What is changing in Sefton?

From 1 November 2026, referrals for residents of Sefton will be assessed against criteria aligned to recommendations published by the Society for Endocrinology and partner organisations regarding access to Specialist Weight Management Services in England. Priority access will focus on:

Individuals with a BMI above 50 kg/m² (ethnicity-adjusted).
Individuals with a BMI above 35 kg/m² (ethnicity-adjusted) who also have significant obesity-related health conditions or complex clinical, psychological or social needs.
Young people transitioning from specialist obesity services.
Individuals requiring urgent weight loss to access time-critical treatments or surgery.
Patients who meet NICE criteria and wish to pursue bariatric surgery.

This proposed change to access criteria has been approved through our governance processes following consideration of demand, clinical need, service capacity, waiting lists, variation in provision across Cheshire and Merseyside, national guidance and emerging evidence-based recommendations.

How will this affect patients?

The revised criteria aims to ensure that people with the most significant obesity-related health complications can access this very specialist, multi-disciplinary weight management support in a timely manner.

Patients already receiving treatment under this service will not be affected by this change to the referral criteria.

However, future patients and those on the waiting list who do not meet the new criteria will no longer be eligible for Tier 3 services.

Depending on individual patient circumstances alternative support will continue to be available through:

Primary care led weight management interventions.
NHS digital weight management programmes.
Weight management medications, prescribed in accordance with NICE guidance and local commissioning arrangements.
Community lifestyle and behavioural support services, please note that these services are not provided to the same level of specialist support as Tier 3 services and may not be suitable for all individuals within this group.

We are also actively exploring options to further strengthen the support available.

Why are these changes being made?

Several key challenges have been identified that need to be addressed, including:

Demand for specialist weight management services now significantly exceeds available capacity.
Access criteria differs across local areas, creating variation and inequity in service provision.
Existing arrangements have relied heavily on BMI thresholds rather than wider assessment of clinical complexity and risk.
National clinical guidance increasingly supports prioritisation based on obesity-related complications and specialist need.

What is happening, and when?

Stage one

In stage one of this work, revised referral criteria will be introduced from 1 November 2026 for new patient referrals in Sefton.

Feeback on this change to referral criteria is currently being gathered directly from primary care clinicians, patients and wider stakeholders in Sefton. You can also share comments and feedback with us by email at: T3SWMS@cheshireandmerseyside.nhs.uk