The Live Active Online Referral Form B is intended for patients WITH established heart disease.
The referring health professional should complete this form. Please ensure the patient meets the referral criteria and the form is fully complete, otherwise they will not be accepted into the service. If patient does not have established heart disease, please use Referral Form A.
This form allows access to medical screening to determine the safety of exercise prescription for the patient.
*These forms will only work when using the latest web browsers, such as Google Chrome, Microsoft Edge or Mozilla Firefox. They will not work when using Internet Explorer.*
Please complete this form if your client/patient would like a Physical Activity Advisor to contact them to discuss becoming more active.
If a patients full medical notes are accessible, a Live Active Referral may be more appropriate. Please use referral form B for patients with established Heart Disease (this should be completed by a patient’s GP or PN).
*These forms will only work when using a modern browser (e.g. Google Chrome, Microsoft Edge or Mozilla Firefox) and will NOT work when using Internet Explorer*
Welcome to the NHS Greater Glasgow and Clyde Physical Activity webpage. Here you will find everything you need to know around the topic of Physical Activity – why it’s important to be physically active, how to be more active and what programmes and opportunities are out there to help you move more in your local area.
To find out more click on the “Get Active” button below OR if you are a Health Professional looking for guidance for your patients please click on “Guidance for professionals” button.
If you’re a health professional, you can refer your patients to Glasgow and Clyde Weight Management Services via SCI Gateway here. Please select send to ‘GGC Weight Management Service.’
Alternatively, acute referrals can be made via TrakCare. Instructions for making a referral in Trak can be found here.
Our full referral criteria and guidance can be found here.
To Self Refer:
Self referral is available if you have a confirmed diagnosis of:
Orlistat is a licensed medication for weight management in NHS Greater Glasgow & Clyde (NHSGGC). This may be offered to some service users following the completion of the 12 week Lifestyle phase of our programme.
Orlistat reduces the production of the enzymes used to break down dietary fat. It works locally in the stomach and intestine to prevent absorption of approximately 30% of the fat from the food we eat.
Orlistat must be combined with a low fat Structured Meal Plan (SMP). Patients are advised to follow a diet containing 40-50 grams of fat distributed evenly over the day.
GP’s are responsible for prescribing the medication. In NHSGGC, our local formulary advises that GP’s should prescribe Orlistat on the advice of SWMS. This ensures regular monitoring within the prescribing guidelines and appropriate dietary support is provided.
LIRAGLUTIDE (Saxenda®)
Liraglutide (Saxenda®) has been approved for use in NHS Scotland to assist diet and exercise weight loss methods.
There are a number of restrictions on the use of this medication. These restrictions state the need for specialist weight management service involvement when deciding if, or when, this medication should be prescribed, monitored or discontinued.
Due to a worldwide shortage of Liraglutide (Saxenda®) the Glasgow and Clyde Specialist Weight Management Service patient pathway for Liraglutide (Saxenda) has been temporarily suspended.
The Glasgow and Clyde Specialist Weight Management Service will update on availability of Liraglutide (Saxenda®) when the worldwide shortage has been resolved and the suspension has been lifted.
If you have any questions about this medication pathway, please email: GWMS@ggc.scot.nhs.uk
SEMAGLUTIDE (Wegovy®)
Semaglutide (Wegovy ®) has been approved for use in NHS Scotland to assist diet and exercise weight loss methods.
The Scottish Government in partnership with NHS health boards across Scotland have recently developed guidance on priority groups for Semaglutide (Wegovy). It was agreed that patients could be treated in any health care setting where evidence based appropriate lifestyle advice can be delivered. Each health board requires to develop and agree clinically safe and effective patient pathways with clear guidance on initiation, monitoring and discontinuation of Semaglutide (Wegovy). Clinical governance requires that the patient pathways and prescribing guidance is developed and agreed with all associated clinical groups prior to a medication being added to the prescribing formulary for each board. NHSGGC is currently developing proposals for implementation.
If you have any questions about this medication pathway, please email: GWMS@ggc.scot.nhs.uk
What is the criteria for weight loss surgery within NHSGGC
BMI ≥ 35 to ≤ 60kg/m2
Age 18 years – up to and including 55 years
Type 2 diabetes (confirmed diagnosis)
Type 2 diabetes diagnosed ≤10 years
HbA1c ≤ 75 mmol/mol (9%)
BMI ≥ 35 to ≤ 60kg/m2
Sleep apnoea (confirmed diagnosis)
Age 18 years – up to and including 45 years
Criteria last revised December 2021.
