Evidence map›Paper›PMID 41775470›Full record

ArticleBMJ open2026

Effect of the English National Enhanced Service on weight management referral rate: an interrupted time-series analysis.

Stella J P Haffner, Richard John Stevens, Ben Amies-Cull, Laura Heath, Clare Bankhead, Paul Aveyard, Susan A Jebb

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Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Stella J P HaffnerNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID http://orcid.org/0009-0000-1153-3724
Richard John StevensNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID http://orcid.org/0000-0002-9258-4060
Ben Amies-CullNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID http://orcid.org/0000-0002-7079-1288
Laura HeathNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Clare BankheadNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID http://orcid.org/0000-0003-1588-3849
Paul Aveyard *Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID http://orcid.org/0000-0002-1802-4217
Susan A Jebb *Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK susan.jebb@phc.ox.ac.uk.ORCID http://orcid.org/0000-0001-9190-2920

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo assess the impact of a National Enhanced Service (NES) incentive for weight management that financially rewarded practices for each eligible patient referred to a weight management programme.

designInterrupted time-series analysis to examine the rate of weight management referral and weight management advice.

settingPrimary healthcare records from January 2018 to December 2024 in the Oxford Clinical Informatics Digital Hub, covering 8.3 million patients in 1198 primary care clinics around England.

interventionsNES payments to practices for weight management were introduced in April 2021.

resultsThe rate of referral increased from 1 referral per 1000 patients per month before the incentive to around 4 referrals per 1000 patients per month afterwards. There was no evidence that the increase differed by age, gender, ethnic group or socioeconomic status. The occurrence of weight management advice was unchanged by the introduction of the NES and was at least three times more common than referral to weight management services.

conclusionsThe NES was associated with a fourfold increase in referrals to weight management services. However, clinicians are much more likely to offer advice rather than a referral to a weight management programme. There is a clear opportunity to improve outcomes for patients by encouraging greater use of referrals to effective weight management services in place of advice.

Indexed as

ObesityPrimary Health CareReferral and ConsultationWeight Reduction ProgramsAdultEnglandFemaleHumansInterrupted Time Series AnalysisMaleMiddle AgedState MedicineDIABETES & ENDOCRINOLOGYHealth policyObesity

Identifiers

PMID41775470
PMCPMC12959051

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.