Endocrine Abstracts

Bariatric surgery has become one of the fastest growing areas of medicine. However, the surgical procedure is only one step in the management of obesity. How should the clinical pathway for the obese individual be designed to ensure optimal results and provide the healthcare savings predicted by the health economic studies?

The Health and Social Care Act 2012 redesigned the NHS in England with local commissioning of clinical services and national commissioning for specialised services. The Specialised Commissioning Board has clinical reference groups including one for complex and severe obesity whose role is to design clinical service specifications.

The management of obesity, from prevention to bariatric surgery, is now structured in four tiers with bariatric surgery being in tier 4. However the four tiers are commissioned by different authorities. The obesity pathway, its’ evolution and development will be discussed.