In addition to the above:
Complete a 12 week SWMS lifestyle programme, demonstrating a weight loss of at least 5kgs (11 pounds)
Attend a multidisciplinary pre-surgery assessment process, including seeing a dietitian, a nurse, psychology screening and a surgeon.
The surgeon will make the final decision if a patient is suitable. This will take into account a patient’s past medical history and other health professional recommendations.
What is the route for weight loss surgery?
Attendance at SWMS is the only way to be referred for weight loss surgery.
Sleeve Gastrectomy – This involves converting your stomach into a long thin tube or ‘sleeve’. The stomach is stapled along its length in a vertical direction. The surgeon removes about 70% of your stomach during the procedure. The smaller stomach pouch, or sleeve, will reduce your ability to eat large portions. This should help you feel satisfied for longer with smaller food portions. This is a permanent procedure and cannot be reversed.
One Anastomosis Gastric Bypass(OAGB) – A smaller stomach is created which will restrict your food intake. A section (about a 1/3,) of your intestine is bypassed. The bypass surgery helps you lose weight by reducing the amount of calories your body can absorb. The surgery reduces hunger and creates fullness quickly, so the amount you can eat is less. Fewer vitamins and minerals (especially iron,) are absorbed as food passes through the intestine. This is a permanent procedure and highly unlikely to be reversed. The OAGB will only be offered to some individuals. This surgery may not be considered if you have a BMI >45 kg/m2 .
How is the surgery performed?
You will need to have laparoscopic (keyhole) surgery under a general anaesthetic.
What are the potential benefits of weight loss surgery
If you meet the criteria outlined above, and completed the SWMS 12 week lifestyle programme – demonstrating a loss of least 5kgs (11 pounds,) you will be invited to a Surgery Information Session (SIS). Following this session, if you wish to proceed, you will be appointed for a surgical assessment with a Specialist Dietitian. If indicated, you may also see a Clinical Psychologist.
What happens next?
Following surgical assessment a report will be sent to the surgeon.
The surgeon will assess if you are suitable for surgery considering your past medical history and clinical risk. You will also require a pre-operative nursing assessment.
It is the surgeon who makes the final decision on surgery.
How does SWMS prepare you for weight loss surgery?
You will be required to attend “preparation for surgery groups”. These groups focus on dietary, eating behaviours and physical activity changes that will be required after surgery.
The surgery team physiotherapist can offer you advice about activity or mobility issues. In addition, there are Physiotherapy led SWMS activity classes at both chair based and moderate intensity levels available.
Some patients require pre-surgery psychological support if indicated.
What follow up support is offered after surgery?
SWMS offers an intensive 2 year follow up package. This includes individual and group appointments and also a patient support group.
Those who have had surgery via SWMS have the option of lifelong follow up after surgery if required.
How much weight loss can be expected after surgery?
The majority of weight loss after surgery happens within the first 6 months to 1 year. Often weight loss can be slower over the second year. On average, people can lose:
50-60% ‘excess’ body weight with a gastric sleeve
60-70% ‘excess’ body weight with a bypass
How much weight a person loses completely depends on the changes they make to their diet, activity levels and behaviour. Some can lose more weight than this; others may lose less.
It is not guaranteed that having weight loss surgery will reduce your weight/BMI to within the healthy range. Predicted weight loss outcomes are calculated individually using the patient’s pre-op weight/BMI.
If I have been through the SWMS Programme and been discharged – Can I be referred directly for surgery?
No, all patients who meet criteria must be re-referred and complete the 12 week lifestyle programme demonstrating a loss of at least 5kgs (11 pounds,) during their current episode of care.
I have had weight loss surgery privately – Can I access follow up through SWMS?
Unfortunately, SWMS does not offer routine post-surgical follow up care for those who have had private weight loss surgery. SWMS can offer weight management support via the lifestyle programme, for those who have had private surgery if the person is; struggling to lose weight, at least 1 year post-op, BMI is >30 and medically stable.
I do not meet NHSGGC criteria for weight loss surgery. I am considering paying privately for this and travelling abroad to have the surgery done.
