Obesity Surgery for Children and Young People - Market Engagement Exercise

NHS Arden and Greater East Midlands Commissioning Support Unit (AGCSU), on behalf of NHS England Specialised Commissioning (referred to as the Commissioner), is undertaking a market engagement exercise to understand the current and future capacity, interest and capability of potential providers in relation to delivering Obesity Surgery for Children and Young People. This notice is to advise prospective providers in the market of the Commissioner's intention to commission this service and to provide an opportunity to engage with and participate in a market engagement exercise.

The outcome of this market engagement exercise will provide Commissioners with the detail required to help inform the commissioning strategy. The deadline for completed market engagement questionnaires is 12pm (noon), Wednesday 15th April 2026.

The key objective of the Market Engagement Exercise is to seek feedback from the market regarding levels of interest, capability and capacity in relation to delivering Obesity Surgery for Children and Young People. Surgery for children and young people with obesity is not recommended (NICE Clinical Guideline 245, 2025) however, there are a small cohort of patients for whom metabolic and bariatric surgery (MBS) is routinely commissioned in line with criteria set out in NHS England Clinical Commissioning policy 16053 Obesity surgery for children with severe complex obesity (https://www.england.nhs.uk/wp-content/uploads/2026/01/cli...)   In 2017, NHS England, as the responsible commissioner of Tier 4 weight management services, published a service specification for Specialised and complex obesity surgery for children which outlines the standards required of a Tier 4 service.

The specification specified that patients will only be referred into Tier 4 services by Tier 3 specialist multidisciplinary weight management teams, except for where individuals have established Type 2 diabetes, where there were significant safeguarding concerns or where syndromic forms of obesity were felt likely. Variable commissioning arrangements for Tier 3 services (via Clinical Commissioning Groups (CCGs)) at that time meant that availability of Tier 3 services was highly limited and no referral pathways existed for children and young people to access surgery.

It is acknowledged that future access to CEW clinics is likely to be dependent upon local priorities at ICB level. NHS England has revised the service specification to reflect the potential for differences in commissioning arrangements for those services responsible for referral into obesity surgery services and ensure that referral into surgical service can be made equitably for all eligible patients.

Although commissioning responsibility for obesity surgery services for children and young people has been delegated to ICBs, the low volume of surgical activity anticipated annually means that NHS England are leading this market engagement exercise to determine next steps. The service specification, originally published in 2017, has been revised to reflect current service arrangements and the revised draft is included in the market engagement documents for any feedback from providers undertaking obesity surgery at present or any providers who wish to express an interest in providing this service in the future.

Following market engagement and review of capable providers, the Commissioner will consider the most appropriate PSR process to formally commission this service. Interested parties may respond to this Market Engagement Exercise in partnership with other organisations as part of a consortium, subject to them appointing a consortium lead to act on their behalf as the lead contracting party would take overall responsibility for delivery of the service(s) in accordance with the requirements of any future contract(s) if successful.

Documentation relating to this exercise including a questionnaire for completion is available through the Atamis (Health Family) portal. To register your interest and access the questionnaire, please follow this link: https://atamis-1928.my.site.com/s/Welcome The project reference is C426286 and the closing date for submission of the completed questionnaire is 12pm (noon) on 12pm, noon, on Wednesday 15th April 2026