Tier 3 Weight Management - Information for Professionals

The information here is for professionals working with the Tier 3 Weight Management service.

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

As of 6 June 2025, GPs and other health professionals can no longer refer patients directly to Tier 3.

All referrals must now go to Tier 2 services first, which are:

  • Livewell Derby (for Derby City patients)
  • Live Life Better Derbyshire (for Derbyshire County patients)
  • NHS Digital Programme

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.

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 MDT meetings, often led by psychology teams, to ensure decisions are clinically appropriate.