Specialist Weight Management Service
Second Nature is now available to your patients via NHS Right to Choose. Find your local eligibility criteria, referral forms, and everything you need to get started.
Eligibility criteria
Your patient must meet one of the following
50 kg/m² or above
Includes patients who have not engaged with Tier 1 or 2, where the GP feels they will benefit from Tier 3 input sooner.
40 kg/m² or above
Has demonstrated maximised primary care and community conservative management
35 kg/m² or above
One or more weight-related comorbidity from the list below
Has demonstrated maximised primary care and community conservative management
Qualifying comorbidities
Significant cardiovascular disease
Hypertension
Hyperinsulinaemia
Dyslipidaemia
Sleep apnoea
Benign intracranial hypertension
Exacerbation of conditions such as asthma
Complex mental health and psychological issues with raised BMI
Eating disorders, disordered eating and weight related mental health issues
Pre-diabetes, HbA1c 42 to 48 mmol/mol, with BMI over 40 kg/m²
Type 2 diabetes, HbA1c over 48 mmol/mol, with BMI over 40 kg/m²
Type 2 diabetes with onset within 10 years, with BMI 35 to 40 kg/m²
Precluded from the surgery waiting list on the basis of BMI, with BMI above 35 kg/m²
Exclusion criteria
Not registered with a North East and North Cumbria practice
Under 18
BMI of 30 kg/m² or below
Referred from an inpatient mental health unit
Unable to participate in all components of a Tier 3 programme
Active inflammatory bowel disease
Requires or requests weight loss injections alone, or requires a very low calorie diet
Consuming more than 20 units of alcohol per week
Previous bariatric surgery
Pregnant
Active substance abuse
Active cancer and undergoing treatment
Severe cognitive impairment, uncontrolled mental health, or personality disorders making engagement difficult
Two pathways, both consultant-led.
We assess each patient and personalise their care.
Our specialist team includes consultant physicians, specialist dietitians, health psychologists, pharmacists, nurses and exercise specialists.
Consultant-led MDT. GLP-1 prescribing (Wegovy) where clinically appropriate. Dietetic, psychological, and behavioural support for up to 24 months.
Consultant-led MDT. Dietetics, psychology, exercise support. Structured lifestyle programme for 12 months.
Refer to us
Referrals can be submitted via NHS e-RS or directly by NHS mail. Follow the steps below for your area.
1
If you can't import files into your clinical system, download the .docx referral form and complete it as a Word document.
Using Ardens, DXS or another local form management system?
Check there first; if we're not listed yet, ask your file management lead to add this form.
2
