Specialist Weight Management Service
Thames Valley
Thames Valley
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.
NHS provider and partner for 9 years
NICE HTE14 recommended
CQC registered
20+ peer-reviewed publications
300,000+ Patients supported
NHS provider and partner for 9 years
NICE HTE14 recommended
CQC registered
Recommended by GPs
300,000+ Patients supported
Clinically-proven treatment
NHS provider and partner for 9 years
NICE HTE14 recommended
CQC registered
20+ peer-reviewed publications
300,000+ Patients supported
Clinically-proven treatment
Eligibility criteria
BMI
35 kg/m² or above and meets one of the additional eligibility criteria
For people from South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean ethnic backgrounds, the qualifying BMIs are 2.5 kg/m² lower (e.g. 32.5 kg/m² instead of 35 kg/m²).
Comorbidities
Active malignancy where rapid weight loss is required for planned therapy, for example radiotherapy or surgery.
*Evidence needed: Letter from specialist confirming planned time sensitive surgery and target weight.
Patients requiring referral to waiting list for organ transplant where BMI is the only criteria that is not met.
*Evidence needed: Letter from specialist confirming planned organ transplant and target weight.
Idiopathic intracranial hypertension (IIH) requiring frequent lumbar punctures and/or visual compromise.
*Evidence needed: Letter from specialist confirming diagnosis.
Patients undergoing planned time-sensitive surgery for life-limiting conditions, where high BMI is the primary barrier to surgery and weight loss would be beneficial e.g. general surgery.
*Evidence needed: Letter from NHS specialist confirming condition and target weight.
Women who meet the Thames Valley ICB criteria for assisted conception that are under the care of a fertility service, in cases where weight loss would be beneficial. Patients need to be on non-oral contraception to start therapy.
*Evidence needed: Letter from NHS fertility service and target weight.
Severe Obstructive Sleep Apnoea (as outlined in the Thames Valley Policy); AHI score > 30 confirmed on sleep study.
*Evidence needed: Date of sleep study and AHI score.
Proven genetic cause of obesity and not eligible for Setmelanotide (Imcivree®) – see NICE HST31 and HST21. Order or find a test – South-East Genomics
*Evidence needed: Letter from genetic clinic.
Exclusion criteria
• Patients under 18 years old.
• Patient’s underlying causes of overweight or obesity needs to be assessed.
• Patients who are currently successfully losing weight with dietetic or reputable evidence-based weight management intervention.
• Patients who have been previously referred into the service and have left the pathway early or have disengaged from the services, who are seeking to re-enter as a re-referral will not be eligible within 24 months.
• Pregnant women - women becoming pregnant or breastfeeding during the programme will be able to pause the programme (‘time out policy’) and return to the service following the birth.
• Patients with uncontrolled hypertension/heart condition/medical condition preventing increase in activity level.
• Patients with unstable hypothyroidism (can be referred if stable).
• Patients with unstable Cushing’s syndrome (can be referred if stable).
• Patients who have had bariatric surgery.
• Active or suspected, untreated eating disorders including binge eating disorder, purging within the last 3 months.
• Patients with unstable or severe mental illness beyond the expertise of primary care.
• Patients with active eating disorders.
• Patients who have made suicide attempts within the last year.
• Patients who have self-harmed in the past 3 months.
• Patients who have had suicidal ideation in the past 3 months.
• Unstable alcohol or drug use (can be referred if the patient has received support and been in recovery for 3 months).
Eligibility criteria
BMI
35 kg/m² or above and meets one of the additional eligibility criteria
For people from South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean ethnic backgrounds, the qualifying BMIs are 2.5 kg/m² lower (e.g. 32.5 kg/m² instead of 35 kg/m²).
Comorbidities
Active malignancy where rapid weight loss is required for planned therapy, for example radiotherapy or surgery.
*Evidence needed: Letter from specialist confirming planned time sensitive surgery and target weight.
Patients requiring referral to waiting list for organ transplant where BMI is the only criteria that is not met.
*Evidence needed: Letter from specialist confirming planned organ transplant and target weight.
Idiopathic intracranial hypertension (IIH) requiring frequent lumbar punctures and/or visual compromise.
*Evidence needed: Letter from specialist confirming diagnosis.
Patients undergoing planned time-sensitive surgery for life-limiting conditions, where high BMI is the primary barrier to surgery and weight loss would be beneficial e.g. general surgery.
*Evidence needed: Letter from NHS specialist confirming condition and target weight.
Women who meet the Thames Valley ICB criteria for assisted conception that are under the care of a fertility service, in cases where weight loss would be beneficial. Patients need to be on non-oral contraception to start therapy.
*Evidence needed: Letter from NHS fertility service and target weight.
Severe Obstructive Sleep Apnoea (as outlined in the Thames Valley Policy); AHI score > 30 confirmed on sleep study.
*Evidence needed: Date of sleep study and AHI score.
Proven genetic cause of obesity and not eligible for Setmelanotide (Imcivree®) – see NICE HST31 and HST21. Order or find a test – South-East Genomics
*Evidence needed: Letter from genetic clinic.
Exclusion criteria
• Patients under 18 years old.
• Patient’s underlying causes of overweight or obesity needs to be assessed.
• Patients who are currently successfully losing weight with dietetic or reputable evidence-based weight management intervention.
• Patients who have been previously referred into the service and have left the pathway early or have disengaged from the services, who are seeking to re-enter as a re-referral will not be eligible within 24 months.
• Pregnant women - women becoming pregnant or breastfeeding during the programme will be able to pause the programme (‘time out policy’) and return to the service following the birth.
• Patients with uncontrolled hypertension/heart condition/medical condition preventing increase in activity level.
