NHS customer case · Plymouth

Specialist obesity care designed around where families live

University Hospitals Plymouth NHS Trust provides specialist Complications from Excess Weight care through a pathway deliberately designed to extend beyond Derriford Hospital.

Every child begins with an assessment at home, while ongoing support can take place by video or telephone, online, at home, at school or in community settings.

Evira adds connected home monitoring and digital communication around this already distributed model of specialist care.

South West CEW spokeHome-first pathwayMultidisciplinary care

At a glance

Home first

every child and young person receives an initial assessment at home with a member of the CEW team

Under 18

the service supports children and young people under 18 with health complications associated with excess weight

Very few hospital visits

University Hospitals Plymouth states that it aims for families to have very few appointments at Derriford

Multiple settings

support can be provided by video, telephone and online, as well as at home, at school and in community locations

University Hospitals Plymouth CEW service. These describe the design of the pathway, not outcome metrics.

The pathway challenge

Specialist care cannot depend on repeated hospital visits

Children referred to the Plymouth CEW service may be living with severe obesity alongside complications such as type 2 diabetes, metabolic liver disease, sleep apnoea and poor mental health.

Effective treatment can require sustained input from several specialist disciplines.

But the work of changing routines, nutrition, activity, sleep and behaviour happens primarily in everyday life — not inside the hospital.

Plymouth has therefore designed its pathway to take specialist care closer to children and families rather than requiring every interaction to take place at Derriford.

The Plymouth model

The pathway starts at home

University Hospitals Plymouth takes an unusually explicit home-first approach to specialist obesity care.

Every child referred to the CEW service receives an initial home assessment with a member of the multidisciplinary team.

The purpose of that first visit is not simply clinical assessment. It allows the team to understand the child and family’s circumstances, explain what treatment involves and help the family make an informed decision about taking part.

The information gathered then informs individual care planning and prepares the family for any hospital-based assessment that follows.

Meet at home

A CEW team member initially meets the child and family in their own environment.

Understand individual needs

The team gathers information about the child, family and circumstances that can inform care planning.

Decide together

Families are supported to make an informed decision about whether they want to engage with the service.

Plan personalised care

The initial assessment helps shape the individual plan and the specialist support that follows.

Source 1

In practice

Hospital when needed. Closer to home when possible.

Home

Home visits are an explicit part of the CEW pathway.

Video

Some specialist interactions can take place through video appointments.

Telephone

Telephone support provides another route for ongoing contact.

Online

The Trust describes online support as part of the pathway.

School

The team can work with children in their school environment where appropriate.

Community

Appointments can take place in locations including the Cumberland Centre and Child Development Centre, with other community settings considered as the service develops.

University Hospitals Plymouth states that its aim is to make treatment easily accessible and minimise the number of appointments families need to attend at Derriford Hospital.

Whole-person care

More than a weight-management programme

The Plymouth CEW service supports the medical complications of severe obesity alongside the behavioural and practical factors affecting long-term health.

Medical health

Specialist assessment and treatment for conditions associated with excess weight, including type 2 diabetes and other complications.

Nutrition

Support can include meal planning, healthy eating, selective or binge eating, motivation and, where clinically appropriate, more intensive dietary interventions.

Activity and mobility

The service helps families find suitable activities, overcome barriers to exercise, manage pain or stiffness and build physical fitness.

Sleep and wellbeing

Support also extends to sleep, motivation and mental health as part of a broader approach to improving health.

Treatment is individualised, with additional specialist services involved when needed. Not every child receives every type of support.

Source 1

The South West pathway

Built through collaboration across the Peninsula

The Plymouth service developed as part of the national CEW programme alongside Royal Cornwall Hospitals NHS Trust.

Public NHS information from Cornwall describes the Peninsula CEW clinics for children under 18 as running at both Royal Cornwall Hospital and Derriford Hospital, beginning with a home visit and combining medical assessment with dietetic, wellbeing and family support.

South West CEW spoke

University Hospitals Plymouth

Home-first specialist pathway based at Derriford, delivered across community, school and remote settings.

South West CEW spoke

Royal Cornwall Hospitals

Peninsula clinics at Royal Cornwall Hospital, described publicly alongside the Derriford service.

Both services sit within the wider South West CEW network, whose NHS England hub is University Hospitals Bristol and Weston. This does not mean individual Plymouth patients are jointly managed by Cornwall or Bristol.

