NHS Tier 3 weight management variation...

[MammaCagna]

Hi...
Wondering if there a consistency within the programme, or is it ad-hoc postcode lottery?

I was referred to this NHS tier 3.

Backstory:
Had an accident 2 years ago & it has had an affect on my mobility, I exercise still but not as much as once did, ive gone from 6 mile walks a day (15mile weekend walking with my dogs & son), HIIT classes, swimming now 3 miles a day, odd weekend, aquatics HIIT once a week & I gained weight put my bmi over 28, which ticked a box.

I have PTSD prior to accident and anxiety there are times I emotionally eat, but never warranted any type of help at the time physically although been asking if mentally is there help, never ticked a box.

Slimming world is not the answer.
So....

My Orthopedics consultant told me about Tier 3 and referred me and the way it was explained, I thought wow, NHS really taking into account everyones emotional journey.
But as its new, process can take upto 9mths.

4months later received a letter for group consultation. My NHS trust sold it as: weekly group meetings, share & learn experiences in face to face group, along with learning about the body, sleep, fuel, exercise etc. It wasnt a teaching you to suck eggs as they used latest research & data.
Weekly exercise classes based on individual mobility & health.
and supposed to be a dietician weekly (this didnt happen)
Informed mental health practioner is also on board for those needed. Saw them once, but was a positive experience.
twice saw the endocrinologist.
This was for 12 week programme and then progressed to tier4 via endocrinologist consultant having a chat, options surgery or wegovy.

I work in a education setting and said it would be hard to fulfill these appointments never ran past 2.30 pm always in morning and they were upto 2hrs long, they said it is a medical so employers should allow you time off for medical appointments, in this case twice a week. This did not go down well with work colleagues actually it added stress and made me mkre anxious. On 3 occasions (adhoc 3 weeks over the 12) I had to miss appointments due to own work short staffing.

There was no online option for this.

Then at their Dr appointment, they said was happy for me to start wegovy, which will be in next 18mths.
Just received a letter stating they've discharged me on grounds of 70% attendance and I feel so peed off. Even though they failed in the programme they offered (dietician turned up once, mental health saw once) supposedly a weekly dietician or fortnightly mental health side.

There was never a conversation about attendance rate target! I feel it's set up to fail especially those that work.

Anyone had similar experience?

Sorry if long winded just feel so deflated, thanks for reading.

Well many years ago I was referred for a weight loss support/programme via the GP, I dont know what tier it was. I just couldnt make the appointments, they were all in the day time and I dont have the sort of job where I can book that sort of regular appointment off for something non critical (statutory front line work)

So that went no where

Around 2 years ago GP wanted to refer me again so that I would progress to WLS, I knew it wouldnt work and he seemed to live in a fantasy land where he thought I would get the surgery in about 6 months, I knew from what Id read on here that its often years in the waiting. So I just went private.

My BMI was around 45 at the time so Im surprised at just 28 they are at least referring you, but as you say, whats the point, its not fit for purpose. Who are these people that can make 2 hour medical appointments (plus more for travel to and from the appointment and then getting back to work)?

Write to PALS & complain. Say you don't want to be discharged, you can't make 2x a week appointments at those times, what do they suggest?

The hoop-jumping of this programme is ridiculous and all of it is completely pointless which is why the majority of people don't bother now and if Wegovy is what you ultimately want you'd be far better just getting a private prescription (if you can afford it). You'll have lost the weight before you've even got near it on the NHS!

My BMI exceeds 28, Dr explained anything over 28 can be referred, my BMI is 40, 2 years ago it was 26.. in that time I've also gone into perimenopause..

I refer people to tier 3. I’ve had people say the same as you. It’s not possible if you have a job that you just can’t take that much time away from.

It really needs reviewing.

One private facility has informed me it is £1800 first month and consult, then it's £500 a month after.

I have already started a private consult with a Clinical Psychologist within an eating disorder service, my GP informed me the NHS wait time was 2 years, private got an appointment within 2 weeks, same clinic which is NHS.

