6427 Obesity pathway for Children and Young people – the need of the hour

Objectives Background: Obesity is a major pandemic and it increases the morbidity and mortality across all age groups. This causes significant burden on health and social care. Creating a comprehensive pathway across the whole healthcare system is important for early identification and effective intervention. Objectives: We aim to discuss the creation of a seamless obesity pathway for CYP in our region (Leicester, Leicestershire and Rutland) and to share our experiences. Methods 1) Scoping phase: We created an obesity working group involving all stakeholders including ICB (Integrated Care Board), local authorities, public health, tier 2 obesity services and the CEW( Complications related to excess weight) clinic.Representative from all the stakeholders met regularly,We reviewed the guidelines and conducted a thorough evaluation. Taking a comprehensive approach, we recognised the necessity for a streamlined pathway to enhance service delivery. 2) Discovery phase: We detailed and mapped the existing obesity services for CYP in our region. The gaps identified were: The Tier 2 Obesity County service did not extend across the whole age group. Tier 2 obesity city service did not include a physical activity component in their intervention. Patients, particularly those with neurodiversity, who could not attend group sessions did not have 1:1 clinics. Screening for co-morbidities was not completed as per the guidelines¹ ² The services were not linked 3) Design phase: The Tier 2 services were aligned to cover the whole age band (2–18 yrs). A new Tier 2 plus service was established to bridge the gaps. The team included a Community Paediatrician, a paediatric dietitian and a physical trainer. Our ICB approved funding for this new service. 4) Implementation phase: The above changes including the Tier 2 plus service were implemented. All the obesity services was linked. Results We created a seamless obesity pathway for CYP in our region and successfully implemented it. We shared our resources between our services and had clear step-up and step- down approach. Our current pathway which is working efficiently is attached. The intervention cost per patient in the Tier 2 plus service is far less than that of CEW clinics. Conclusion Tackling obesity in CYP requires a whole system approach and joint working. A clear pathway facilitates early identification, referral, and intervention. This will improve the outcome and substantially reduce the cost. We highly recommend creating a similar pathway in every region to complement the recently established CEW clinics. References NICE guideline [CG189].Obesity: identification, assessment and management. Published: 27 November 2014 Last updated: 26 July 2023, avilable at www.nice.org.uk/guidance/cg189. Viner RM, White B, Barrett T, Candy DC, Gibson P, Gregory JW, Matyka K, Ong K, Roche E, Rudolf MC, Shaikh G. Assessment of childhood obesity in secondary care: OSCA consensus statement. Archives of Disease in Childhood-Education and Practice 2012 Jun 1;97(3):98–105.