Chamber and committees

The Quality and Outcomes Framework (QOF) element of the GP contract already recognises obesity and weight management within a number of the clinical indicators, including mental health and diabetes. Any changes to QOF clinical indicators are considered by an advisory committee led by the National Institute for Health and Clinical Excellence and are then subject to UK negotiation and agreement.

The Obesity Treatment Subgroup of the National Planning Forum (NPF) is reviewing the evidence on clinical pathways and will provide options to the NPF to facilitate agreement on pan Scotland approaches to enable equitable access to weight management interventions.

There are no reliable estimates of the percentage of obese people with comorbidities.

At a population level, increased mortality and higher incidence of disease related to increased fat mass are seen most markedly when BMI raises above 30 kg/m². The Scottish Public Health Observatory has calculated that around 47% of type 2 diabetes, 36% of hypertension, 29% of colon cancers, 18% of myocardial infarctions, 12% of osteoarthritis and 6% of strokes can be attributed to obesity.

It is for clinicians and patients to agree, in line with national guidelines and frameworks, the appropriate support required by individuals for whom bariatric surgery is not considered the appropriate option.

The commitment in Preventing Overweight and Obesity in Scotland: A Route Map Towards Healthy Weight to ensure that cost-effective and appropriate weight management services and treatments are available for patients in Scotland include investing in resources for the continuing professional development of primary care professionals to develop a better understanding of obesity, its management and treatment.

The Obesity Treatment Subgroup of the National Planning Forum (NPF) is reviewing the evidence on clinical pathways and will provide options to the NPF to facilitate agreement on pan Scotland approaches to enable equitable access to weight management interventions.

A health inequalities impact assessment workshop was held and is seeking additional evidence to find out whether services meet the needs of all population groups.

The Scottish Government sets national direction of policy on mental health and provides funding to agencies, including NHS boards and local authorities, to support implementation of policy. The management of local actions in implementing and evaluating national policy are the responsibility of relevant local agencies.

Officials together with colleagues from the Mental Health Collaborative, ISD and NES have met with each NHS board to discuss progress in developing workforce capacity, referral pathways and information systems to ensure delivery of the Psychological Therapies HEAT target.

In addition we published Applied Psychologists and Psychology in NHS Scotland in March 2011 which has identified the key challenges and opportunities in the provision of psychology services, and the role of psychologists in supporting staff from all disciplines to increase the capacity to deliver psychological therapies in the future.

The main recommendations in the report are directed specifically to the NHS board concerned and we have asked that board to take immediate action to implement all of the report’s recommendations directed to it.

All NHS boards have responsibility for ensuring appropriate care pathways when transferring patients from mental health wards to general acute wards.

Improving service response in general hospitals is a key improvement area in Scotland’s National Dementia Strategy and the Cabinet Secretary for Health, Wellbeing and Cities Strategy has asked the Chief Nursing Officer to oversee implementation of the national dementia standards in general hospital settings and to give assurance that care for older people in these settings, whether or not they have dementia, is meeting the highest standards of care and compassion.

Implementation of the new dementia care standards together with accelerated implementation of the dementia integrated care pathway standards and the new dementia skills and knowledge framework for health and social services staff will be key to ensuring that care pathways are improved across and within all care settings, including general hospitals.

Treatment options are a matter for discussion between patients and their doctors. Clinical need is the main factor that determines the type, timing and location of any intervention required. NHS boards need to look at the services they provide for people with severe weight problems, to ensure that people have access to the services they need.

This information is not held centrally.

This information is not held centrally.