The Weight Management Support

Service

A Guide for Participating Community Pharmacies

Service leads: Lisa Meeks Service Implementation & Evaluation Lead Mobile: 07736 636 023

Email: lisa@cpwy.org Darren De Souza Public Health & Engagement Lead Mobile: 07793 218 059 Email: darren@cpwy.org

Community Pharmacy West Yorkshire Brooklands Court Tunstall Road Leeds LS11 5HL Tel: 0113 272 7560

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Contents

Service Overview Pg 3

Summary Pg 4

The weigh-in record card Pg 4

Staff providing the service Pg 6

Before you start Pg 6

Elligibility criteria Pg 6

Recording on PharmOutcomes Pg 6

Claims & payments Pg 7

Resources to support delivery Pg 7

Background information Pg 7

Referring back to the weight management provider Pg 8

Weight management referrals Pg 8

Instructions for PharmOutcomes Appendix 1

Consultation Form Appendix 2

Disclaimer This Guide has been developed to assist pharmacies in delivering the Weight Management Service in Wakefield. It should be used alongside other reference sources, guidance provided and current published evidence. Community Pharmacy West Yorkshire does not accept any responsibility for any errors or omissions.

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Service Overview

The Weight Management Support Service has been commissioned by Wakefield Council to support clients following completion of a 12-week Weight Management programme.

Clients will be referred to a participating community pharmacy, (from the programme), onto the service which will help each client keep track of their weight for a further 10 to 14 weeks. As well as taking basic measurements the pharmacy will provide support and encouragement to each client reviewing progress against goals set. The service consists of:

Recruitment – On completion of the 12-week weight management programme the provider will refer clients to one of the participating pharmacies. Each client will be provided with a hand held referral/weigh-in record card (see below) which will record the height, weight, BMI and goal set for the client. The client will be asked to present this record card at their first and subsequent visits to the pharmacy.

An initial consultation – This will be the client’s first visit and baseline measurements, (as supplied by the programme provider), will be recorded on PharmOutcomes. The pharmacy will then weigh the client using the Tanita scales supplied for the service and record the weight and BMI on both the client’s weigh-in record card and PharmOutcomes. Appropriate health literature should be offered at this point on nutrition/physical activity.

Review x 5 (fortnightly) – Measurements for each client (weight and BMI) are to be repeated at 2-weekly intervals and recorded on both the client’s weigh-in record card and PharmOutcomes. At each consultation the client should be encouraged and supported and a review of goals discussed. Clients should be weighed every 2 weeks for a period of 10 to 12 weeks, (although this may be extended up to 14 weeks to allow for holidays etc.), until they have reached a maximum of 6 consultations1.

Referral – Clients should be encouraged to contact the Wakefield Council Weight Management Service if they have consistently gained weight at 3 or more weigh ins. Telephone: 01924 306765 or 01924 306069 (these contact numbers are on the back of the client’s hand held weigh-in record card).

ALL consultations under this service MUST be provided in the consultation room.

1 The funding for this service is limited and pharmacies can only claim payment for a maximum of 6 weigh ins per client.

The aim of the Wakefield Weight Management Support service is to help clients keep track of their

weight, provide support and regularly review progress against goals.

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Summary

The Weigh-In Record Card

The Weight Management Programme is delivered with input from a range of providers including dietitians, consultants in endocrinology, psychologists and physical activity instructors.

Once the client has completed their 12-week programme they will be supplied with a credit card sized weigh-in card record card:

FRONT BACK

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Example:

The programme provider will fill in the client’s weight, height, BMI and will work with the client to

set a smart goal at their final appointment or session:

The client will be asked to present their weigh-in record card at each pharmacy visit so that the

pharmacy staff member providing the service can record the most up-to-date measurements at each

visit (example below).

Provider will complete this line with the client’s baseline measurements at referral

Measurements taken by programme provider

Measurements taken by community pharmacy

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Staff Providing the Service

Any member of the pharmacy team who has undertaken the training provided by Wakefield Council

on the correct use of the Tanita scales can provide this service.

It is recommended that where possible, the same member of the team provides the service to the

client at each of their follow up appointments. This will help establish relationships and make some

clients more at ease when they come in for their appointment.

