title: NICE-Accredited Commissioning Guidance for Weight Assessment and Management Clinics: a Model for a Specialist Multidisciplinary Team Approach for People with Severe Obesity.
abstract: Despite increasing prevalence of obesity, no country has successfully implemented comprehensive pathways to provide advice to all the severely obese patients that seek treatment. We aimed to formulate pathways for referral into and out of weight assessment and management clinics (WAMCs) that include internal medicine/primary care physicians as part of a multidisciplinary team that could provide specialist advice and interventions, including referral for bariatric surgery. Using a National Institute of Health and Care Excellence (NICE)-accredited process, a Guidance Development Group conducted a literature search identifying existing WAMCs. As very few examples of effective structures and clinical pathways existed, the current evidence base for optimal assessment and management of bariatric surgery patients was used to reach a consensus. The model we describe could be adopted internationally by health services to manage severely obese patients.
authors.affiliation: Department of Upper GI and Bariatric Surgery, Musgrove Park Hospital, Taunton, TA1 5DA, UK. Richard.Welbourn@tst.nhs.uk.
authors.forename: Richard
authors.initials: R
authors.lastname: Welbourn
authors.affiliation: Baker IDI Heart and Diabetes Institute, Melbourne, Australia. John.Dixon@bakeridi.edu.au.
authors.forename: John
authors.initials: J
authors.lastname: Dixon
authors.affiliation: Chemical Pathology and Metabolic Medicine, Leeds General Infirmary, Leeds, LS1 3EX, UK. julian.barth@nhs.net.
authors.forename: Julian H
authors.initials: JH
authors.lastname: Barth
authors.affiliation: UCLH Centre for Weight Loss, Metabolic and Endocrine Surgery, University College London Hospitals, 250 Euston Rd., London, NW1 2PG, England, UK. n.finer@ucl.ac.uk.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Finer
authors.affiliation: Fakenham Weight Management Service, University of East Anglia, Norfolk, NR21 8SW, UK. carly.hughes@nhs.net.
authors.forename: Carly A
authors.initials: CA
authors.lastname: Hughes
authors.affiliation: Conway Institute, Diabetes Complications Research Centre, University College Dublin, Dublin, Ireland. carel.leroux@ucd.ie.
authors.forename: Carel W
authors.initials: CW
authors.lastname: le Roux
authors.affiliation: Royal College of Physicians of London, 11 St Andrews Place, Regent's Park, London, NW1 4LE, England, UK. john.wass@nhs.net.
authors.forename: John
authors.initials: J
authors.lastname: Wass
mesh_terms: D050110:Bariatric Surgery; D019091:Critical Pathways; D019468:Disease Management; D006801:Humans; D008962:Models, Theoretical; D009767:Obesity, Morbid / Q000601:surgery / Q000628:therapy*; D010348:Patient Care Team; D012017:Referral and Consultation
keywords: Bariatric surgery; Clinical pathways; Obesity management; Service access