Call to pay practices for management of obesity

Obesity management needs more than another set of DoH guidelines, claim experts who say funding is required to meet demand.

The call follows publication of a commissioning tool kit for obesity put together by the DoH, the National Heart Forum and the Faculty of Public Health.

The tool kit says evidence shows benefits from behavioural psychologists training GPs in obesity management.

Under local action plans, GP practices may have to hold clinical audit meetings on obesity management with all their members of staff every three months.

By the second year, practices should have an agreed protocol for management of obese and overweight patients. This could include criteria for exercise on referral and motivational counselling.

GPs should also be able to set up a register of patients who are overweight or obese and have a greater than 3 per cent annual risk of a cardiovascular event, according to the tool kit.

But Dr David Haslam, Hertfordshire GP and clinical director of the National Obesity Forum, said the tool kit adds little to what GPs know about obesity management.

‘It’s just adding more and more to the frameworks without helping us to implement them.’

Providing local services and resources for GPs to manage obesity is more important than introducing strict structures, such as quarterly audit meetings and telling GPs to train in behavioural therapy, he said.

‘I’m not sure that to put in place such a tight schedule is going to be effective,’ he added.

Nottingham GP Dr Ian Campbell, medical director of the charity Weight Concern, said a lack of funding for obesity services meant few GPs were able to refer patients to specialists.

‘At the moment clinics are closing as quickly as they are opening.

‘We do need to have specialist centres but part of obesity management would be management of type-2 diabetes and CHD.’

The quality framework already provides some incentive for this, he added.

‘The biggest disincentive for primary care staff is a lack of time and a lack of resources.’

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