Paediatric complications of excess weight service

About us:

The Paediatric Complications of Excess Weight (CEW) Service provides support to patients aged 2-17 years old, from the North NENC region (Newcastle, Durham, Gateshead, Sunderland, North Cumbria, Northumberland, North and South Tyneside). We work across multiple settings including GNCH outpatients (Great North Childrens Hospital), wards, at home and community settings. The CEW service provides care for children and young people over a period of 12-18 months dependent upon individual need.

Aims

Provide positive family engagement and nurture enthusiasm for change
Improvement in health care outcomes for young people
Provide excellent standards of medical care addressing health concerns and complications
Deliver multi-disciplinary education
Holistic family focused support
Encourage long term healthy goals

Our roles include

Offering comprehensive stigma-free care that includes medical assessments, to identify any complications of excess weight, referrals to other specialist teams and treatment as needed.
Creation and implementation of nutritional plans tailored to each child’s needs and preferences.
Emotional and psychological support including therapeutic interventions around body image and eating behaviours.
Social support.
Group education and activity sessions.

Meet the team

We are a friendly team and work together to ensure you receive support from the most appropriate professionals to meet your goals and live the best, healthiest life. We have a range of professionals in the team including medical, dietetics, psychology, nursing, and family support.

Referral form

Referral to the Newcastle CEW Obesity Service (142.37kB DOCX)

The CEW Service is a regional tertiary referral service. As such it can only accept referrals from a secondary care general paediatrician. This is to ensure there is a paediatrician who has fully assessed and investigated the patient, seeking to identify any weight related complications. We can accept referrals directly from the GP for patients aged 16 if there is no paediatrician involved. We currently cannot accept referrals from patients aged 17 (because of the length of our current waiting list).

That paediatrician (referring GP if over 16 years) remains responsible for the following.

making referrals to other services regarding any complications identified.
follow up of the patient and monitoring for developing weight related complications whilst the patient is waiting to see the CEW service.
following the patient up after discharge from the CEW clinician (if age appropriate)
working collaboratively with the CEW service regarding any safeguarding concerns.

Referring doctors must ensure they have fully understood the service structure, before making a referral. In particular, please note that this is a tertiary weight management service and that pathway of care is typically for one year only. This means that the referring paediatrician should expect to follow up the child, after discharge from CEW.

Areas covered by Newcastle CEW:

North NENC region: Newcastle, Gateshead, Durham, Sunderland, North Cumbria, Northumberland, North and South Tyneside. Patients from the South of NENC can be referred to Middlesbrough CEW.

Age range

2 – 16 years at time of referral. Patients younger than this should referred to Paediatric Endocrinology.

Engagement of the patient and family with the service is essential. Please ensure families referred to the service are willing to attend all appointments and engage constructively with the CEW team. Families not attending appointments and not engaging constructively with the CEW service will be discharged back to the referring doctor.

Referral Criteria

BMI of > 40 kg/m2 or BMI SDS > 3.5

BMI > 99.6^th centile with 2 diagnosed complications of obesity

Hypertension
Obstructive sleep apnoea
Intracranial hypertension
Polyendocrine Metabolic Ovarian Syndrome (previously known as PCOS)
Genetic cause for obesity diagnosed or strongly suspected (with good reason)
Fatty liver disease (MASLD)
Dyslipidaemia
Iatrogenic cause of obesity (Hypothalamic surgery)
Significant safeguarding concerns with ongoing Social Care involvement

NB

Patients with Type 2 Diabetes, under the care of a local diabetes team will NOT normally be accepted as the CEW service will not be able to provide support additional to what the diabetes service is commissioned to provide. Such patients must be discussed with a CEW consult prior to a referral being made if CEW involvement is felt to be essential. There should be a clear reason why support additional to the commissioned diabetes team is required.

Triage

All accepted referrals are clinically reviewed and triaged. However, the overwhelming majority of patients will be placed on the waiting list in time order. Cases may be expedited at the discretion of the CEW consultant, but this will only be due to significant and / or immediate life-threatening clinical risk. The development of obesity related complications or safeguarding concerns alone is not sufficient reason for referrals to be expedited. If you feel a referral needs to be expedited, please document this on the referral form and clearly outline your rationale.