BSW REFERRAL PATHWAYS - NDPP: Staggered, wave-based engagement; Provider Engagement Officer supports practices to run searches and texts eligible patients with an opt-out (opt-in assumed if no response), then enrols and agrees engagement plan (timing, virtual or F2F). T2DR: ICB invites PCNs to engage with the Provider Engagement Officer; searches identify eligible patients, opt-in events or PCN text invites signpost to information; consenting patients are assessed by GP/approved clinician and referred. BSOP: Tirzepatide in primary care prescribed via a Local Commissioned Service (LCS); LCS payment requires the BSOP e-referral form to be completed when the first prescription is issued.

PLANNED BSW PATHWAY: Stepped implementation prioritising areas of high social/economic deprivation, high-risk ethnic groups and 18-30 year olds, with F2F venues identified in medical and non-medical settings close to home in deprived areas - aligned with neighbourhood health plans. SINGLE POINT

OF ACCESS: Align with locally agreed future referral processes (e.g. pre-populated forms on Ardens/SystmOne).

STEERING GROUP: BSW public health team, GP practice managers, ICB Diabetes Lead, Diabetes UK and Community service provider provide strategic oversight; day-to-day implementation delegated to the ICB project co-ordinator; aligns with the new community provider responsible for the diabetes pathway. DORSET: Operates a Weight Management Referral Hub (WMRH) - does not currently include T2DR. Community Weight Management (Medicated Tier 3) commences January 2026 with two providers (Mid-Dorset PCN and Modality). Pathway based on appropriate eligibility criteria, activation level via the referral hub (interim offer where capacity is exceeded), ongoing support, warm hand-off back into local offers, and robust secure data flows (interoperable into SystmOne; activity flowed to DiiS for PHM). SOMERSET: ICB committed to easy-to-refer approaches keeping primary care involvement light-touch. Stakeholders include Community Pharmacy, Local Authority Public Health, VCSE, Secondary Care and specialist diabetes services. Build trust with under-served populations (including Gypsy/Roma/Traveller) via primary care and the voluntary sector.

BSW POPULATION: ~940,000 with an older age profile (23% aged 65+) and significant variation across urban centres (Swindon, Bath) and extensive rural communities. Pockets of significant deprivation in Swindon, parts of Trowbridge and Melksham (Wiltshire) and South West Bath - lower life expectancy, higher emergency use, delayed access.

BSW ETHNICITY: Swindon most diverse (~81.5% White, 11.6% Asian); Bath & NES moderately diverse (92.2% White, 3.3% Asian, 2.7% Mixed); Wiltshire predominantly White (~94%) with Asian 5.1%, Black 1.6%, Mixed 2%.

BSW LANGUAGES: Polish, Urdu, Punjabi, Arabic, Konkani - interpretation services and translated materials helpful.

BSW BARRIERS: Core 20; ethnic minority communities; refugees and asylum seekers; Gypsy, Roma, Boating and Travelling communities; people experiencing homelessness; people with learning disabilities.

DORSET INEQUALITIES: 6.3-year (male) and 5.4-year (female) life expectancy gap between most and least deprived; ~9% live in national CORE20 areas, mainly coastal/urban communities like Weymouth, Portland and parts of Bournemouth (younger and more diverse).

DORSET LANGUAGES: Polish (~8,000); Portuguese, Romanian, Spanish (~3-4,000 each); Hungarian, Italian, Turkish, Arabic (1,000+).

DORSET FAITH: Muslim (8,000), Buddhist (3,600), Hindu (3,500), Jewish (2,000), Pagan (1,500).

DORSET ADDITIONAL SUPPORT: People with Serious Mental Illness (~7,500); Learning Disability (~5,000) - Easy Read; ~11,000 awaiting orthopaedic procedures - tailored exercise advice. SOMERSET: Need to support Gypsy, Roma and Traveller communities with a more flexible approach.