NHS Tier 4 Pre-Op Question

[Bari_Hopeful 3]

I posted this in the Pre-Op Q&A, but thought perhaps it might be helpful to post it here as well since maybe those post-op could help…?

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Hello, hello!
This is my first post here and after searching for this topic, not much came up for me, so here I am! 🙂

I was wondering if anyone here could share their experience going through the NHS Tier 4 appointments, particularly this first meeting with the bariatric dietitian? I'm assuming each trust probably has their own system of doing Tier 4, but for me, this is my first Tier 4 appointment and it’s a video call. After this appointment, if all goes well, I will (eventually 🤞) progress onwards to the in-person-at-the-hospital “one-stop clinic” to meet with the bariatric nurse, anaesthetist, psychologist, and surgeon.

I was successfully discharged from Tier 3 in Dec 2023 and have since been waiting for a Tier 4 appointment - the time has finally come! 🥳 Needless to say, I’m both excited and nervous - and happy to receive any words of advice or wisdom anyone can offer.

Also, for what it’s worth, I’m under the Portsmouth NHS trust (Queen Alexandra) and hoping for either the OAGB or RNY. Anyone have any experience with the QA bariatric team?

Thanks in advance!

Edit: typo

Edited Tuesday at 08:40 AM by Bari_Hopeful

[WendyJane 45]

I can tell you that my nutrition consults were easy, more educational than not. I have no idea what an NHS Tier appointment even is, let along the difference between a 1, 2, 3 or 4. How many tiers are there and what is NHS mean?

[summerseeker 2,354]

6 hours ago, WendyJane said:

NHS

Its our much loved National Health Service. I paid for my op so I cant help with this

[SpartanMaker 1,234]

@Bari_Hopeful Sorry you're not getting much in the way of responses. We don't have a lot of UK members to begin with, and so the likelihood of having one that's still active here and then also had their surgery at Queen Victoria Hospital is probably pretty low.

Just a thought, but you might try checking with the Tier 4 team at Queen Victoria to see if they have a post-surgery support group? A lot of Hospitals (at least in the US), have their own local support groups, so they would be worth seeking out.

Alternatively, if you have more general questions that might apply regardless of where the surgery is done, please feel free to post and hopefully we'll better be able to assist.

[NeonRaven8919 569]

I'm a London, UK based NHS patient. I've only just found your post, but I've added some hopefully helpful waffle to your original post.

I don't have experience of Portsmouth hospitals (only their seaside touristy spots) but in general, I've had only good experiences with the NHS treatment I got.

The psychologist visit is usually just a formality because I don't think a ten minute phone call is a really good gauge of someone's preparedness for a life altering surgery. If they NHS has already gotten you past the referral stage, I would imagine, you'll just need to wait until they can find a surgery slot.

I was approved in July of 2024 and told that "unless the moons and planets all align, you will likely get your surgery Spring 2025" I guess the moons aligned because two weeks later, they called to tell me it was time to start the 12 week milk pre-op diet and I was scheduled for October 2024. You will probably not have a 12 week pre-op diet. I was told this was a test group trial for University College London Hospital and because I had NAFLD.

Don't be too nervous (easier said than done, I'm sure) and congratulations! You've made it this far! You can do this!

We're all here to support you!

Edited 11 hours ago by NeonRaven8919