• Patients with unstable hypothyroidism (can be referred if stable).
• Patients with unstable Cushing’s syndrome (can be referred if stable).
• Patients who have had bariatric surgery.
• Active or suspected, untreated eating disorders including binge eating disorder, purging within the last 3 months.
• Patients with unstable or severe mental illness beyond the expertise of primary care.
• Patients with active eating disorders.
• Patients who have made suicide attempts within the last year.
• Patients who have self-harmed in the past 3 months.
• Patients who have had suicidal ideation in the past 3 months.
• Unstable alcohol or drug use (can be referred if the patient has received support and been in recovery for 3 months).
Our pathways
A specialist service built around your patient's needs
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.
Medication pathway
Medication pathway
Consultant-led MDT. GLP-1 prescribing (Wegovy) where clinically appropriate. Dietetic, psychological, and behavioural support for up to 24 months.
Behavioural pathway
Behavioural pathway
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
Download and complete your referral form
Download and complete your referral form
Before referring, download the referral form and complete it in full.
Incomplete referrals cannot be processed.
Before referring, download the referral form and complete it in full. Incomplete referrals cannot be processed.
EMIS users
EMIS users
Import the auto-populating referral form template directly into your system. This pulls patient information from the record automatically, reducing manual entry. For guidance on how to do this, see the EMIS Setup and Referral Guide.
Import the auto-populating referral form template directly into your system. This pulls patient information from the record automatically, reducing manual entry. For guidance on how to do this, see the
SystmOne users
SystmOne users
Import the auto-populating referral form template directly into your system. This pulls patient information from the record automatically, reducing manual entry.
For guidance on how to do this, see the SystmOne Setup and Referral Guide.
Import the auto-populating referral form template directly into your system. This pulls patient information from the record automatically, reducing manual entry.
For guidance on how to do this, see the SystmOne Setup and Referral Guide.
All other systems
If you can’t import files into your clinical management systems
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
Submit your referral form
Submit your referral form
Once the referral form is complete, submit it using one of the following methods.
Once the referral form is complete, submit it using one of the following methods.
NHS e-RS
NHS e-RS
Access e-RS directly or through your clinical system. Attach the completed referral form before submitting. Need a step-by-step walkthrough?
Access e-RS directly or through your clinical system. Attach the completed referral form before submitting. Need a step-by-step walkthrough? View our e-RS guidance
NHSmail
NHSmail
Send the completed referral form as an attachment to secondnature.referrals@nhs.net
Send the completed referral form as an attachment to secondnature.referrals@nhs.net
If you have a question about the referral process, contact
Matt Reid (Partnerships Associate) at matthew.reid@secondnature.io or call 07540235288.
Free webinar
Tue 22 Sept, 13:00
Obesity is now in QOF.
What it means for your practice
Dr Rachel Hall MRCGP, MRCP
Principal Doctor and Registered GP
Dr Becky Richards PhD Lead Psychologist and HCPC Registered Health Psychologist
Register your interest
Free webinar
Tue 22 Sept, 13:00
Obesity is now in QOF.
What it means for your practice
Dr Rachel Hall MRCGP, MRCP
Principal Doctor and Registered GP
Dr Becky Richards PhD Lead Psychologist and HCPC Registered Health Psychologist
Register your interest
Free webinar
Tue 22 Sept, 13:00
Obesity is now in QOF.
What it means for your practice
Dr Rachel Hall MRCGP, MRCP
Principal Doctor and Registered GP
Dr Becky Richards PhD Lead Psychologist and HCPC Registered Health Psychologist
Register your interest
Free webinar
Tue 22 Sept, 13:00
Obesity is now in QOF.
What it means for your practice
Dr Rachel Hall MRCGP, MRCP
Principal Doctor and Registered GP
Dr Becky Richards PhD Lead Psychologist and HCPC Registered Health Psychologist
Register your interest
Nine years delivering specialist weight management on the NHS
We've supported over 300,000 patients, hold outcomes data for every ICB in England, and are backed by over twenty peer-reviewed publications. We don't just claim to deliver results. We can showcase years of exceptional outcomes for patients in your area.
Week 2
Building healthy habits
Nine years delivering specialist weight management on the NHS
We've supported over 300,000 patients, hold outcomes data for every ICB in England, and are backed by over twenty peer-reviewed publications. We don't just claim to deliver results. We can showcase years of exceptional outcomes for patients in your area.
Week 2
Building healthy habits
Nine years delivering specialist weight management on the NHS
We've supported over 300,000 patients, hold outcomes data for every ICB in England, and are backed by over twenty peer-reviewed publications. We don't just claim to deliver results. We can showcase years of exceptional outcomes for patients in your area.
Week 2
Building healthy habits
Nine years delivering specialist weight management on the NHS
We've supported over 300,000 patients, hold outcomes data for every ICB in England, and are backed by over twenty peer-reviewed publications. We don't just claim to deliver results. We can showcase years of exceptional outcomes for patients in your area.
Week 2
Building healthy habits
Nine years delivering specialist weight management on the NHS
We've supported over 300,000 patients, hold outcomes data for every ICB in England, and are backed by over twenty peer-reviewed publications. We don't just claim to deliver results. We can showcase years of exceptional outcomes for patients in your area.
Week 2
Building healthy habits
Second Nature®
Scale Space, 58 Wood Lane, London, W12 7RZ
hello@secondnature.io
Registration No: 08511152 registered in England and Wales © Second Nature Healthy Habits Ltd 2026
Scale Space, 58 Wood Lane, London, W12 7RZ
hello@secondnature.io
Second Nature®
Registration No: 08511152 registered in England and Wales © Second Nature Healthy Habits Ltd 2026