Project start: 01/02/2024

Project end: 30/09/2026

Background: Following recommendations set out in the NHS Long Term Plan (2019) over thirty Complications of Excess Weight (CEW) clinics have been commissioned by NHS England. The CEW clinics aim to deliver tailored holistic support to children and young people (CYP), aged 2-17 years, who live with severe or complex forms of obesity and co-morbidities and prevent the need for more invasive treatments. The clinics operate using different models which are tailored to suit local populations.

Aims: 1) To undertake a co-produced, comprehensive mixed-methods clinical and economic evaluation of the CEW clinics, which develops the evidence base and understanding of optimal models of care, and 2) to contribute to the national CEW clinic framework development to support future roll out and commissioning.

The study will be delivered through a comprehensive programme of five work packages to address the overarching question: ‘What are the optimal models of care to support children and young people living with severe obesity?’

Aims will be addressed through five work packages:

• WP1 Project management, coproduction, public and patient involvement and engagement and dissemination: will a) facilitate coproduction with all stakeholders and embed insights from CYP and their families/caregivers across every WP; b) co-ordinate dissemination and communication; c) contribute to the development of the national CEW framework to support future commissioning activity; and d) provide overarching project management and cohesive cross-site working.
• WP2 Mapping the delivery and workforce models of CEW clinics: will use documentary reviews, surveys, process mapping, semi-structured interviews and focus groups with commissioners and NHSE / CEW staff. 
• WP3 Exploring the views and experiences of CYP and their families attending CEW clinics: will be underpinned by a realist informed approach using surveys, interviews, questionnaires and focus groups with CYP and families. These findings will be aligned to, and integrated with, quantitative process and outcome data from the CEW national dataset.
• WP4 Clinical and economic data evaluation: will assess service user demographics, analyse clinical, quality-of-life and cost outcomes over time, and provide an economic evaluation of each CEW delivery model.
• WP5 Triangulation: A triangulation protocol will be co-developed to bring together the findings and display them in a convergence coding matrix.

The study is funded by NIHR HSDR (ref 158453) and being delivered in collaboration with Sheffield Hallam University, Leeds Beckett University, University of Leeds, University of Bristol, University of Sheffield, Sheffield Children's Hospital Trust, Leeds Teaching Hospitals Trust, Personal Lifestyle Management and Nifty Fox Creative. The study team includes a Patient and Public Involvement Group including CYP and their families from Sheffield, Leeds and Bristol.