Before You Start Actions

Please ensure members of staff providing the service have read the service specification.

Check that you are able to access PharmOutcomes (have user names and passwords etc.).

Discuss the service with the whole pharmacy team to ensure that everyone knows that the pharmacy is providing the Weight Management Support Service. Ensure that all are aware of eligibility criteria and know what to do if a client presents asking for the weight management service or shows a weigh-in record card.

Eligibility Criteria Clients who have been referred from the Weight Management Service provider are eligible to access the community pharmacy weight management support service. This is evidenced by the weigh-in record card (described above). Clients should be encouraged to bring this record card to every pharmacy appointment.

Recording on PharmOutcomes

All consultations must be entered onto PharmOutcomes within ONE WEEK of the consultation. There is a consultation form available at appendix 2 should you wish to record on paper before recording onto PharmOutcomes (although it is recommended that you input the information straight onto PharmOutcomes. This should also make it easier for you).

At the client’s initial consultation you will need to complete a registration section on PharmOutcomes. This only needs to be completed ONCE for each client. The registration section records the client’s baseline measurements as supplied by the weight management provider. These are the client’s final measurements before referral to the community pharmacy (recorded on the top line of the weigh-in record card).

Refer to appendix 1 for step by step instructions on how to record activity for this service on PharmOutcomes.

Accessing PharmOutcomes

PharmOutcomes is accessed at: www.pharmoutcomes.org.uk If you have forgotten or lost your log on details, please either:

Go to www.pharmoutcomes.org.uk and click the Help button

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Or call the Helpdesk on 0330 660 0689 and leave a message clearly stating your location, your phone number and a brief description of the problem you are experiencing

Pharmacies who require further information on the use of PharmOutcomes should contact Lisa Meeks lisa@cpwy.org

Claims - Payment

Pharmacies will be paid £3 plus VAT for each recorded weigh-in.

Payments will be made based on activity reported on PharmOutcomes. Community Pharmacy West Yorkshire will access the data required for payment purposes directly from PharmOutcomes.

Resources to Support Delivery of the Service

Each pharmacy will be supplied with a new set of Tanita weighing scales.

Additionally a height conversion chart, weight conversion chart and Tanita information sheets (which explain what the readings mean and can be given to clients) will be supplied.

All of these resources, (and a consultation form for pharmacies not inputting the consultation directly onto PharmOutcomes), are available to download on the CPWY website at http://www.cpwy.org/pharmacy-contracts-services/local-services-enhanced-/weight-management-service.shtml

Background Information

Healthy Weight – Why Is It A Priority? Maintaining a healthy weight and taking regular exercise are vital for long-term health and wellbeing. As well as affecting confidence and self-esteem, being overweight can lead to a number of health problems, including type 2 diabetes, heart disease, stroke, dementia, osteoarthritis, and some cancers in later life. Recent evidence also suggests that good nutrition is essential for our mental health and that a number of mental health conditions may be influenced by dietary factors. Currently in the UK it is estimated that there are 70,000 premature deaths each year which could have been avoided if diets matched nutritional guidelines.2 Figures for Wakefield show that 69.9% of the adult population have “excess” weight with 28.5% recorded as very overweight (obese). These figures are significantly worse than the average for England. There are a number of factors that contribute to a person’s weight such as environment, family history and genetics, metabolism (the way the body changes food and oxygen into energy) and behaviour. The best way to lose weight is steadily, through a combination of healthy eating, eating less and taking regular exercise.

What Does Your BMI Mean?

There are a number of ways in which a person’s health in relation to their weigh can be classified but the most widely used method is body mass index (BMI). This is a measure of whether a person is a healthy weight for their height. To calculate BMI a BMI healthy weight calculator can be used.

2 Public Health England, Annual Report and Accounts 2014/15

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For most adults, a BMI of:

18.5 to 24.9 represents a healthy weight which should be maintained. It is still important to eat a healthy, balanced diet and to keep active.

25 to 29.9 is above the ideal range and therefore is classed as being overweight. Being overweight increases the risk of suffering weight-related illness.

30+ is classed as obese (40+ classed as severely obese). People in this range are at greater risk of health problems such as heart disease, diabetes and some cancers.

