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BMA: new weight management enhanced service will ‘micromanage practices’

by Jess Hacker
18 June 2021

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NHS England’s new enhanced service for weight management shows a ‘lack of trust in GPs and their teams’ and tries to ‘micromanage practices’, the BMA has said.

The Association described the new service – which NHSE announced yesterday (17 June) in a letter to practices – as being ‘clinically flawed’ and ‘overly bureaucratic’, adding that it ‘creates a laborious tick-box exercise’.

Dr Richard Vautrey, BMA GP committee chair, said that practices are ‘already buckling’ under unsustainable workloads, as the latest GP appointment data (17 June) show general practice carried out 31.5 million recorded patient appointments in April.

He added that the new enhanced service will have ‘little to no impact in tackling the problem, and will present a significant rise in workload at a time when practices are at breaking point’.

The ‘very limited funding’ – up to £20m for referrals to weight management services – does ‘not match up with the work involved’, while the proposed cap on individual practice earnings could limit people who would benefit from the service, he said.

‘Meanwhile, it is no use having such a scheme in general practice when receiving specialist services are so patchy across the country, with many having long waiting times or being already full,’ Mr Vautrey said.

The new enhanced service

The new voluntary enhanced service, which will start on 1 July, will see enrolled practices receive £11.50 per patient living with obesity who is referred to eligible weight management services.

Under the new proposals, practices would need to develop a protocol for identifying and supporting patients living with obesity.

The letter to practices outlined that this protocol should seek to normalise conversations about weight management in consultations and ‘empower patients to provide the practice with information on their weight’.

It should also ensure this is updated and recorded annually in cases where a patient’s BMI indicates they are living with obesity.

NHSE also said that practices should commit to restoring the practice obesity register to pre-pandemic levels ‘at a minimum’, after suggesting the numbers of people identified by general practice as living with obesity have fallen during the pandemic.

Similarly, it said that practices should make individual assessments of patient readiness to engage with weight management services for those recorded on the QOF obesity register as of 31 March 2021, and for those identified as living with obesity during the service period.

These assessments should include a recorded BMI, taken within the last 12 months, and an offer of a referral to a weight management or specialist service, it said.

The enhanced service is accompanied by a wider expansion of weight management services, including the launch of the NHS Digital Weight Management Service in May.

From July, this service should become the default for obese patients with hypertension and/or diabetes, NHSE said yesterday.

NHSE also announced a second enhanced service for GPs to treat patients with long Covid, supported by £30m funding, as reported by Management in Practice’s sister title Pulse earlier this week.