I would like to begin this month’s blog by sincerely thanking teams across our system for the support you continue to show one another — particularly our ICB colleagues — as we work through restructuring and prepare to formally come together as one ICB from 1 April. Change on this scale inevitably brings uncertainty, additional workload and the personal toll this can take. I am especially grateful to our partners for the compassion and care you have shown during this period.

Alongside this organisational transition, we are also navigating significant national policy change. This month, I want to focus on one important area: weight management and obesity.

Obesity and prevention

Obesity is central to the Government’s health strategy and its “third shift” — from treatment to prevention. It is a significant modifiable risk factor for multiple long-term conditions, including type 2 diabetes, cardiovascular disease, arthritis and at least 13 different types of cancer.

We also know that people living in areas of deprivation are disproportionately affected by overweight and obesity. If we are serious about tackling inequalities and preventing avoidable disease, this is a crucial area for us to prioritise.

National changes

Nationally, the landscape is evolving rapidly. We are seeing:

• A move away from rigid tiered models towards more integrated pathways
• Greater delivery in community settings
• Increased use of digital and virtual support
• Clearer referral criteria for specialist services
• Expansion of pharmacological treatment in primary care

Recent updates to QOF for 2026/27 further signal national intent. Two new obesity-related indicators will support referrals into structured weight management programmes and medicines optimisation. This is a fast-moving area, and we will communicate with primary care colleagues as soon as we have greater clarity on what this will mean locally.

Local developments: Suffolk and north east Essex

The ESNEFT Weight Management and Complex Obesity Service (WMCOS) went fully live on 16 February and is now open to GP referrals across Suffolk and north east Essex. This marks an important milestone, following more than two years of strong partnership working, between clinical and operational leads at the Trust and the ICB.

Primary care colleagues can now refer patients via a single point of access (SPoA), which will risk-stratify and triage them to the most appropriate service.

Options range from lifestyle support through Feel Good Suffolk and the national digital programme to specialist hospital services for patients with complex needs, including bariatric surgery where appropriate.

Overall, we expect to see a significant increase in the number of people in Suffolk and north east Essex who can benefit from structured weight management support and, where appropriate, pharmacological treatment. This represents a major step forward for prevention.

Local developments: Norfolk and Waveney

For Norfolk and Waveney, we anticipate that WMCOS will open to GP referrals very soon, although the final date is yet to be confirmed.

In the interim, tirzepatide is available in primary care in line with NICE guidance for GPs with appropriate expertise. As colleagues will appreciate, this requires comprehensive assessment, behavioural support and structured follow-up — not simply prescribing.

I am therefore pleased to share that a GP-led accelerator programme for community tirzepatide delivery is due to launch shortly. This will support patients in the highest priority cohort while we mobilise the wider pathway. Commissioning at PCN footprint level will enable delivery to remain as local and flexible as possible.

Looking ahead

We are also awaiting the outcome of a joint £8 million bid to the Obesity Pathway Innovation Programme (OPIP), developed collaboratively across both ICBs, ESNEFT and with support from the University of Suffolk.

If successful, this would enable:

• Development of community “spokes”, including community pharmacy prescribing for lower-complexity patients
• Expansion of the single point of access
• Use of population health management tools to proactively identify and prioritise those at highest clinical risk

This is prevention in practice: earlier identification, proportionate intervention and targeted support for those at greatest risk of long-term harm and inequality.

This work also exemplifies all three shifts — from sickness to prevention, from hospital to community where clinically appropriate, and from analogue to digitally enabled pathways.

Obesity care will continue to evolve rapidly. Our priorities remain clear: widen equitable access, embed WMCOS safely across Norfolk and Suffolk, support primary care colleagues through change, and minimise unintended workload pressures while maintaining our focus on prevention and reducing inequalities.

These are challenging times, but this programme demonstrates our shared determination to improve services and outcomes for our population.

Thank you again for your leadership and continued commitment.

Warm regards,

Frankie