Common use of Follow-up Clause in Contracts

Follow-up. The provision of after-care and weight management support for the patient remains a lifetime commitment. Structured, systematic and team based follow up should be organised by the Tier 4 provider for up to 2 years after surgery (annex 2). Lifelong specialist follow up is also advocated via local services (GP and Tier 3). Tier 4 structured, systematic and team based follow up for 2 years post-surgery should be organised to include:  monitoring nutritional intake (including protein and vitamins) and mineral deficiencies  monitoring comorbidities  medication review  dietary and nutritional assessment, advise and support  physical activity and support  psychological support tailored to the individual  information about professionally led or peer support groups. Long term follow up should use a shared care model of chronic disease management. It is the responsibility of the Tier 4 bariatric team to develop clear protocols for the required monitoring with local community (GP and Tier 3) based services to ensure they are aware of the patient’s ongoing progress. “Lost to follow up” across the whole pathway should be minimised and a robust mechanism should be in place for early identification of post-operative complications. Rapid access to the specialised complex obesity Tier 4 MDT will be available for assessment of complications and post-operative care will be available to manage complications as they occur including revision surgery in line with NHS policies. Failure to lose ‘sufficient’ weight is not deemed a complication.

Follow-up. The provision of after-care and weight management support for the patient remains a lifetime commitment. Structured, systematic and team based follow up should be organised by the Tier 4 provider for up to 2 years after surgery (annex 2)surgery. Lifelong specialist follow up is also advocated via local services (GP and Tier 3). Tier 4 structured, systematic and team based follow up for 2 years post-surgery should be organised to include:  monitoring nutritional intake (including protein and vitamins) and mineral deficiencies  monitoring comorbidities  medication review  dietary and nutritional assessment, advise and support  physical activity and support  psychological support tailored to the individual  information about professionally led or peer support groups. Lifelong specialist follow up is advocated and providers should have arrangements in place to discharge patients to the local community Tier 3 based obesity service within 2 years. The patients GP will also provide additional support. Refer to gp Long term follow up should use a shared care model of chronic disease management. It is the responsibility of the Tier 4 bariatric team to develop clear protocols for the required monitoring with local community (GP and Tier 32) based services to ensure they are aware of the patient’s ongoing progress. “Lost to follow up” across the whole pathway should be minimised and a robust mechanism should be in place for early identification of post-operative complications. Rapid access to the specialised complex obesity Tier 4 MDT will be available for assessment of complications and post-operative care will be available to manage complications as they occur including revision surgery in line with NHS policies. Failure to lose ‘sufficient’ weight is not deemed a complication.

Follow-up. The provision of after-care and weight management support for the patient remains a lifetime commitment. Structured, systematic and team based follow up should be organised by the Tier 4 provider for up to 2 years after surgery (annex 2)surgery. Lifelong specialist follow up is also advocated via local services (GP and Tier 3). Tier 4 structured, systematic and team based follow up for 2 years post-surgery should be organised to include:  monitoring nutritional intake (including protein and vitamins) and mineral deficiencies  monitoring comorbidities  medication review  dietary and nutritional assessment, advise and support  physical activity and support  psychological support tailored to the individual  information about professionally led or peer support groups. Lifelong specialist follow up is advocated and providers should have arrangements in place to discharge patients to the local community Tier 3 based obesity service within 2 years. The patients GP will also provide additional support. Long term follow up should use a shared care model of chronic disease management. It is the responsibility of the Tier 4 bariatric team to develop clear protocols for the required monitoring with local community (GP and Tier 32) based services to ensure they are aware of the patient’s ongoing progress. “Lost to follow up” across the whole pathway should be minimised and a robust mechanism should be in place for early identification of post-operative complications. Rapid access to the specialised complex obesity Tier 4 MDT will be available for assessment of complications and post-operative care will be available to manage complications as they occur including revision surgery in line with NHS policies. Failure to lose ‘sufficient’ weight is not deemed a complication.

Follow-up. The provision of after-care and weight management support for the patient remains a lifetime commitment. Structured, systematic and team based follow up should be organised by the Tier 4 provider for up to 2 years after surgery (annex 2)surgery. Lifelong specialist follow up is also advocated via local services (GP and Tier 3). Tier 4 structured, systematic and team based follow up for 2 years post-surgery should be organised to include:  • monitoring nutritional intake (including protein and vitamins) and mineral deficiencies  • monitoring comorbidities  • medication review  • dietary and nutritional assessment, advise and support  • physical activity and support  • psychological support tailored to the individual  • information about professionally led or peer support groups. Lifelong specialist follow up is advocated and providers should have arrangements in place to discharge patients to the local community Tier 3 based obesity service within 2 years. The patients GP will also provide additional support. Long term follow up should use a shared care model of chronic disease management. It is the responsibility of the Tier 4 bariatric team to develop clear protocols for the required monitoring with local community (GP and Tier 32) based services to ensure they are aware of the patient’s ongoing progress. “Lost to follow up” across the whole pathway should be minimised and a robust mechanism should be in place for early identification of post-operative complications. Rapid access to the specialised complex obesity Tier 4 MDT will be available for assessment of complications and post-operative care will be available to manage complications as they occur including revision surgery in line with NHS policies. Failure to lose ‘sufficient’ weight is not deemed a complication.