Borders Ref Help Toolkit
Who to Refer:
Adult Weight Management
- Over 18 years old and BMI >25kg/m2
- Or BMI >23kg/m2 for Black African, Africa Caribbean, and Asian ethnic groups.
- Those who can make independent choices about food shopping and meal planning.
Pre-Diabetes Education:
A diagnosis of Pre-Diabetes:
- HbA1c 42-47mmol/mol
- Impaired FBG (5.5-6.9mmol/l)
- Impaired GTT
- A moderate or high risk of type 2 diabetes on completion of the ‘Diabetes Know Your Risk Tool’
Diabetes Remission Programme:
- Diagnosed with type 2 Diabetes within the last 6 years
- BMI≥27 kg/m2 (no upper BMI limit)
- Aged 18-65 years old
- Diet controlled with HbA1c >48mmol/mol, or on oral agents e.g. Metformin with HbA1c >43mmol/mol.
To refer into the diabetes remission programme, patients need to discuss and agree this course of action with their GP or consultant as medical sign off is required to be involved in this programme
Bariatric Surgery
There is no direct referral into the bariatric surgical service. All patients who wish to be considered for bariatric surgery are required to successfully complete the Tier 3 weight management programme. We do not have a local service for bariatric surgery. Those who meet the criteria are referred to NHS Lothian Bariatric Service after completion of the tier 3 programme. We have an agreement that we can refer 4 patients a year to NHS Lothian for this service.
Who not Refer
- Have a diagnosis of a current eating disorders or potential binge eating disorder
- Have uncontrolled hypothyroidism
- Have unstable psychosis or severe and unstable personality disorder
- Have current alcohol or drug abuse
- Have dementia
- Have moderate to severe learning disability
How to refer:
Referrals are accepted from all health care professionals via SCI-gateway or patients/carers can refer using our self-referral form:
SCI-gateway:
Weight Management/Diabetes Remission: Borders General Hospital- Weight Management Team
Diabetes Prevention: Borders General Hospital - Weight Management Team (B Diabetes Prevention)
PRIMARY CARE MANAGEMENT
Weight and Height are required for a referral to be accepted.
- Please include the date the weight was taken.
Weight loss injections (GLP1s) Update:
The Scottish Medical Consortium (SMC) has approved the following medications for restricted use in NHS Scotland for weight management.
Liraglutide (Saxenda®)
Semaglutide (Wegovy®)
Tirzepatide (Mounjaro®)
NHS Borders does not yet have a pathway for introducing these medications. Until a pathway has been agreed, we will not be able accept referrals for these medications. NHS Borders are currently working on a robust clinical pathway to ensure patient safety. At present, we do not have anyone who can prescribe within our service.
Scottish Government Guidance on the proposed role out of these medications:
Government advice on GLP-1 Medications:
GLP-1 medicines for weight loss and diabetes: what you need to know - GOV.UK