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). Twenty one clinics are now open and care is being 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 21 centres will be based across the country in the following locations:

Map of Complications from Excess Weight clinics

South West

  1. University Hospitals Plymouth NHS Trust Derriford
  2. Royal Cornwall Hospitals NHS Trust
  3. Bristol Royal Hospital ​For Children

South

  1. University Hospital Southampton
  2. Queen Alexandra Hospital
  3. Royal Sussex County Hospital
  4. Darent Valley Hospital
  5. John Radcliffe Hospital

London ​

  1. Kings College Hospital / Bart’s Health NHS Trust
  2. University College Hospital / Great Ormond Street Hospital / Tavistock Hospital

East of England ​

  1. Norfolk and Norwich ​University Hospital
  2. Cambridge University Hospitals NHS Foundation Trust

Midlands ​

  1. Birmingham Women and Children’s Hospital ​
  2. Nottingham University Hospital
  3. University Hospitals Leicester

North East and Yorkshire​

  1. Sheffield Children’s Hospital
  2. Leeds Teaching Hospital ​
  3. The James Cook University Hospital

North West​

  1. Royal Manchester Children’s Hospital ​
  2. Alder Hey​ Children’s Hospital
  3. Lancashire Teaching Hospitals NHS Foundation Trust

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