Quality statement 8: Monitoring after discharge from the bariatric surgery service
Quality statement
Adults discharged from the bariatric surgery service have follow up at least annually, as part of a shared-care model between specialist weight management services and primary care. [2016, updated 2025]
Rationale
Lifelong nutritional monitoring and supplementation is important after bariatric surgery to avoid nutritional deficiencies that can cause long-term harm. After discharge from the bariatric surgery service an agreed shared-care model of management should be in place with collaboration between specialist weight management services and primary care as well as locally agreed monitoring arrangements and responsibilities. This will enable follow up care, at least annually, to ensure the benefits from bariatric surgery are maximised and prevent harm.
Quality measures
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.
Process
Proportion of adults discharged from the bariatric surgery service more than 12 months ago with a record of follow up by a primary care or specialist weight management service in the preceding 12 months.
Numerator – the number in the denominator who have a record of follow up by a primary care or specialist weight management service in the preceding 12 months.
Denominator – the number of adults discharged from the bariatric surgery service more than 12 months ago.
Data source: Data can be collected from information recorded locally by healthcare professionals, for example from the electronic medical record.
Outcome
Proportion of adults who had bariatric surgery who developed a micronutrient deficiency.
Numerator – the number in the denominator who developed a micronutrient deficiency.
Denominator – the number of adults who had bariatric surgery.
Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from the electronic medical record.
What the quality statement means for different audiences
Service providers (such as secondary care services, specialist weight management services and primary care services) ensure that adults who have had bariatric surgery have lifelong annual follow up as part of an agreed shared-care model of management between specialist weight management services and primary care.
Healthcare professionals (such as GPs, nurses and dietitians) offer lifelong annual follow-up care as part of an agreed share-care model between specialist weight management services and primary care.
Commissioners ensure that they commission services that provide lifelong follow-up care for adults who have had bariatric surgery. They ensure commissioning of shared-care models of management between specialist weight management services and primary care.
Adults who have had an operation to help them to lose weight (called bariatric surgery) and have been discharged from the bariatric surgery service have a check-up at least once a year for the rest of their life to make sure they are getting the support they need.
Source guidance
Overweight and obesity management. NICE guideline NG246 (2025), recommendation 1.18.18
Definitions of terms used in this quality statement
Follow up
Follow up after discharge from a bariatric service involves identifying any nutritional deficiencies, including vitamins, minerals and trace elements, after bariatric surgery and providing appropriate nutritional supplements. Other elements of follow up could include weight check, assessment of comorbidities such as hypertension, sleep apnoea, atherosclerosis disease and metabolic dysfunction-associated steatotic liver disease, investigation of abnormal test results and appropriate treatment and review of potential concerning symptoms such as vomiting and heartburn. There should be a process in place to allow primary care clinicians to liaise with the local bariatric unit or specialist weight management services about patient-specific nutritional deficiencies and necessary treatment (shared-care model of management). [Adapted from NICE's guideline on overweight and obesity management, recommendations 1.18.17 and 1.18.18, Guidelines for the follow-up of patients undergoing bariatric surgery (O'Kane et al. 2016) and expert opinion]