Complications from Excess Weight (CEW) clinics for children

Obesity affects one in four children in the UK and can increase the likelihood of a child developing serious health issues such as Type 2 diabetes, liver conditions and early heart disease.

Children living with obesity can also develop difficulties such as breathing problems, sleep issues and mental health problems, which can dramatically impact their quality of life. However early action can prevent the onset of these long-term health problems which is beneficial for the health outcomes of patients and the sustainability of the NHS.

The number of children living with obesity almost doubles from the start of primary school to the end of primary school. The latest data shows one in four children aged 10-11 are obese in England. Two and a half million children in England are affected by excess weight or obesity, with 1.22 million significantly obese and eligible for treatment according to NICE guidance.

Complications from Excess Weight (CEW) clinics use a holistic approach to treating conditions related to obesity in children and young people (CYP). Fifteen CEW clinics will be rolled out in a pilot scheme. Clinics will be delivered by a multidisciplinary team (MDT), linked to a specialist children’s hospital.

The three aims of the service are to:

  • Identify the factors involved in the development of severe obesity. Assessment should be holistic with equal consideration for mental health, physical health and social needs.
  • Treat complications associated with severe obesity and coordinate / refer onto other services where required.
  • Consider an individualised holistic plan. This may include interventions such as family-based therapy, behavioural coaching, dietary strategies, and mental health support. This aims to address health inequalities by considering culturally appropriate factors and a personalised approach.

Children will receive holistic treatment and person-centred care packages developed with their family, which could include mental health treatment, coaching and advice around a healthy diet.

The rollout of the pilot delivers on the NHS Long Term Plan ambition to treat children for severe complications related to their obesity, avoiding the need for more invasive treatment. One thousand children a year, who are aged between two and 18 and experiencing health complications related to severe obesity, will be supported through the new services.

The 15 centres will be based across the country in the following locations:

  1. Bristol Royal Hospital for Children – University Hospitals Bristol and Weston NHS Foundation Trust
  2. Derriford Hospital – University Hospitals Plymouth
  3. University Hospitals Southampton including Dartford, Portsmouth, Brighton and Oxford
  4. Kings College Hospital and Bart’s Health NHS Trust
  5. Great Ormond Street Hospital, University College London Hospital and the Tavistock and Portman NHS Foundation Trust
  6. Addenbrooke’s Hospital – Cambridge University Hospitals NHS Foundation Trust
  7. Norfolk and Norwich University Hospitals NHS Foundation Trust
  8. Birmingham Women and Children’s NHS Foundation Trust
  9. Nottingham Children’s Hospital / Leicester Royal Infirmary
  10. Sheffield Children’s NHS Foundation Trust
  11. Alder Hey Children’s NHS Foundation Trust
  12. Royal Manchester Children’s Hospital – Manchester University NHS Foundation Trust
  13. Royal Preston Hospital – Lancashire Teaching Hospitals NHS Foundation Trust
  14. Leeds Teaching Hospitals NHS Trust
  15. South Tees Hospitals NHS Foundation Trust

Mobilisation of the clinics has already begun, and we expect some patients to access care in 2021. We will continue ramping up access in 2022 as specialist teams are recruited and trained to give expert care.

How will people be able to get an appointment and what are the criteria for referral?

Children and young people will be able to access CEW clinics following a referral from secondary or tertiary paediatrician following referral by a range of clinicians including:

•    Community paediatrician
•    General practitioners from primary care; and
•    From another clinical speciality (i.e. CYP MH services) or secondary care paediatrician
•    Community paediatrician
•    General practitioners from primary care; and
•    From another clinical speciality (i.e. CYP MH services) or secondary care paediatrician

Referral to the specialist obesity clinic should be based on (i) the degree of obesity and (ii) presence of comorbidities. It is suggested some blood tests could be conducted on referral. It is acknowledged each local system may need to adapt its referral criteria according to local demand and within the context of existing. Referrals should be considered based on need.

If you would like more information on the obesity programme please contact the CYP Transformation Programme team at: england.cyptransformation@nhs.net