Pharmacy weight management service integrated into care pathway Liz Stafford NHS Commissioning Lead Rowlands Pharmacy Vice- Chair Central Lancs LPC lstafford@rowlandspharmacy.co.uk 07795-037677

Working with GPs, Healthcare Professionals and the LPC - “Leading Across Boundaries” Structured Behaviour Change programme (12 months) based on motivational interviewing and brief interventions (NICE guidelines) aimed at those with BMI >25 and < 40, over 18 years. Holistic tailored healthy lifestyle advice, including diet and activity with quality information materials and incremental goal setting. “Raise the issue” and “Assess readiness to change” before offering a choice of weight management options across the care pathway. Leading Across Boundaries Programme was developed by RPSGB and NW SHA. Liz Stafford was a Steering Group member.

Working with GPs, Healthcare Professionals and the LPC - “Leading Across Boundaries” Project Team – GP PEC lead, LPC, community pharmacist, PCT development pharmacist, public health lead, PCT commissioning lead, PCT weight management care pathway co-ordinator, PCT finance lead, PBC business manager. Public Survey – showed that people wanted a service which was free of charge, medically approved, easily accessible and flexible. Metrics - weight , BMI, waist circumference , B.P. Criteria, Consent & Referrals - agreed with GPs

Working with GPs, Healthcare Professionals and the LPC - “Leading Across Boundaries” Evaluation Results (UCLAN) : Statistically significant results – at least 5% body weight loss , sustained over 12 months (average 2.9kg & BMI 2.4 reduction) At £160 per patient, it is more cost effective than prescribing Orlistat over 12 months (120mg tds @ £419.51) Average reduction in BP 9/6 (substitute for antihypertensive?) Positive patient experience and pharmacist satisfaction (patient -centred)

Working with GPs, Healthcare Professionals and the LPC - “Leading Across Boundaries” Recommendation: Clinically and cost effective , based on NICE standards . High satisfaction in service users and pharmacists (patient -centred) The pharmacy weight management service should be commissioned to play it’s part within the pathway, especially as NICE (CG 43) advises that “Drug treatment should only be considered after dietary, exercise and behavioural approaches have been started and evaluated.