Tier 3 Weight Management - Information for Patients

Here you will find all the information you will need if you have been referred to our service. It will also help those who would like to know more about how our service works.

If you would like more information regarding our Tier 3 Weight Management programme, please click here.

Depending on where you live, if you haven’t attended a Tier 2 service in the last two years, you will need to attend a local programme for 10-12 weeks:

  • In Derby City, your programme is likely to be with Livewell Derby. Priority will be given to patients who have not accessed these services before
  • In Derbyshire, it is likely to be with Live Life Better Derbyshire
  • If you have diabetes or high blood pressure, you can instead be referred to the NHS Digital Weight Management Programme

These services offer group sessions, advice, support from friendly coaches and help with eating, activity and wellbeing.

These Tier 2 lifestyle services provide structured, evidence-based support to help individuals achieve long-term behavioural change. For most patients, this support will be sufficient. Only those with more complex or unresolved needs may be referred to the Tier 3 Specialist Weight Management Programme by the Tier 2 service, following assessment and multidisciplinary team (MDT) discussion.

In Derby City the Tier 2 Service is called Livewell. You can find out more here: Lose Weight | Livewell (livewellderby.co.uk)

In Derbyshire the Tier 2 Service is called Live Life Better Derbyshire. You can find out more here: Losing weight – Live Life Better Derbyshire

Decisions to escalate a patient to the Tier 3 Specialist Weight Management Programme are made collaboratively between the Tier 2 and Tier 3 teams, based on set clinical thresholds.

Patients must first engage with and complete a Tier 2 programme.

Minimum attendance requirements are:

  • Livewell Derby: at least 7 out of 10 sessions
  • Live Life Better Derbyshire: at least 9 out of 12 sessions

Patients may be referred to Tier 3 if they:

  • Have complex physical or psychological health needs
  • Have not made sufficient progress despite full Tier 2 engagement
  • Are potentially eligible for Tier 4 (bariatric surgery)
  • Are unable to access Tier 2 due to neurodiversity, trauma, or other significant barriers

These referrals are considered through regular joint multi-disciplinary meetings, often led by psychology teams, to ensure decisions are clinically appropriate.

If you are thinking about weight loss surgery in the future, you will need to still complete the 12 weeks education aspect of our programme to prepare you with what dietary changes you will need to ideally maintain pre and post-surgery. You will be assessed by a specialist dietician and a doctor as well as one of the psychologists, to ensure that you are in a good place to consider surgery. Surgery can be a big thing, so we want to make sure you are mentally and physically prepared.   

Weight loss surgery is only successful in the long term when you build in good habits in your eating and exercise habits.   

Once all members of the team agree, you may then be referred on to a tier 4 surgical service.

For more information on weight loss surgery please follow this link:

You can read some general information about weight loss surgery on the NHS website by following this link - https://www.nhs.uk/conditions/weight-loss-surgery/ 

Our colleagues at University Hospitals Derby have some excellent information on their website too: Bariatric surgery (weight loss) | University Hospitals of Derby and Burton NHS

You can find get lots of information about losing weight and keeping healthy here: NHS Better Health.

If Tier 3 Weight Management isn’t right for you, you might be interested in the free Tier 2 Weight Management services.  

In Derbyshire the Tier 2 Service is called Live Life Better Derbyshire. You can find out more here: Losing weight - Live Life Better Derbyshire.

In Derby City the Tier 2 Service is called Livewell. You can find out more here: Lose Weight | Livewell (livewellderby.co.uk).

If you also have Type 2 Diabetes, you can ask your GP to refer you to our Diabetes Education programmes. You can find out more information about Diabetes Education here.

Diabetes Remission Programme - Diabetes Remission Programme | Help to Reverse Diabetes

If you need support with your mental health, you can self-refer to free talking therapy services. In Derbyshire and Derby City these are: 

Trent PTS - Telephone: 01332 265 659.

Vita Minds - Telephone: 0333 0153 496.

Insight Healthcare - Telephone: 0300 555 5582.

Talking Mental Health Derbyshire - Telephone: 0300 123 0542.

Other websites that might be helpful to support you:

Derbyshire Mental Health Helpline and Support Services - Mental health helpline and support.

Derbyshire Recovery Partnership - support for people experiencing alcohol or drug related issues.

Cost of Living Support- lots of information and advice, to help make sure that you're getting all the help that you are entitled to.


Psychologists

Our psychologists are experts in helping people make changes to their behaviour and lifestyle. They can help people understand the underlying issues that make it difficult to lose weight. They can also help people understand what they need to do to lose weight for the long term. 

You may have an appointment with a psychologist whilst you are in the service if we feel that you could benefit. Note that even if you don’t meet a psychologist 1-1, we do have resources to share with you that our psychologists have written which can help you with things like emotional eating, stress management and being kinder to yourself. These topics are often relevant when it comes to working with weight management. They will support the Weight Management Advisers whilst you are working with them.

Nutrition Professionals

Our specialist dietitians support patients with weight loss through lifestyle and behaviour change. They have lots of knowledge about many conditions that are linked to obesity. They will also support those who are thinking about weight loss surgery. They will help patients that have extra clinical needs for weight loss.

Doctors

You may see a doctor during your time with us. Our doctors see people who need a medical assessment. They help to manage some of the health problems linked to being overweight. They will also see some people who are thinking about weight loss surgery, and help decide if this is the right choice.

Weight Management Advisors

You will see our weight advisors several times whilst in the service. They will talk about how you have been getting on with the core messages and help you to apply them in your own life. They might help you to set small goals. Their advice will be geared towards helping you make changes in the long term.​​​​​​​


"It's been amazing.  I will miss talking to my adviser. Even when I hadn't lost weight he would tell me to be pleased I hadn't put weight on” 

"It's been excellent. I got out as much as I can, everybody has been very professional. I'd recommend it to anybody. I’d like to thank you and your colleagues for all you did for me".  

“All I’ll say is keep doing what you’re doing. It has opened my eyes. Thank you”.    

“When I came to you, I couldn’t imagine I could get anywhere. You’ve given me something I never thought I’d have. I had tried anything I could and had been referred to tier3 before. I was genuinely not expecting results. The changes in my thinking, the realisations, the freedom that I have choices and control.” 


Contact Us:

  • Email: dchst.swm@nhs.net
  • Post: Tier 3 Weight Management Service, Lea Hurst, Walton Hospital, Whitecotes Lane, Chesterfield, S40 3HW