BMI isn't used to definitively diagnose obesity, because people who are very muscular sometimes have a high BMI without excess fat. But for most people, BMI is a useful indication of whether they're a healthy weight, overweight or obese.

Generally, the higher the BMI, the bigger the potential risk to health.

For more information on healthy weight:

https://www.nhs.uk/live-well/healthy-weight/12-tips-to-help-you-lose-weight/

www.nhs.uk/oneyou/weight

https://www.nhs.uk/live-well/healthy-weight/start-losing-weight/

https://www.nhs.uk/Tools/Documents/WEIGHT-LOSS-PACK/all-weeks.pdf

Referring Back to the Weight Management Provider (for clients already on the weight management support service)

Clients should be encouraged to contact the Wakefield Council Weight Management Service if they

have consistently gained weight at 3 or more weigh ins.

Telephone: 01924 306765 or 01924 306069 (these contact numbers are on the back of the client’s

hand held weigh-in record card).

Weight Management Referral Many people who are overweight or obese pass through a pharmacy and staff are ideally placed to

opportunistically offer advice on weight loss or recruit people onto a weight management programme.

If an individual meets any of the below criteria, they can be referred by the pharmacy to the weight

management service (consent required):

o Resident of Wakefield

o BMI 30+ (27.5+ for South Asian or Black African clients)

o Aged 18+ (teenagers aged 13-17 with parental support judged able to access adult

services).

To refer to the weight management service in Wakefield download and complete the referral form from the weight management section of the CPWY website at http://www.cpwy.org/pharmacy-contracts-services/local-services-enhanced-/weight-management-service.shtml and follow the instructions below.

Key message

A BMI above the healthy weight range can increase the risk of serious health problems, like heart

disease, type 2 diabetes, stroke and certain cancers.

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Weight Management Referral – Instructions

1. Ask patient to fill in part A of the referral form. 2. Pharmacist to fill in part B of the referral form. If the client has a BMI 40+ then blood information will be requested from the GP if necessary. 3. Send the referral to Wakefield Council, following instructions on the form.

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Instructions for Using PharmOutcomes to Record Service Activity

for the Wakefield Weight Management Support Service

1. Registration (@ initial consultation)

At the initial consultation you will need to complete the registration stage on PharmOutcomes

(before recording pharmacy weigh in details).

Registration only needs to be completed ONCE for each client.

To do this you must:-

(a) Login to PharmOutcomes.

(b) Under services tab select Registration –

Weight Management Service

(c) Take and record client’s name, DOB, gender,

ethnicity, postcode and contact telephone no.

(d) Record client’s baseline measurements

as supplied by Oviva (recorded on the top

line of the patient weigh-in card).

Don’t forget to save!

Appendix 1

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2. Pharmacy Weigh-Ins (initial visit and 2-weekly follow-ups) Once the registration details have been recorded during the initial consultation, (as described

above), you will then need to enter the measurements that have been taken by the pharmacy at the

initial consultation (weight and BMI).

To do this you must:

(a) Under services tab select Pharmacy Weigh-Ins (Visits 1 to 6) – Weight Management Service

(b) Select the correct session number,

e.g. “initial session” on the first

consultation:

(c) Take client’s weight and record.

The BMI should automatically calculate

using the weight inputted and the height of

the client (recorded at registration stage).

(d) Select whether client has lost weight

since their previous consultation

(at the initial consultation this will be the

baseline weight recorded by Oviva).

(e) Repeat this process, (except the registration stage which only

needs to be done once), at each review visit.

Follow up appointments should be undertaken at 2-weekly

intervals until the client has reached their maximum of 6

sessions.

Ensure that the correct session is selected from the drop down

list, e.g. if it is the client’s second weigh-in this is “session 2”.

If it is the client’s sixth weigh-in this is “session 6”.

It is important that these are selected in the correct order:

(f) Text reminder messages can be sent to clients to remind them of their next appointment if this is

felt to be helpful AND the client has given their consent. Select “consent granted” and enter client’s

mobile number:

All consultations provided under this service must be recorded on PharmOutcomes with ONE week of the

consultation.

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The consultation form can be downloaded from the weight management section of the CPWY website at http://www.cpwy.org/pharmacy-contracts-services/local-services-enhanced-/weight-management-service.shtml

Appendix 2