A choice of services at various locations should be available so people’s needs are met. These could be:

• at GP practices, delivered by practice nurses, health care assistants or possibly community dietitians - practices could get together to form a “cluster group” as a way of sharing costs.
• via Community pharmacists - it has been shown that this is a particularly good route to reach minority groups.
• through community centres, healthy living zones and secondary care specialist services - most patients would be able to access and afford these type of services this way
• via commercial weight loss schemes such as Rosemary Conley, Weight-Watchers or Slimming World – such schemes are funded by some PCT’s, thereby reaching people in deprived areas who wouldn’t normally be able to afford these programmes.

In order to be sustainable, healthy weight loss needs to be part of a programme that encourages a change in everyday behaviour. As will all behavioural-based interventions, patients will need to be supported through a range of services, dipping in and out as required.

Ensure Patient and Public Involvement (PPI)

Racial diversity awareness

Disability Discrimination Act compliance. This means in all its forms:

• ramps to get up to the clinics
• scales which take patients over 120kg
• tape measures which are long enough
• awareness of sensitive issues such as small toilets/cubicle areas
• training for all staff coming in contact with the patient

Services should be tailored to ensure access to all regardless of racial or social background