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Significant gaps and inequalities in the provision of specialist child weight management services in England, study finds

Child's feet on a weighing scales.

Press release issued: 30 November 2022

Over three quarters of acute NHS trusts in England (77%) do not have a child weight management service, despite being responsible for providing specialist services for the most severely obese, according to a study led by researchers at the University of Bristol and funded by the National Institute for Health and Care Research (NIHR).

The study, published in BMJ Open, also found considerable variation between geographical areas, with 36% of trusts in London, and 32% in the Northeast and Yorkshire providing services, compared with just 4% of trusts in the Midlands.

The Midlands had the lowest proportion of NHS trusts providing a weight management service (4%), despite the West Midlands having the highest prevalence of severe obesity according to 2019/2020 reception National Child Measurement Programme (NCMP) data.

The data were collected through Freedom of Information requests sent to 148 acute NHS trusts in England between March 2020 and March 2021. Most trusts (139; 94%) responded. Just 32 provided a child weight management service. It is the first time that the nature of child weight management services provided by acute trusts in England has been explored.

Multi-service and teaching trusts were more likely to provide a weight management service compared to other acute NHS trusts. The study also found a lack of consistency in funding sources and eligibility criteria for children to access services.

A multidisciplinary approach to child weight management service provision is recommended in national guidance, but the survey found that this was not routinely provided. There was no standardisation of the service provided between trusts in terms of length of intervention, follow-up period and outcome measures.

Dr Ruth Mears, Clinical Research Fellow from the Centre for Academic Primary Care at the University of Bristol, who was funded by an NIHR In-Practice Fellowship Award for this research, said: “One in five children in England is obese. The sparsely distributed acute NHS trust services revealed in our study will therefore only reach a minute fraction of children living with obesity or severe obesity.

“There needs to be a clear, realistic national strategy outlining who should receive priority for specialist multidisciplinary obesity care.

“Even the planned expansion of clinics, known as CEW clinics, for treating children with severe complications related to their obesity set out in the NHS Long Term Plan will not reach the majority of children who may require treatment in the future.”

Julian Hamilton-Shield, Professor in Diabetes and Metabolic Endocrinology at Bristol Medical School: Translational Health Sciences, said: “The paucity of childhood weight management provision in many areas suggests that many children, young people and their families continue to face inequality in access for local secondary care facilities and will have no obvious route into the regional CEW clinics if needed.”

The study was supported by the National Institute of Health and Care (NIHR) Bristol Biomedical Research Centre (NIHR Bristol BRC), a partnership between University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol.

Paper: Cross-sectional survey of child weight management service provision by acute NHS trusts across England in 2020/2021 by Ruth Mears, Sofia Leadbetter, Toby Candler, Hannah Sutton, Deborah Sharp and Julian P H Shield in BMJ Open [open access]

Further information

About the Centre for Academic Primary Care

The Centre for Academic Primary Care (CAPC) at the University of Bristol is a leading centre for primary care research in the UK, one of nine forming the NIHR School for Primary Care Research. It sits within Bristol Medical School, an internationally recognised centre of excellence for population health research and teaching.

Follow on Twitter: @capcbristol

About the NIHR

The mission of the National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research. We do this by:

  • Funding high quality, timely research that benefits the NHS, public health and social care;
  • Investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services;
  • Partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research;
  • Attracting, training and supporting the best researchers to tackle complex health and social care challenges;
  • Collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system;
  • Funding applied global health research and training to meet the needs of the poorest people in low and middle income countries.

NIHR is funded by the Department of Health and Social Care. Its work in low and middle income countries is principally funded through UK Aid from the UK government.

About the National Institute for Health and Care Research Bristol Biomedical Research Centre (NIHR Bristol BRC)

The National Institute for Health and Care Research Bristol Biomedical Research Centre’s (NIHR Bristol BRC) innovative biomedical research takes science from the laboratory bench or computer and develops it into new drugs, treatments or health advice. Its world-leading scientists work on many aspects of health, from the role played by individual genes and proteins to analysing large collections of data on hundreds of thousands of people. Bristol BRC is unique among the NIHR’s 20 BRCs across England, thanks to its expertise in ground-breaking population health research.

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