Evaluation of the experience of people referred under the NHS enhanced service incentive for obesity to the NHS digital weight management programme: a mixed method study.

backgroundInternationally, guidelines recommend clinicians identify patients living with obesity and offer referral to weight management programmes, especially patients with related co-morbidities. In 2021, NHS England introduced the NHS Digital Weight Management Programme for people living with obesity and a diagnosis of hypertension or diabetes or both. The programme is offered at three levels of intensity with people triaged to the appropriate level determined through age, sex, ethnicity, and deprivation. The aim of this study was to assess the experiences of people referred to the programme.

methodsA mixed methods evaluation, involving questionnaires and semi-structured interviews with patients. Questionnaires were sent to everyone who registered and chose a preferred service Provider between March 2022 and June 2023, and responses are reported as proportions. Differences in health status, demographic characteristics and experience on the programme were assessed using ordinal logistic regression. A sample of patients were interviewed, and data were analysed using a framework.

results17,553 questionnaires were distributed, with 3885 (22.1%) completed. We interviewed 24 patients (27 to 79 years of age; 15 females, 9 males), who had various levels of support and rates of completion. The programme was reported to be easy to use, and around half of survey respondents felt the programme helped them change their diet or activity or improved their wellbeing, regardless of the level of support received. Participants from minority ethnic groups were less likely to describe the programme or the coaching as helpful in terms of changing behaviour. Interview participants valued weight tracking, goal setting, and meal planning, but some felt the service was too generic for their individual needs. Some participants reported they did not receive sufficient in-person or group support, and that online forums were not a suitable alternative. Around half of participants found coaching helpful, but some described the coaches as unresponsive or scripted.

conclusionThe NHS Digital Weight Management Programme was moderately well received by most participants, and facilitated weight loss, behaviour change, and continued engagement. It was less helpful for people from minority ethnic groups, and some participants wanted more frequent contact and greater personalization in interactions with health coaches.