Agenda item

Presentation by Kate Green, Public Health Specialist

Kate Green, Public Health Specialist gave the following powerpoint presentation:-

 

What we know

-          25.5% of 4-5 year olds and 36.1% of 10-11 year olds are overweight or obese

-          Obesity levels are much higher in our most deprived communities: the three most deprived Wards (Rotherham East, Rotherham West and Valley) have some of the highest rates for obese children at Reception and Year 6

-          Adult obesity levels are significantly higher than the England average with 71.2% of adults aged over 18 either overweight or obese and 6 of the 7 most deprived Wards are above the Rotherham average for obese adults

-          Only 1 in 20 obese children at Reception will have a healthy weight at Year 6

-          These levels of obesity cost the local economy an estimated £23.7M

 

“There comes a point when you had to stop pulling people out of the river, get upstream and find out why they are falling in” Desmond Tutu

-          Current ‘Weight Management’ Service for age 4+ identified with weight concern

-          Model of delivery only able to work with around 150 children per year

-          There were around 1,000 obese children in Reception and Year 6 alone in 2017/18

-          If only 1 in 20 obese children at Reception have a healthy weight at Year 6, resources need to be directed much more towards early years

-          Obese children are more likely to become obese adults and will generally have poorer health than their non-obese peers – the Health and Wellbeing Board has a strategic aim to ensure “all Rotherham people live well for longer”

-          Need a much stronger focus on prevention

-          Use a whole systems approach to understanding local causes of obesity and what works best to tackle them

 

A Whole System Approach

Tackling obesity is everyone’s business – there is no single individual, group or organisation that can do this alone

-          6 phases which aim to help local authorities deliver co-ordinated actions involving stakeholders across the whole local system

-          Early phases focus on preparation – securing senior leadership support, developing stakeholder groups, building an understanding of the local obesity picture

-          The next phases are all about collective working: stakeholders from across the system are brought together to create a map of the local causes of obesity in their area and identify and prioritise areas of action – it allows stakeholders to recognise their role in the system and how they can make a difference

-          The latter phases of the process focus on taking actions forward as a group, continuously monitoring and revising them and reflecting on how things can be improved

 

Local Plans and Strategies

-          Health and Wellbeing Strategy

Aim 1:  All children get the best start in life

Aim 3:  All people live well for longer

Roll of Aim 4 in preventing obesity

-          Children and Young People’s Plan – being refreshed for 2019

-          Rotherham Active Partnership Plan

(contributing to Cultural Strategy and Health and Wellbeing Strategy)

 

Aim:  for everyone in Rotherham to achieve and maintain a healthy weight

Strategic Themes:

-          Whole systems approach

-          Effective use of intelligence and data (including assets)

-          Reducing inequalities

-          Workforce development

Priorities:

-          Maximise universal preventative action across the life course

-          Give every child the best start in life

-          Create environments that promote healthy weight

-          Effective early intervention and support when needed

 

Outcomes

-          More children and adults with a healthy weight

-          More children from deprived communities with improve health outcomes (reduced gap in excess weight between the least and most deprived areas)

-          More people with improved mental wellbeing

-          More people active, more often

-          More children and adults eating ‘5 a day’

-          Fewer people with  Type 2 Diabetes

 

Key Actions

Priority 1.  Maximise universal preventative action across the life course

a.    Sign up to the Local Authority Declaration of Healthy Weight

·                Food Active developed the Declaration in North-West which is now being rolled out across this region

·                Led by the Local Authority but partner engagement is crucial

·                14 ‘set’ commitments with option to include further local priorities (e.g. linking to existing work) including:

-          Engagement with the local food and drink sector to consider responsible retailing

-          Reviewing provision in all public buildings, facilities and via providers to make healthy foods and drinks more available, convenient and affordable and limit access to high calorie, low nutrient foods and drinks

-          Increase public access to fresh drinking water on Local Authority controlled sites

-          Consider supplementary guidance for hot food takeaways specifically in areas around schools, parks and where access to healthier alternatives are limited

-          Advocate plans with partners including the NHS and all agencies represented on the Health and Wellbeing Board to address the causes and impacts of obesity

-          Ensure food and drinks provided at public events include healthy provisions, supporting food retailers to deliver this offer

-          Invest in the health literacy of local citizens to make informed healthier choices

-          Ensure clear and comprehensive healthy eating messages are consistent with Government guidelines

-          Consider how strategies, plans and infrastructures for regeneration and town planning positively impact on physical activity

