In the Aneurin Bevan University Health Board (ABUHB) area (Wales, UK), prevalence of overweight and obesity in children (45 years) are approximately 13.5 and 11.6% (n=~1650) respectively (Child Measurement Programme for Wales, 201718). It was estimated that approximately 4400 children (418 years) have severe obesity (BMI ≥99.6th centile) in the ABUHB area. An audit of ABUHB paediatric case notes indicated that almost one-third of patients had overweight or obesity (n=1182), with nearly one-fifth having obesity (n=648). Six percent (n=216) of these patients had severe obesity. Value Based Healthcare (VBHC) aims to increase the value that is derived from the resources available for a population (Gray, 2017). ABUHB operates a VBHC programme whereby value is based on the Porter Model (patient value = patient-relevant outcomes/costs per patient to achieve these outcomes), initiatives are clinically-led but focused on patient outcomes, and look to ensure allocative value (i.e. resources are moved to where they can have the greatest impact for patients and their experience of care). In these contexts, in 2018 the ABUHB commissioned a tier 3 multidisciplinary treatment (MDT) service (named Connect) for children and adolescents aged 016 years. This service is family-focused and has several innovative features. Individual, patient-centered treatment is allocated following the Care Aims framework (https://careaims.com/) which is designed to focus on outcomes that are important to the patient and encourages clinicians to use appropriate interventions during specific episodes of care. Outcome evaluation is being undertaken using a variety of clinic measured (e.g. change in BMI-z-score, blood pressure and lipids) and patient-reported outcome (PROM) and experiential measures (PREM) (e.g. functioning, disability & health; quality of life; sedentary time). DrDoctor (https://www.drdoctor.co.uk/), a digital outpatient management solution, is being used to enhance communication with patients and to collect PROMs and PREMs. In accordance with the concept of VBHC, financial cost data are also being considered as part of a comprehensive evaluation of this service. This MDT service commenced in May 2019 and aims to support approximately 250 children & families in the first 12 months.
12 Sep 2019 - 13 Sep 2019