Endocrine Abstracts

Introduction: Severe obesity is unevenly distributed. By the end of primary school, severe obesity is four times as prevalent in the most deprived areas¹. Children from ethnic minority backgrounds are over-represented in CEW clinics compared to Office for National Statistics Data² distribution. Ethnicity and deprivation do not operate in silo. They compound and deepen vulnerability, worsening health outcomes³. For many families, immediate tasks of daily survival supersede prevention or action towards improving long term health. Significant CEW MDT time is spent assisting with basic needs of shelter and security causing barriers for progression with weight management.

Methods: Sensitive enquiry of socioeconomic barriers is part of holistic CEW assessments to understand family factors and context affecting resilience or compromising ability to follow lifestyle management plans. From December 2024, a CAS advisor joined the Sheffield CEW MDT for a 12-month pilot. This integration enables direct and consented referral to the CAS Advisor who contacts families to arrange confidential expert help with various legal, financial and housing challenges. This is relational care - support from someone who knows your story, offered by someone you already trust. Hands on digital assistance, using interpreters as required, ensures no one is excluded from care. With permission the advisor reports back and can directly request additional gateway information from MDT to promptly unlock access.

Results and Conclusion: In just 6 months, 31 families disclosing a single issue to the CEW MDT were referred to the CAS advisor. Proactive and expert enquiry by CAS then identified a total of 222 issues including benefits, debt, housing, utilities, tax, travel, education, asylum, and untapped charitable support such as food banks. The advisor worked alongside families to navigate overwhelming systemic complexities resulting in a total of £29 514 of recovered access to rightful financial support. When embedded in a CEW service model, CAS can address Maslow’s hierarchy of needs to create the conditions for motivation, engagement and improved well-being, increasing the effectiveness of CEW services⁴.

1. NCMP 23/24 School year.

2. https://www.enhance-research.com

3. Health Equity in England: The Marmot Review 10 Years On, 2020

4. A.H.Maslow 1943, A theory of human motivation.