Community pharmacy teams go one step further to help people manage their weight

by Dr Bruce Warner, Deputy Chief Pharmaceutical Officer, NHS England and NHS Improvement

Pharmacists and their teams based in the heart of local communities have always been a trusted port of call for people wanting clinical advice and support with their health.

It has been one of our top priorities to ensure that every pharmacy in England is a Healthy Living Pharmacy, so that we can best support people to lead healthy lifestyles, either through individual conversations and ongoing consultation, or by sharing information and signposting to other services.

This includes advice on healthy eating, exercise and stopping smoking, to help people make healthier choices.

Global obesity rates have tripled since 1975, and the UK ranks among the worst in Europe, with two thirds of adults in England overweight or obese.

Obesity and poor diet are linked with type 2 diabetes, high blood pressure, high cholesterol, and increased risk of respiratory, musculoskeletal and liver diseases. Obese people are also at increased risk of certain cancers, including being three times more likely to develop colon cancer and are more vulnerable to COVID-19.

Our Long-Term Plan sets out how the NHS is working to improve health, reduce health inequalities and support people living with obesity.

And in 2020, we asked all community pharmacy staff to complete the Public Health England training and assessments on adult and childhood obesity, to better enable them to support people to measure their BMI and understand the impact of excess weight on their health. 

We are now supporting pharmacy teams to go one step further and, as part of this year’s Pharmacy Quality Scheme (PQS), community pharmacy has been asked to support people with their weight through referrals to the NHS Digital Weight Management Programme – a 12 week, online behavioural and lifestyle programme.

The PQS rewards community pharmacy against a set quality criteria, which includes referring into the NHS Digital Weight Management Programme and encourages collaboration with the new service requirements for Primary Care Networks and IIF.

Community pharmacy teams have been referring adults with a BMI of 30+ (adjusted appropriately for ethnicity), plus a diagnosis of either diabetes, hypertension or both, and into the programme since September.

An individual is assessed by the pharmacy team for suitability for the NHS Digital Weight Management Programme, either opportunistically, or from their clinical system. We appreciate this may not be an easy conversation to have, but we know that on the whole, the public trust their local pharmacy teams and there are plenty of resources to support when initiating that conversation, including CPPE training on dealing with difficult discussions.

Certain people won’t be suitable for referral including those with severe/moderate frailty as recorded on a frailty register, pregnant women, those who have an active eating disorder, people who have had bariatric surgery in the last two years and where a weight management programme is considered to pose a greater risk of harm than benefit. We have worked with PSNC to develop a 'How to refer' video.

If the person is eligible, the pharmacy team can refer them into the programme by visiting the NHS Digital Weight Management Programme Pharmacy Referral website

The individual is then contacted via a text message within two working days, with a link that will enable them to complete the referral process online.  They will be able to select their preferred programme from a choice of providers and the chosen provider will contact them within 10 working days to start the programme, which can be accessed via smartphone or a computer with internet access.

If the patient is not eligible for the NHS Digital Weight Management Programme – they may be eligible for alternative services and can be referred to local Tier 2 weight management services. This is based on their personal results and the community pharmacy team will guide the patient/patient representative accordingly.

For further information and to make a referral visit: https://www.england.nhs.uk/digital-weight-management/