NHS Scotland does not recommend choosing to pay to travel abroad for surgery. Please see the link below for more information:
Furthermore, the British Obesity & Metabolic and Surgery Society (BOMSS) have released a statement which strongly advises against having weight-loss surgery abroad:
We advise that you consider the above information when making your decision to have private weight-loss surgery out with the UK.
Other factors to consider when thinking about weight loss surgery?
Smoking – tobacco use is a well documented surgical risk factor. Smoking can increase the risk of post-operative complications. The surgeon will not operate on a patient who is smoking or using electronic cigarettes (vapes). NHS Smoking Cessation can provide support.
Pregnancy – it is recommended that a female should not become pregnant until at least 12-18 months post-op. This allows time for weight loss to stabilise and ensure that they are able to eat a varied nutritious diet. Losing weight can increase fertility in some women, therefore contraception should be considered and discussed with your GP/Practice Nurse if appropriate.
Further information and useful links can be found below:
BOMSS – British Obesity and Metabolic Surgery Society.
BOSPA – British Obesity Surgery Patient Association.
For GP’s/Healthcare professionals: the link below provides guidance on nutritional pre/post op monitoring and supplementation, from the British Metabolic and Obesity Surgery Society (BOMSS).
If you have any questions about weight loss surgery after reading this information please contact a member of the SWMS team.
Regular support has been shown to help maintain weight loss. Patients attending the Specialist Weight Management Service (SWMS,) enter the maintenance phase after they have successfully lost weight in Phase 1 (Lifestyle intervention) and Phase 2 of the programme.
They are invited to attend 4 weekly for blocks of 4 sessions, up to a maximum of 3 blocks (44 weeks). Weight progress will be reviewed after each block. Weight management is a long term and often relapsing problem, it requires lifelong management.
SWMS recommend that people utilise support within their local community to help manage their weight long term. Evidence from studies including the National Weight Control Registry has shown that there are five key factors that predict success in maintaining weight loss. These are:
Self-monitoring – weight, diet, physical activity
Lower daily calorie intake and portion control
Regular meals – planning and organisation
Regular physical activity
Maintain habits and behaviour change
At the Specialist Weight Management Service (SWMS,) we support increases in activity. This improves health and assists with weight loss. People who exercise regularly have:
Improved bone health, strength and mobility
Reduced risk of heart disease, stroke and some cancers
Improved blood sugar control and a lower risk of type 2 diabetes
Lower risk of stress, depression, dementia and Alzheimer’s disease
Better sleep quality, enhanced mood and energy
SWMS have Specialist Physiotherapists who lead individualized exercise consultations and activity classes. The physiotherapists also have direct referral links with medical services and community activity opportunities.
Individual Physiotherapy Exercise Consultations
Following the first SWMS assessment, you may be offered an exercise consultation with a SWMS Physiotherapist. These consultations are for those who find it difficult to engage in physical activity, who may have musculoskeletal, medical or psychological conditions. The SWMS Physiotherapists can work with you to address barriers to activity and help you to achieve your goals.
Get Started Classes
These classes provide a safe and supportive environment to exercise for SWMS participants, and are led by SWMS Physiotherapists. The classes are held at the West Glasgow Ambulatory Care Hospital. Patients can book for a block of classes. There are two levels of class intensity:
Chair based class
Moderate intensity circuit class
The Chair Based Class
The chair based classes have specialist seating. There are seated exercises as well as standing exercises for those that are able. The class incorporates aerobic, strength and balance exercises. The class lasts 45 minutes. There is an optional 10 minute seated relaxation at the end of the class.
Who is this class suitable for?
This class is best suited for those who use walking aids, or are wheelchair users, or participants who feel particularly deconditioned and/or are under-confident exercisers.
The SWMS physiotherapists have developed an exercise video of the chair based class.
Moderate Intensity Circuit Class
These SWMS classes last 1 hour and include a warm up, a circuit session, muscle strengthening, balance activities and a cool down.
For those with health conditions or painful joints the physiotherapists can modify the exercises to suit.
The physiotherapists encourage all patients to work at their own pace, ideally at a moderate intensity. This means that no participant should feel uncomfortable or too out of breath.
Who is this class suitable for?
This class is best suited to those who are independently mobile; however, if you use only 1 walking stick or 1 crutch this class may still be appropriate.
