Introduction of a biopsychosocial assessment to the Adult Weight Management Service

Project background:

The Adult Weight Management Service (AWMS) was established in 2013 and until 2021 consisted of predominantly dietetic and psychological pathways with some medical input.

In 2021 funding was received to enable the pathway to be strengthened and physiotherapy and occupational therapy were added to ensure a full MDT for the Level 3 AWMS.

The assessment consisted of service users having a dietetic assessment as their first appointment to assess their needs and signpost them to the most appropriate treatment pathway. In practice it took a median of 3 appointments to identify if  service users’ needs were outside of the dietetic pathways. This resulted in delays in patients being signposted into the appropriate intervention and duplication of assessment with service users having to repeat the same information multiple times.

With the addition of new pathways within the MDT, this process was no longer fit for purpose.

Project Aims:

• To achieve a reduction in the number of appointments needed to identify individuals needs by the introduction of a multidisciplinary biopsychosocial (BPS) assessment as the first appointment within the Level 3 AWMS.
• To ensure the full range of disciplines available within the AWMS are reflected in the BPS assessment and to reduce duplication by removing the need for profession specific assessments.
• To improve service user experience.

Project Outcomes:

A new multidisciplinary biopsychosocial assessment was initiated as the first appointment for individuals living with complex obesity attending the Level 3 Weight Management Service.   The new process merged individual professional assessments into one holistic biopsychosocial assessment that enabled the service users to tell their story and discuss the history and background to their weight and health at one time, in one place, to one person.

Project Impact:

253 people attended a virtual BPS assessment between January and December 2023.  100% of these had their weight related needs identified at this appointment.

36 people completed the patient experience questionnaire with 97% reporting they ‘always’ felt listened to in the appointment (figure 1) and 80% rating their experience as a 9 or 10 on a scale of 1-10 (figure 2).

The model is cost effective with the BPS model saving £15 – £30 per service user compared to the old model of single profession assessment, and £36 to £49 per patient compared to a model of multiple profession specific assessments.

Staff at more junior bandings have been upskilled to deliver this specialist assessment which is possible due to the ongoing clinical supervision and governance provided by senior clinicians via the fortnightly MDT meeting.