 

b.    Increase physical activity levels for all ages across Rotherham:

-               Continue to support the Rotherham Active Partnership to increase physical activity levels for the least active children and young people and older people

-               Support roll out of the ‘daily mile’ in primary schools

-               Continue to support the Physical Activity Clinic Advice Pad trial

-               Explore opportunities to use Social Prescribing to promote physical activity

-               Explore opportunities in the work place to promote physical activity such as stair challenges, walking/running groups, moving more often during the working day (linked to Healthy Workplace Award)

 

Priority 2.  Give every child the best start in life

a.    Upskill the workforce to deliver a healthy weight programme for families with young children:

-               Train professionals in 0-19 Service and CYPS to deliver an evidence-based longer term behaviour change programme for families of young children (0-5 years)

-               To include breastfeeding, weaning, sugar smart, active play, oral health

-               Provided for all families to access but with targeting in deprived communities (via Children’s Centres)

b.    Actions to support maternal health

-               Targeted to areas of deprivation

-               What is already being done/what more could be done

 

Priority 3.  Create environments that promote healthy weight

a.    Explore opportunities to ensure the local environment does not ‘promote obesity’ including

-                 Planning policies and local developments (including the Town Centre)

-                 Increasing availability of healthy food and physical activity opportunities

-                 Explore opportunities presented in the Childhood Obesity Trailblazer Eol

b.    Continue to roll out the Healthy Workplace Award

-               Supporting employers to create healthy environments in the workplace

c.    Commit to actions described in the LA Declaration on Healthy Weight

-               Impacting on the environment in relation to food and opportunities to be physically active

 

Priority 4.  Effective early intervention and support when needed

a.    Develop pathway to support the National Child Measurement Programme (NCMP)

-               Upskill staff within 0-19 Service and CYPS to deliver an evidence based longer term behaviour change programme for families of children aged 5-11

-               To provide an appropriate pathway for primary age children identified with a weight concern following NCMP

-               To enhance the NCMP ‘offer’ by providing more personalised support and advice for families

b.    Explore opportunities for providing support/advice for young people aged 12+ identified with a weight concern

-               Evidence (both national and local) suggests traditional ‘weight management programme’ not as effective for this age group

-               Need a more ‘holistic’ positive approach which focuses on healthy behaviours not just ‘weight’

c.    Get Healthy Rotherham to continue to provide adult weight management service until 2021

 

National and Regional Context

-          Government Childhood Obesity Strategy

-          PHE-led Community of Improver Group (Healthy Weight and Physical Activity)

-          Regional Childhood Obesity Action Plan

-          Yorkshire and Humber sign up to the Local Authority Declaration on Healthy Weight

 

Discussion ensued on the presentation with the following issues raised/clarified:-

 

-          How would it be evaluated to ascertain if it was working?

 

-          Obesity was a priority within the Place Plan.  Consideration was needed as to whether signing up to the Declaration would provide anything additional

 

-          The HENRY Programme focussed on the 0-5 age group.  Its evidence suggested that resources targeted much earlier in a child’s life was where the most benefit would be achieved.  There was an opportunity to possibly work with HENRY on a pilot programme for primary aged children which they would evaluate

 

-          The current service, although successful, was successful in very small numbers – something different was needed

 

-          The School Meals Service provided approximately 1,500 school meals and had a Food for Life Bronze award.  Work in this area would hit a cohort from the age of 4 years upwards

 

-          Engagement with Head Teachers in a deprived area

 

-          Proposed to reactivate the Active Schools Group

 

-          Food for All worked with children to develop healthy cooking of food

 

-          Stocktake required of what all partners were currently doing to avoid duplication and ascertain where the gaps were

 

-          Activity currently took place in Children’s Centres and with Health Visitors on weaning and breastfeeding support, however, should it be a time fixed programme of support that families could be referred into?

 

-          Was there a danger of over simplifying

 

Resolved:-  (1)  That work take place in gathering together all the work that already existed on this issue.

Action:  Kate Green

 

(2)  That Kate Green contact Lydia George, RCCG, to discuss the Obesity Priority within the Place Plan.

Action: Kate Green

 

(3)  That the Local Authority Declaration on Healthy Weight be circulated to members of the Health and Wellbeing Board

Action:-  Kate Green/Dawn Mitchell

 

(4)  That a further discussion take place on the Local Authority Declaration on Healthy Weight at the next meeting of the Board.

Action:  Becky Woolley