Physical Activity Opportunities
Live Active
The Live Active exercise referral scheme are available. Discuss with your GP, Practice Nurse, or Physiotherapist.
Vitality (Glasgow Life)
Vitality exercise classes support participants to exercise at a level suitable to their abilities. Classes aim to help build and maintain strength, co-ordination, endurance and flexibility. Several different classes are available. These classes are suitable for people with different physical abilities and medical conditions.
Football Fans In Training Programme
Football Fans In Training is a healthy living and weight loss programme that was carefully designed to appeal to men. It incorporates the latest scientific approaches to weight loss, physical activity and diet.
Health Walks
Health Walks provides details of free, walking groups in your local area.
Greenspace
Greenspace is a free digital map to find accessible recreational and leisure greenspace anywhere in the UK.
Green Gym
Green Gym provides information on outdoor activity, helping with environmental conservation projects (various projects across Glasgow and Clyde.
NHS Choices Livewell – Fitness
NHS Choices Livewell – Fitness provides lots of useful information, hints and tips on activity and fitness at all levels.
Cycling Scotland
Cycling Scotland is a national cycling promotion organisation for Scotland.
Living Streets is the UK charity for everyday walking opportunities.
Muscle, bone and joints
Muscle, bone and joints provides self-management support for musculoskeletal problems, injuries and conditions that affect muscles, bones and joints in adults.
Talk Lipoedema
Talk Lipoedema is a registered charity with a vision for the future that everyone with lipoedema will be given an accurate diagnosis with access to an appropriate range of services and support with self management.
Physical Activity Apps
Physical activity apps are becoming more popular and are a quick and convenient way to track how much activity is in your day. There are many apps that you can download on your smart phone. Some are free and very easy to use.
MyFitnessPal
MyFitnessPal provides food and exercise tracking, barcode scanner, large food database with >6+million foods including restaurants menus. The app can connect with popular apps and devices such as – Garmin, Strava, Runkeeper, Fitbit. The app allows you to share your progress with friends and is free.
A free walking tracker app which takes away the guess work of how active you have been. By using the sensors in your device the app records every minute of walking you do. It will then show you how much brisk walking you are doing and how you can do more. The app is easy to use and helps you set goals for the day.
Zombies, Run!
Zombies, Run! helps you increase aerobic exercise (running, jogging) by providing an adventure mission to complete. Interval training, walking, jogging and favourite songs can also be incorporated. This app has a fee.
Strava Running and Cycling
Strava Running and Cycling tracks running and cycling activities and users can compare their performance on social media with friends and professionals, and can network locally to find popular places to run or ride.
Nike Training Club
The Nike Training Club app tracks indoor (treadmill) or outdoor running, and coaches user to complete races (5km to marathon). Provides in-run audio feedback of mile split metrics including time miles, calories, elevation, average pace and number of runs. This app is free.
Runkeeper
Runkeeper tracks all aerobic exercise and weight loss, synchronising with 70 other apps including Fitbit and My Fitness Pal. This app is free.
Runtastic
Runtastic tracks running and other aerobic exercise (biking, walking) including interval training, target pace, and challenge running. It shows the users route on a map, provided 1 mile slit times, distance, duration, speed, elevation change and calories burned. This app is free.
Map My Fitness
Map My Fitness is a workout trainer with 600 exercises including track running, cycling, and calories (input and output). Synchronizes with heart rate, speed, cadence, and power sensors. This app is free.
Get stronger, lose weight, or gain muscle mass with Fitbod! When you hit your gym or living room Fitbod’s training will guide you through the right sets, reps and weight to reach your fitness goal. For beginners strength trainers find the confidence to try new resistance exercises and gym equipment. Learn the correct movements form over 400 demonstration videos. This app has a fee.
Fitbit
Fitbit tracks exercises, food intake, net calories, weight and sleep. Provides weekly summaries to users featuring steps, miles, calories burned, calories consumed and weight. This app is free.
Map My Run
Map My Run tracks multiple aerobic and resistance exercises, including running, cycling, cardio, jogging, walking, and gym workouts. For outdoor activities, it provides pace, elevation, calories burned, and split times. This app is free.
Fitocracy
Fitocracy tracks workouts and motivates through extensive social network sharing. Expert guidance with virtual coaches is available, and team fitness routines can be chosen. This app is free.
