At home
Children and families can use a connected scale at home without the daily weight number being displayed to them.
NHS customer case · Bristol
Digital support within a regional specialist obesity service
University Hospitals Bristol and Weston NHS Foundation Trust is the South West hub within NHS England’s Complications from Excess Weight programme, providing specialist care for children and young people living with severe and complex obesity.
As part of the national CEW model, digital support through Evira adds home monitoring and communication between families and clinical teams — extending support beyond individual hospital appointments.
South West CEW hubDigital supportSpecialist paediatric care
At a glance
- 1South West hub
University Hospitals Bristol and Weston is listed within NHS England’s regional CEW programme.
- 2Bristol Royal Hospital for Children
The specialist service is based within UHBW’s paediatric care environment.
- 3Multidisciplinary care
CEW services bring specialist medical, nursing, dietetic, psychological and wider support around children with severe and complex obesity.
- 4Digital support
NHS England describes home weighing, trend feedback, clinical data transfer and personalised communication within the national CEW model.
The pathway today
Caring for children with complex needs
Children referred to specialist CEW services often live with severe obesity alongside multiple physical, psychological and social complications.
A 2025 peer-reviewed observational study involving Bristol Royal Hospital for Children and Alder Hey examined 185 new patients across the two specialist services.
The study found substantial levels of obesity-related complications and poor health-related quality of life, illustrating why specialist obesity care requires more than weight monitoring alone.
Source 4Working together
Adding digital support around specialist care
The CEW model combines specialist multidisciplinary treatment with support that continues outside the hospital.
NHS England describes a national model in which connected home measurements and communication give clinical teams visibility between appointments. For a regional hub such as Bristol, this creates a digital layer around the existing specialist pathway rather than replacing the multidisciplinary care already being delivered.
Source 2
In practice
Connecting home and clinic
Progress over time
The app presents the direction of progress visually rather than focusing families on individual weight readings.
With the clinical team
Measurement data is transferred to the clinical team, giving clinicians visibility of progress between appointments.
Between appointments
Families and clinicians can communicate digitally, allowing personalised feedback and behavioural support without requiring every interaction to happen in hospital.
NHS England describes this model as a way for specialist CEW teams to monitor and support children remotely while reducing the need for frequent hospital visits. These descriptions concern the national CEW digital technology programme, not observations uniquely measured at Bristol.
Source 2
Public evidence
What the public evidence tells us
Bristol service evidence
A highly complex specialist population
Research involving clinicians from Bristol Royal Hospital for Children has documented the significant physical and psychological complexity seen in specialist paediatric weight-management services. The 2025 observational study with Alder Hey found high rates of cardiometabolic complications, neurodevelopmental conditions and poor health-related quality of life among children and young people attending the two services.
View peer-reviewed study ↗Evira in the national CEW programme
Digital support between appointments
NHS England describes hidden-digit smart scales connected to an app, automatic transfer of measurements to clinical teams and personalised feedback between hospital visits. This is national programme evidence and is not presented as a Bristol-specific outcome.
View NHS England evidence ↗The national programme
Extending specialist care into the home
In May 2025, NHS England reported that its digital smart-scale technology was being piloted across 15 CEW clinics.
15
CEW clinics using the digital technology
~350
patients and families using it at the time of the update
Home + clinic
connected measurements and personalised clinical feedback
NHS England describes the technology as hidden-digit smart scales connected to a mobile app. Measurements are transferred to the clinical team, which can provide personalised feedback and support behavioural change between hospital visits.
These figures describe the national CEW technology programme as reported by NHS England in May 2025. They are not Bristol-specific activity figures.
Read the NHS England update ↗The role of digital care
More continuity without replacing the MDT
Specialist paediatric obesity care is multidisciplinary by design. Digital support does not replace medical, psychological, dietetic or social care. Instead, Evira gives CEW services another way to maintain contact with families, follow progress at home and support behaviour change between scheduled appointments.
Ongoing evaluation
Building the evidence for specialist obesity care
The CEW programme continues to be evaluated through ENHANCE, an NIHR-funded mixed-methods clinical and economic evaluation examining how the specialist services work, for whom, and how they should develop. Bristol is represented within the research collaboration through the University of Bristol. The public submission does not establish Bristol-specific Evira outcomes or the clinical effectiveness of Evira.
Source 3
Sources and references
- 1NHS EnglandComplications from Excess Weight clinics for childrenNational CEW programme and clinic network
- 2NHS EnglandSpecialist NHS clinics and technology help children to lose weight13 May 2025
- 3UK Parliament · ENHANCEENHANCE evidence to the Health and Social Care CommitteeAugust 2025 · NIHR-funded national evaluation
- 4Peer-reviewed · PubMedComplications of excess weight seen in two Tier 3 paediatric weight-management services2025 · Joint Bristol and Alder Hey observational study
- 5UK Government procurementEvidence-based technical support for children with complications of excess weight29 January 2024 · National NHS England programme
No Bristol-specific Evira clinical outcomes are presented. Joint service research and national CEW programme evidence are labelled separately throughout this page.
More stories
Other NHS services using Evira
Liverpool · CEW hub
Alder Hey
The first UK CEW service to trial and implement Evira, with independently published implementation and clinical evaluation.
Independently documented implementationPublished results
Read the case →
Birmingham · CEW hub
Birmingham Women's and Children's
A West Midlands CEW hub with a published service evaluation of Evira and practical implementation experience.
Published service evaluationPublished results
Read the case →
Cambridge · Regional CEW service
Cambridge University Hospitals
A research-led regional service already designed around a mix of specialist appointments and remote follow-up.
Hybrid pathway described by the serviceNo published results yet
Read the case →
Interested in how this would fit your service?
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