In late 2015, M·E·L Research was commissioned by NHS Nottingham City CCG to carry out an evaluation of the Healthy Weight Advisor pilot. This ran as a pilot service in the Robin Hood Cluster of GP practices in Nottingham, from June 2014 to November 2015. The pilot was designed to address the needs of a cohort of patients who were overweight or obese and were not accessing the existing weight management services offered to them, for a variety of reasons. Over the lifetime of the project, 173 patients were referred to the service and of those 118 went on to use the service. The service was delivered by one Advisor, who had responsibility for all elements of the service. The intention was initially for the Advisor to see patients in a mixture of their home environment (60%) and community settings, such as the GP Practice (40%).
The evaluation addressed a number of high-level questions, which included determining whether the pilot met its aims and objectives, the successes of the pilot, any barriers to success, patient and health care staff experience, outputs, outcomes and considerations for future services. The evaluation was mixed-method comprising the following elements:
The evaluation highlighted a number of key successes including the need for a one-to-one model of support and home visits for a specific cohort of patients, the importance of focusing on a small number of tangible changes for patients to make, and the importance of having a non-judgemental and motivational worker. The pilot also achieved successful and sometimes significant weight loss for a number of patients, with the majority committed to making long term changes to their behaviour. The evaluation also identified some key areas for future consideration, including the need for psychological support for patients, getting buy-in from GP surgeries, the need for more resources to deliver the intervention and the setting objectives around wider outcomes, not just weight loss (such as increased levels of activity and improvements in mental health and wellbeing). As a result, the CCG have included the learning for the pilot in their commissioning of their weight management pathway in 2016.