Lose it
Lose it creates customises weight loss plan based on user’s goals (weight, body fat, hydration, sleep, exercise, nutrients, hip to waist ratio measurements). It accurately tracks food calories and calories burned with exercise. This app is free.
Couch to 5km
Couch to 5km takes a non exerciser and prepares them to run a 5km (3.1mile) race in 3 months. Includes a training plan, 4 different motivating virtual coaches, real human audio cues, together with their favourite playlists. This app is free.
Relive
Run, ride, hike and more with Relive! If you like to go out for a run, ride or hike, or any adventure outdoors, you will love Relive and it is free. Just go out, track you activity, take some photos and enjoy the moment. Finished? Time to create your video! Your outdoor activities have never looked so cool. Relive works with just your phone as well as with many other tracker apps like Apple Health. See your route in a 3D landscape share your videos on Facebook, Instagram and more. This app is free.
MapMyWalk
Track and map every walk with MapMyWalk. For every mile you go you will get feedback and stats to help you improve your performance. Use the routes feature to find nearby places to walk. It can also connect to My Fitness Pal. This app is free.
Location
West Glasgow Ambulatory Care Hospital, Glasgow & Clyde Weight Management Service, Ward 2, Second Floor, West Glasgow Ambulatory Care Hospital,
There is a free patient car park at West Ambulatory Care Hospital.
Here are some Success Stories from SWMS service users:
Brian
Brian’s Journey
Brian was referred by his GP to SWMS. He wanted to improve his general mobility and health.
“I needed to ask for help as I knew I couldn’t do it on my own”.
Following his initial assessment, Brian was offered a SWMS Physiotherapy assessment. Brian was struggling with painful joints and was inactive.
“Everything was sore bar my hair”
Brian was provided with a walking stick, walking programme and started the “Get Started” weight management activity classes.
“The classes were good fun and gave me structure to my activity”.
Brian started a SWMS group in February 2019 until March 2020. During this time Brian lost 37kgs (20% of his body weight). Using dietary and activity lifestyle changes. What a fantastic achievement!
The SWMS staff helped me to change my lifestyle without being judgemental.
“The group support was really helpful. Everyone was on the same journey which made the process easier”.
Catherine
Catherine’s Journey
After years of yo yo dieting, I was referred to SWMS in June 2019, weighing 152kgs. My aim was to lose weight, to reduce my significant joint pain, and ultimately improve my low mood.
Following my initial assessment, I was referred to the Psychology team, where I discussed my issues with eating control and anxiety. I was given techniques to support my issues and was offered a special “disordered eating” group programme.
The “COVID-19 lockdown” interrupted my treatment. I now attend my disordered eating group and Psychology sessions via a video appointment, which has worked well for me.
The team physiotherapist has helped me become more active and I follow the SWMS exercise video regularly.
“!I’ve had many failed attempts but I do think having Cognitive Behavioural Therapy really helped, plus being more realistic – it’s not a quick fix – it takes time, planning and organisation. Realising that going off track is not a failure. It’s being kind to yourself and continuing with the plan. Tracking is my saviour. You have to know what you are eating. Every time I’ve lost weight it’s because I knew what was going in. It’s very easy to lose track with mindless eating”.
Susan
Susan’s Journey
I came to SWMS after years of weight loss success and failures. I am now in my second episode of care building on previous learning.
“The team have an enormous amount of clinical expertise, who don’t quit and stay cheerful – it’s catching!”
Following my first assessment in the service I lost 34.5kgs. I engaged in the lifestyle programme and attended SWMS moderate intensity exercise classes and Physiotherapy – as even sitting around gets hard after a while.
I relapsed, regaining weight having to tackle my depression and binge eating behaviours: The Psychologists in the service helped me focus on the cycle of change in accepting and refocusing in periods of weight regain through Cognitive Behavioural Therapy and Mindfulness in group sessions and 1:1 therapy.
In the midst of COVID-19 I am now receiving Interpersonal Psychotherapy with a SWMS Psychologist through telephone consultations. I am now at my lowest weight in the service and in many years.
“To make change you have to believe in the possibility of change and this is what the SWMS has helped me so much with. I have had weight loss successes and failures and have been able to deal with whatever has happened”.
