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Nearly two-thirds of adults in England are living with overweight or obesity. A third of children leaving primary school are living with overweight or obesity. 

Obesity is a serious health concern that increases the risk of many other health conditions, including Type 2 Diabetes, cardiovascular disease, joint problems, mental health problems, and some cancers.

NHS England have established the National Obesity Audit (NOA) as part of the National Clinical Audit and Patient Outcomes Programme. 

NOA will bring together comparable data from the different types of adult and children’s weight management services across England in order to drive improvement for the benefit of those living with overweight and obesity. 

The audit will make use of data already collected from hospitals, community settings and general practices (GPs). This will include data from all weight management services and interventions commissioned (funded) by local authorities and the NHS.

Weight management services in England are currently categorised into 4 tiers:

• Tier 1: Universal prevention services
• Tier 2: Lifestyle multicomponent weight management
• Tier 3: Specialist multi-disciplinary weight management
• Tier 4: Bariatric specialist services

Further information about overweight and obesity interventions can be found in the NICE guidelines for overweight and obesity management.

Data from complications for excess weight (CEW) clinics is exempt from the NOA audit. 

Some Tier 2 and Tier 3 weight management services may need to register and start submitting to the Community Services Data Set (CSDS).

The technical guidance for Tier 2 and Tier 3 and weight management services using CSDS is now available. 

Learn more about how community providers submit to NOA.

The NOA seeks to answer seven important questions:

1. What proportion of people and which population groups living with overweight and obesity are being identified and recorded?
2. What proportion of people living with overweight and obesity have been offered appropriate NICE recommended interventions?
3. Which people living with overweight and obesity access weight management services?
4. What are the short and long term weight loss outcomes of weight management services?
5. Do people living with overweight and obesity transition successfully between the different types of weight management services available and from children’s to adult services?
6. What are the health outcomes for people living with overweight and obesity?
7. What is the coverage and provision of weight management services?

Services and commissioners will be able to use the NOA data to deliver equitable access to effective prevention and care programmes.

The Department of Health and Social Care has directed NHS England to establish and operate a system for the collection and analysis of the NOA. This type of instruction is commonly known as a Direction (under section 254 of the Health and Social Care Act 2012).

The information is required by NHS England under section 259 of the 2012 Act to comply with the National Obesity Audit Directions 2023. In line with section 259, all organisations in England that are in scope of the NOA Data Provision Notice, must comply with the requirement and provide information to NHS England in the form, manner and period specified, therefore patient consent is not required.

A Direction must specify the information to be collected and include relevant details such as why the information is needed and what analysis is to be carried out. This information is included in the National Obesity Audit Requirement Specification  and NOA dataset specification documents. 

Where a collection is directed under the mechanism described above, the national data opt-out (NDOO) does not apply. Therefore, all patients’ records must be submitted to NHS England.

This is detailed in section 6.4 ‘When does a national data opt-out not apply?’ of the NDOO operational policy guidance document.

We are obliged to apply the national data opt-out if we supply the data onwards to any other organisation. For example, if a research body applies for NOA data via the Data Access Request Service (DARS) run by NHS England, then we are required to apply the NDOO to the data before supplying the data extract to the research body. We do this by checking the patient cohort against the national register.