The Counterweight Programme: Scotland Rollout

Overview

Counterweight was commissioned by the Scottish Executive Health Department as the option for weight management services to be made available to health boards taking part in Keep Well.  Keep Well is a cardiovascular anticipatory care programme underway in areas of highest deprivation in Scotland. 

Counterweight is underway in three areas of Scotland: Tayside, Lanarkshire and Lothian and commenced April 2006 with funding for 2 years. In each area funding was also made available for a 0.4 WTE ‘buddy’ dietitian to work alongside the Counterweight Weight Management Adviser as they will support the sustainability of the Counterweight delivery post Keep Well.

Keep Well

In each of the three areas, priority is given to the Keep Well practices and patients. The selected target population for Keep Well are patients aged 45-64 who are either currently sub optimally managed for cardiovascular risk or have had little or no contact with their general practitioner in the last five years.  In two areas additional funding has been made available directly to the practices to delver the care (including Counterweight) and in one, the Keep Well service has been developed outwith general practice with relevant data fed back into general practice patient registers.

Patients are invited to attend for an initial screening session which covers all aspects of cardiovascular disease risk including lifestyle factors. Patients are then signposted to relevant services including those providing support for lifestyle change. To date referral to Counterweight is only surpassed by the need for chronic disease management. Around 11% of the total Keep Well population being assessed is eligible and motivated to take part in the Counterweight. Of particular note is the emerging pattern, at this time, of weight management being of greater interest to this population than smoking cessation.

Action in Other Areas

In addition to the Keep Well practices, Counterweight is available to non-Keep Well practices in the three areas. The aim for total coverage by the WMA in each area being 40 practices over the two year funding period.  Work with non-Keep Well practices is likely to be the emerging focus over the next few months with the majority of Keep Well practices at a fairly advanced stage in their period of support.

Data Collection

Data collection for evaluation of the programme is focusing on a specific number of fields that can easily be collected in general practice. Practice IT systems will be the medium for collection of the information, this will ultimately improve sustainability of the programme.  Data to be collected Includes patient characteristics, baseline weight, number of patients offered the programme, number going on to take part in the programme, number of Counterweight appointments and weight loss outcomes. In Lanarkshire however, a stand alone database has been developed of the programme and has the additional benefit of allowing capture of additional information. The data relevant to general practice will be transferred at agreed time points throughout the programme.