An update on Tier 3 Weight Management services in north east London
In response to the increasing volume of queries around Tier 3 Weight Management Services, and in particular Oviva, we would like to make GPs aware of the current position in regard to weight management services in NEL.
NHS North East London has not directly commissioned Oviva and does not hold a direct contract with them. However, Oviva has listed themselves on eRS based on contracts they hold or have held with other ICBs, as per the Right to Choose Framework.
While a NEL Tier 3 service is in the process of being commissioned, referrals to Oviva are permitted where clinically appropriate. However, it is important to note that usually Tier 3 services would only offered to patients who have already completed Tiers 1 and 2 services. We would therefore ask GPs to exercise their clinical judgement before referring to Oviva and consider whether Tier 2 services would be more suitable. Tier 2 services are offered by your local authority, and can be accessed here:
- Barking and Dagenham – support offered via the NHS Digital Weight Management Programme NHS England » Information for healthcare professionals
- City and Hackney Healthier Together Hackney – GP Website
- Havering Live Healthier Havering – Everyone Active
- Newham Weight Management Programme in Newham | Xyla Services
- Redbridge Health & Wellbeing • Vision RCL
- Tower Hamlets Weight Action Programme (WAP) by Queen Mary University of London
- Waltham Forest Home Page – Free Healthy Lifestyle Services | Waltham Forest
We understand that heightened interest in Oviva is prompted by the potential access to weight loss medication. A referral to Oviva does not guarantee provision of medication for every patient and as patients can only be on Wegovy (Semaglutide) for a maximum of two years, they should be encouraged to engage with services that can help them to lose weight in a more sustainable way.
We know that there is significant demand for weight loss services in NEL, and that Oviva won’t be suitable for everyone. We are currently in the process of developing a NEL wide Tier 3 service and as a first step, we are developing a phase 1 service, for the most seriously ill patients, with a high BMI, who have weight-related illness, where their weight is currently a barrier to accessing treatment such as required transplant surgery, or who need to lose weight in the near future to avert a serious deterioration in their health.
In addition, we are developing a commissioning policy to govern the ICB’s approach to weight management services, to ensure equity of access and make sure that patients in the greatest need are prioritised.
The ICB is also considering the implications of the NICE Technology Appraisal for Mountjaro (Tirzepatide). NHS England are currently considering what the national response will be to this new service need, prior to a NEL rollout. There will be further communications on this subject in early 2025 clarifying the service offer and eligible cohorts.