{
  "abstract": "Objective The UK faces a significant obesity crisis, and multiple management options are now available, including pharmacotherapy, endoscopic and surgical interventions. Endoscopic Sleeve Gastroplasty (ESG) has emerged as a National Institute for Health and Care Excellence-approved, minimally invasive obesity care procedure, which is a safe and effective option for selected patients. Despite its promise, National Health Service (NHS) providers lack standardised guidance for the implementation of this intervention. This initiative is aimed at creating a comprehensive pathway for the implementation of ESG within the NHS using a diverse stakeholder approach.Methods A modified nominal group technique (NGT) was employed, bringing together a diverse group of healthcare professionals (HCPs) involved in obesity management from primary and secondary care, commissioner representatives and patient groups in an iterative consensus-building process. The NGT methodology allowed for structured discussion, prioritisation of key elements and sequential refinement of the pathway through multiple rounds of expert input and feedback.Results The panel reached agreement on HCP requirements, resource allocation and identified key considerations for successful ESG implementation. Critical elements included primary care engagement, dietetic support, psychological assessment and anaesthetic involvement alongside the procedural aspects of training and mentoring, patient selection and technical factors. Notably, no areas of significant disagreement were identified throughout the process, enabling the development of a comprehensive framework for ESG delivery.Conclusion This framework provides practical proposals to facilitate ESG implementation across NHS centres, supporting multidisciplinary care delivery while acknowledging operational feasibility within existing NHS resource constraints.",
  "authors": [
    {
      "affiliations": [
        "University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK"
      ],
      "name": "Andrew Currie"
    },
    {
      "affiliations": [
        "Compass Medical Inc, Jackson, Wyoming, USA"
      ],
      "name": "Francis O’Neill"
    },
    {
      "affiliations": [
        "King’s College London, London, UK"
      ],
      "name": "Bu Hayee"
    },
    {
      "affiliations": [
        "Imperial College London, London, UK"
      ],
      "name": "Devinder Bansi"
    },
    {
      "affiliations": [
        "Whittington Hospital NHS Trust, London, UK"
      ],
      "name": "Chetan Parmar"
    },
    {
      "affiliations": [
        "King’s College London, London, UK"
      ],
      "name": "Emily McBride"
    },
    {
      "affiliations": [
        "North Berwick Health Centre, North Berwick, UK"
      ],
      "name": "Kevin Fernando"
    },
    {
      "affiliations": [
        "Spire Health, Southampton, UK"
      ],
      "name": "Laura Grimes"
    },
    {
      "affiliations": [
        "James Cook University Hospital, Middlesbrough, UK"
      ],
      "name": "Arutchelvam Vijayaraman"
    },
    {
      "affiliations": [
        "Sunderland Royal Hospital, Sunderland, UK"
      ],
      "name": "Kamal Mahawar"
    },
    {
      "affiliations": [
        "Southampton University Hospitals NHS, Southampton, UK"
      ],
      "name": "Charlotte Allan"
    },
    {
      "affiliations": [
        "County Durham and Darlington NHS Foundation Trust, Darlington, UK"
      ],
      "name": "Anjan Dhar"
    },
    {
      "affiliations": [
        "The UK Coalition for People Living with Obesity, Liverpool, UK"
      ],
      "name": "Ken Clare"
    },
    {
      "affiliations": [
        "North Bristol NHS Trust, Bristol, UK"
      ],
      "name": "Dimitri J Pournaras"
    },
    {
      "affiliations": [
        "University of East Anglia, Norwich, UK"
      ],
      "name": "Helen M Parretti"
    },
    {
      "affiliations": [
        "Southampton University Hospitals NHS, Southampton, UK"
      ],
      "name": "Jamie Kelly"
    }
  ],
  "title": "Development of an optimal pathway for endoscopic sleeve gastroplasty implementation in the NHS: a modified nominal group technique study",
  "uid": "8b42627c-abee-5ca6-a621-d1aa0d2ad0ed"
}