assess and work with patients to establish the most suitable care, considering psychological, behavioural, dietary drivers, as well as underlying disordered eating or compulsions. These tier three SWMS are primarily delivered in secondary care, with occasional specialist primary and community-based provision.

In 2021, during the pandemic, NHS England oversaw a SWMS mapping exercise, via voluntary ICB and trust submission, to inform the COVID-19 recovery plan. Overall findings at the time suggested 37 out of 42 ICBs were commissioning provision of tier three SWMS, with approximately 35,000 patients in England accessing services. However, capacity constraints indicated an estimated 12,000 patients waiting to access services, with an average waiting time of six months nationally. ICBs who participated in the voluntary mapping exercise did not consent to the publication of identifiable information. NHS England does not routinely capture specific data on waiting times to access tier three SWMS.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how much the NHS has spent on treating obesity-related diseases in each of the last five years.

Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)

It was estimated that in 2021 obesity related ill-health cost the National Health Service £6.5 billion annually.

The NHS is committed to improving obesity care and other major causes of ill health through a preventive approach as outlined in the NHS’s Long Term Plan. It continues to offer support to the population, enabling them to take greater control of their own health and stay healthy for longer.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, with reference to Government grants statistics 2020 to 2021, published 31 March 2022, what assessment his Department has made of the effectiveness of the Adult Weight Management Services Grant.

Answered by Neil O'Brien

91% of local authorities in receipt of the Adult Weight Management Services Grant funding shared data on participants and their progress with the Office for Health and Disparities. Provisional data, covering the period April 2021 to December 2022, was published on 27 April 2023.

The statistical summary is available at the following link: https://www.gov.uk/government/statistics/adult-tier-2-weight-management-services-provisional-data-for-april-2021-to-december-2022-experimental-statistics/adult-tier-2-weight-management-services-short-statistical-commentary-april-2023.

It shows that 40% of participants had lost weight by the end of their service, with 15% having lost at least 5% of their initial body weight. A final report will be published in due course.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps he is taking to help tackle obesity in adults.

Answered by Neil O'Brien

In addition to the answer I gave the hon. Member on 27 February 2023 to Question 151337, the weight loss drug Semaglutide (Wegovy) will be available on the National Health Service within three months of its launch in the United Kingdom with eligibility in line with National Institute for Health and Care Excellence recommendations to ensure clinically and cost effective use.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps his Department is taking to help tackle levels of obesity; and if he will make an assessment of the potential merits of publishing an obesity strategy.

Answered by Neil O'Brien

The Government published its obesity strategy in July 2020. On what steps we are taking, I refer the hon. Member to the answers I gave on 6 February 2023 to Question 137874 and 20 February 2023 to Question 143770. We will continue to follow the evidence and consider what more we can do.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what the terms of reference of the internal review of the obesity strategy will be.

Answered by Caroline Johnson

There are no terms of reference as this is a routine internal review.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, if it remains her policy to allocate £100 million funding toward for weight management services in 2023 and 2024.

Answered by Caroline Johnson

Funding for weight management services for 2023/24 will be subject to normal annual business planning processes.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, with reference to the suspension of the £100 million of funding for weight management services, announced on 4 March 2022, what assessment his Department has made of the impact of that suspension on other weight management services run by local authorities that were already established prior to the announcement of extra funding in 2021.

Answered by Maggie Throup

The Adult Weight Management Services Grant distributed for use in 2021/22 was in addition to local authorities’ existing expenditure on adult tier 2 behavioural weight management services from the Public Health Grant. This funding must be used to commission new or expand existing services and was not intended to replace other funding. In 2022/23, the total Public Health Grant to local authorities is £3.417 billion. Decisions on how the Public Health Grant is spent are made by individual local authorities.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether his Department undertook an impact assessment prior to the suspension of the £100 million of funding for weight management services, announced on 4 March 2021.

Answered by Maggie Throup

While no formal impact assessment has been undertaken, the Department considered the impact of the suspension of this funding alongside the costs of ‘COVID-19 Response: Living with COVID-19’ within existing budgets. We remain committed to addressing the causes of poor diet, obesity and inactivity and supporting people living with obesity to achieve a healthier weight.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, with reference to the suspension of the £100 million of funding for weight management services announced on 4 March 2021, whether the Government has plans to reinstate that funding at a future date.

Answered by Maggie Throup

While some healthy weight programmes will continue, the reduction will include £35 million which was to be provided to local authorities for weight management services. Future funding will be subject to the normal business planning processes.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, with reference to the suspension of funding for weight management services, announced on 4 March 2022, whether that suspension is in respect of the £35 million additional funding provided to local authorities as part of the £100 million announced in 2021 or the entire £100 million that was announced.

Answered by Maggie Throup

While some healthy weight programmes will continue, the reduction will include £35 million which was to be provided to local authorities for weight management services. Future funding will be subject to the normal business planning processes.

Found: Question for Department of Health and Social Care: Obesity: Health Services.