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Tue, 31 March 2020

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The Chancellor must provide national funding for Tier 2 weight management programmes

The Chancellor must provide national funding for Tier 2 weight management programmes

Slimming World

2 min read Member content

National funding is needed for Tier 2 weight management programmes, writes Paul Sharpe, Head of Partnerships at Slimming World.


In 2010, the Coalition Government published its public health White Paper, ‘Healthy lives, healthy people’, outlining its plans for a ‘radical shift in the way we tackle public health challenge’.

It argued that there was no one-size-fits-all approach to public health, and the new approach outlined in the paper would put ‘local communities at the heart of public health’.

It promised that there would be ring-fenced public health budgets for local authorities and that Directors of Public Health would be the ‘strategic leaders of public health and health inequalities’ in local communities.

The Government argued that centralisation had failed, and it proposed a ‘health premium’ which would incentivise Local Authorities to improve health and reduce inequalities.

In 2012, the Health and Social Care Act moved commissioning for most public health functions from the NHS to Local Authorities and established Public Health England on 1st April 2013.

Seven years on, it has become increasingly difficult for Local Authorities to sustain the commissioning of Tier 2 weight management programmes under the pressure of regular funding cuts. Local authority public health budgets are scheduled to undergo further cuts and there is a limited prospect of an uplift to this thereafter within the current fiscal policy framework.

Clinical Commissioning Groups (CCGs) are not currently stepping up to fund Tier 2 weight management programmes where Local Authorities are unable, or unwilling, to find the funds. Data from Freedom of Information Requests show only three CCGs report funding for Tier 2 programmes in the last spending year (average spend of £113,000 per annum) compared with 65 CCGs who are funding Tier 3 services (average spend of £154,000).

Meanwhile, obesity levels continue to rise as does the pressure on the NHS. The Obesity Health Alliance, a coalition of over 40 leading charities, medical Royal Colleges and campaign groups, estimates that the NHS spends at least £5.1 billion a year dealing with ill health caused by overweight and obesity in England (1). This figure is based on NHS data from 2005-6 so is likely to be an underestimate as rates of obesity have increased since then and the analysis did not include all diseases linked to obesity.

There is no national funding for Tier 2 weight management programmes, and it is time for the Government to take back responsibility.

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