And I have really questioned this but was informed NHS have always had a private NHS tier.

So maybe with this route see if my GP refer me to Slimming world and see if the two work together.

That's my thinking and hopes.

Gained just under 5 stone in 2 years but with perimenopause and the accident (fractured knee, MSL tear x 2) I also suffered PGP whilst pregnant twice and have sciatica pain and now told osteoarthritis. I've just got on with it, as you do but the pain is consistent now.
Always tried to stay active, early life was swimmer and danced. I do eat healthy but I have triggers. The PTSD is from domestic abuse..

So fingers crossed I will get there...

Similar, got put on the nhs healthy eating 1:1. I worked full time, she worked part time. If I didn't get a lunchtime appointment on the day I WFH that was it. Useless!

What have you been told is £1800 then £500/month?

For example, if you wanted to look into Mounjaro, it starts off at around £120/month including the private consult and moves up to around £200/month as you increase strength. You only move up the dosage as the lower dose becomes less effective (due to your body getting used to it).

Was for wegovy, nearest private clinic

Isn't Mounjaro for diabetics type 2?

@MammaCagna - have a look at the various threads running in the Weight Loss Injections section.

I had a BMI of 28 and chronic back issues. I've been on Mounjaro now, prescribed privately via Voy, for almost a month and I've lost 11lb. It's costing £120 a month. Mounjaro is another of the recently-approved injections for weight loss. Same sort of thing as Wegovy but with better results.

There are so many private prescribers now, I'd just crack on if you can afford it. You'll likely get nowhere fast with the NHS.

A friend in another part of the country, has a family member who was referred. Found this out earlier today, they were 5 stone overweight and pre diabetic their GP/clinic service is in the pilot scheme, that government/NHS started last year, they attended a digital tier 3, drs appointments and received wegovy prescription after their programme.

I asked about appointments they said had option to do digital or face to face but Dr had to be in person and being weighed, they were told if you didnt hit weight loss milestones in first 8 weeks could be discharged, which was 1Ib a week, no mention of % had to attend, as they worked why they took digital option.

So I think feedback to whom run the service and PALs is critical.

I was neither pre-diabetic, no high blood pressure, actually my blood pressure was normal range. On physical beep test I had to do within mobility range, my score was healthy but its the pain afterwards, cold icepacks on knees, swelling in legs. I use walking poles for stability and tens machine on my hip lumber area.. I now weigh 17 stone and I'm 5ft 8 and of mixed ethnicity. On paper the GP I once saw said he was expecting a 9 stone person if didn't look at weight part, I replied I havent been 9stone since before I had my first child, 24 years ago, I also said, there are plus size women who dance for Beyonce, theyre healthy for now. But excess at some point will have some toll on bone and joints especially when you hit perimenopause age.

Just went over their head and said joys of womanhood, like it's a joke. My reply, am I laughing with you...no.

That annoyed me and also made me anxious like I was a failure, but that GP no longer at surgery, which is great as I don't always have a choice.

I just feel it's all over the place, it's not take what high % has worked use as a guideline, see how fares elsewhere.. tweak where outcome may be more successful. Like you do in your own work life...

🙂

What got the ball rolling for this journey was my Orthopedics consultant along with my physio person, then my GP acted on it.

Ortho said loosing the weight would be a good start.

Your health needs to be prioritised over work. Of course you need to show commitment to weight loss on your side before surgery or wegovy. Stop blaming the health care system that provided a service you didn’t fully engage with.

Thank you, glad I posted as its good to learn from others. As information isn't offered up and when you ask questions it's not readily offered or there's always a BUT. Which I feel at times, holding back on cos there's no kickback or incentive that they will gain, this maybe via the pharmaceutical side. We know this happens.

I appreciate everybody's replies.

I agree to some point with that point! But this was not discussed at the time, so your point to me is irrelevant and also who pays the bills when you don't get paid for the time off.

But thanks for your input.