Tier 2 adult weight management services in the UK: A case study evaluation of local authority provision of targeted services for higher-risk groups in England

In 2021, the UK Government announced additional funding in England for Adult Weight Management Services (AWMS); it was specified that the extra funding must be used to commission or extend existing tier 2 services. The Office for Health Improvement and Disparities encouraged commissioners to prioritise services for higher-risk groups such as those with learning disabilities, severe mental illness, people from minority ethnic groups, those living in deprived areas and men. To better understand the findings from previous survey work and to explore the implementation of targeted services in greater depth, we undertook a multiple case study comprising eight tier 2 adult weight management service providers and 35 individual stakeholder interviewees. Using the Consolidated Framework for Implementation Research as an interview guide and in data analysis, we determined key enablers and barriers to successful service provision and programme implementation. Good practice for successful AWMS provision for higher-risk groups includes, having an existing programme in place that can be adapted, ensuring adequate time for programme development/implementation, having good existing networks/partnerships, collaborative working and putting the target group at the heart of any intervention. The findings from this work provide practical recommendations for policy and practice when targeting tier 2 services for higher-risk groups.