Source 5, 4

Where Evira fits

A digital layer for a pathway already built around home

Plymouth’s pathway already recognises that specialist treatment cannot happen only during hospital appointments.

Evira extends that principle.

Connected home measurements provide an ongoing view of progress in the same environment where much of the family’s treatment journey takes place.

Digital communication gives the clinical team another way to stay connected with families between scheduled interactions.

At home

Families can collect regular measurements using a connected device without daily weight numbers being displayed.

Over time

Progress is presented as a trajectory rather than a series of isolated measurements.

Between contacts

Digital communication provides another route for personalised support between home visits, remote consultations and clinic appointments.

Evira complements Plymouth’s established home and community model — it does not replace the multidisciplinary team.

Continuity of care

Connecting the moments between specialist interactions

Plymouth’s public pathway is already designed around the reality that families spend most of their treatment journey outside hospital.

A child may move between home assessment, specialist clinic, telephone support, school, community interventions and online contact over the course of treatment.

Digital monitoring can provide continuity across those settings — creating a shared view of progress without requiring each interaction to happen in the same place.

A wider system approach

Plymouth is treating childhood obesity as more than an individual problem

Plymouth City Council’s long-term healthy-weight work describes childhood obesity as a highly complex issue with no simple solution, shaped by factors well beyond individual choice.

Its ten-year strategic action plan, A Compassionate Approach to Children and Young People Health & Weight, places a strong focus on strengthening community assets, addressing weight stigma, tackling inequalities and working as a whole system rather than commissioning new services first.

The council also provides weight-stigma and compassionate-practice learning for teams working with children, young people and families across the city.

This wider philosophy closely complements the personalised, home-based approach used by the specialist CEW pathway.

This is Plymouth-wide public health context. It is not a description of individual CEW patients or their circumstances.

Source 6, 7

Clinical expertise

Contributing to the wider evidence base

University Hospitals Plymouth clinicians also contribute to academic work on childhood obesity.

In 2025, University Hospitals Plymouth paediatrician Thomas Siese co-authored a peer-reviewed clinical review of childhood obesity with colleagues from Bristol, covering the causes, complications and evolving treatment options for children and adolescents.

View published review ↗

This is evidence of clinical and academic involvement. It is not an evaluation of the Plymouth CEW service or of Evira.

The national digital model

Supporting specialist care between appointments

Across the national CEW programme, connected digital technology has been introduced to allow children to take measurements at home while clinical teams follow progress remotely.

Independent ENHANCE evidence identifies Evira as the digital weight-management system available to CEW services for weighing and communication with patients and families.

Early findings describe digital communication as providing additional clinician contact and support outside scheduled appointments.

Home monitoring

Connected measurements collected outside hospital.

Clinical visibility

Progress available to the specialist team over time.

Ongoing communication

Digital feedback and support between scheduled clinical interactions.

These are national CEW findings and should not be presented as Plymouth-specific Evira outcomes.

Source 9, 10

Public evidence

What Plymouth publicly describes

University Hospitals Plymouth

Complications from Excess Weight service

Primary source for the home assessment, multidisciplinary pathway, health complications treated and the aim to minimise Derriford visits.

View Plymouth CEW service ↗

University Hospitals Plymouth

CEW — how to find us

Public evidence that care can be delivered at Derriford, in community centres including the Cumberland Centre and Child Development Centre, at school and at home.

View care locations ↗

Royal Cornwall Hospitals

Peninsula CEW information for families

Public evidence that the Peninsula CEW model runs across Royal Cornwall Hospital and Derriford, using a holistic approach that begins with a home visit.

View regional programme ↗

Plymouth City Council

Children and young people’s healthy weight

Local context on Plymouth’s compassionate, relationship-based and system-wide approach to childhood weight and health inequalities.

View Plymouth strategy ↗

NHS England

Complications from Excess Weight clinics

Confirms University Hospitals Plymouth within the current national CEW network as a South West spoke.

View national CEW network ↗

University Hospitals Plymouth

CEW referral information for professionals

Referral route into the service from a local paediatrician or specialist service.

View referral information ↗

Sources and references

Plymouth has not published Evira-specific clinical outcomes. Everything described above is public service information from the trust, the Peninsula programme, the local authority and national CEW evidence, kept clearly separate. Evira is presented as a digital continuity layer around the specialist pathway.

More NHS customer cases