Current programmes and pathways
Obesity management and prevention is separated into 4 tiers.
- Tiers 1 and 2 are actioned through population level communication (i.e Change4life, One You, MECC), opportunistic intervention through Primary care, commercial and bespoke slimming programmes and medication (i.e. Orlistat).
- Tier 3 is a multi-disciplinary programme delivered from a hospital setting and
- Tier 4 is bariatric surgery.
- To support a reduction in excess weight in children across a wide range of initiatives and legislation, the Government published the Childhood Obesity Plan in September 2016[i].
- Prevention and management of excess weight are complex issues. In new guidance published by NICE in May 2014 recommendations are made to adopt an integrated approach to preventing and managing obesity. There are 18 recommendations altogether and the focus is on lifestyle behaviour changes supported by all stakeholders to reduce sedentary behaviour and promote a healthy diet. There should also be opportunities for self referrals to commissioned weight management programmes and access to opportunities across the whole community.[ii]
- The Government’s universal social marketing strategy for promoting healthy living is underpinned by Change4life.
- Excess weight pathway:- The new pathway shows the route that should be followed to refer children (and adults) to specialist excess weight services. There is also a more detailed written support paper to ensure all partners are able to use the pathway to the best effect
- Placement of services is determined through combined NCMP and Index of Multiple Deprivation data identifying geographical areas of increased prevalence together with MOSAIC data to support decision making to ensure that the best services are commissioned and delivered in the appropriate areas.
Services for childhood obesity are listed below:
BeeZee Bodies as the commissioned weight management provider also deliver free programmes for children's weight management.
A healthy lifestyle 8 week programme for families with children aged 2 – 4, including physical activity, healthy eating and parenting support. The course is free and is delivered through Children’s Centres and community venues. Open to all families.
This is a Family Weight Management Programme for 5 to 15 year olds and their families. The age groups are 5 to 8, 7 to 11 and 12 to 15.
The programme is delivered through 17 weekly sessions, which run in:
- Houghton Regis / Dunstable
- Leighton Buzzard
- Sandy / Biggleswade
The programme covers:
- advice and ideas about how to live a healthy lifestyle
- help to manage your child’s weight
- sessions for parents/carers and child/young person
- ways to enhance children’s self confidence
- practical healthy eating sessions including quick, easy and cheap recipe ideas
- advice about portion sizes
- activities like basketball, street dance and tennis
Key performance indicators for these programmes will be monitored quarterly across the life of the contract.
Other services for children include:-
This programme is delivered by Sustrans and was commissioned by Public Health from 1st September 2015. The project is funded until 31st March 2018. 3 ‘Bike It’ officers have been appointed to deliver the work.
The Central Bedfordshire ‘Bike It’ project is working with 32 schools across Central Bedfordshire to increase the number of young people travelling to school actively and/or sustainably with an emphasis on increasing cycling and activity levels, reducing car travel and creating a culture of active travel within schools and during leisure time which can be sustained. The schools have been identified using excess weight data from 3 year aggregated NCMP figures from 2013/14 – 2015/16. The programme is delivered in 17 schools across Dunstable, Leighton Buzzard and Houghton Regis. 11 schools across Sandy and Biggleswade and 4 in Caddington.
From the Annual Report for 2015 – 16 the programme has:
- Engaged with over 43,696 pupils, staff, parents and volunteers.
- In Sandy there has been a 3.9% increase in cycling to school, a 4% increase in scooting to school and a 2% decrease in car use across the year. Cycling outside school has risen by 6.1%.
- In Dunstable, Leighton Buzzard and Caddington there has been a 2.9% increase in cycling to school, a 3.8% increase in scooting to school and a 4.6% decrease in car use across the year. Cycling outside school has risen by 4.4%.
- The Santa Challenge in December 2016 totalled 111,534 miles that participating schools recorded. This was an increase of 100% on last years total.
Key performance indicators for this programme will be monitored quarterly across the life of the contract.
The National Child Measurement Programme (NCMP)
School Nursing Teams measure all children in Reception year and in year 6 each year. Generic healthy living information is delivered in parents packs and targeted information is delivered to parents of overweight or obese children offering access to weight management programmes within Central Bedfordshire.
This is promoted by Public Health, School Nurses, Health Visitors Early Years settings and Childrens Centre staff through a range of programmes and families are directed to a free to use on-line support package at www.nhs.uk/change4life
Making the Most of Me
This is an obesity intervention programme which is run in schools for pupils in Reception year and year 4. The programme trains teaching staff to deliver a 6 week course of Healthy Eating alongside a 6 week course of Physical Activity through Dance. It fits into the school curriculum areas for PSHE and PE across a half term. It is delivered using complete formatted lesson plans and resources. This makes delivery and preparation easier and is more likely to be used year on year. The programme has just been evaluated after 2 years. Briefly the evaluation shows that staff and pupils enjoyed all aspects of the programme and particularly liked being part of the show to parents at the end of the 6 weeks. They felt proud of their achievements. The children also commented that they remember the slogan ‘Swap it Don’t Stop It’ and staff felt empowered to deliver the programme because of the quality of the resources. Pupils are encouraged to share their class learning with their parents and involve them in the activities that are sent home during the 6 weeks. From 2011 – 2016 in Central Bedfordshire:-
- 89 staff from 45 schools have received training.
- 32 schools with year R.
- 32 schools with year 4.
- Training sessions are usually once a year for each year band.
- ‘Excess Weight Partnership Strategy 2016 – 2020’ was signed off in March 2016. This sets out how we will tackle a reduction in levels of excess weight in adults and children in Central Bedfordshire using a ‘Whole Systems Approach’, where excess weight is ‘Everyones business.’ The strategy has been developed in partnership with 14 departments including planning, environmental health, Staff wellbeing action group, leisure and libraries and transport with partners from other services including School Nurses, Health Visitors, Childrens Centres, Midwifes, Dietitians and weight management providers.
- Alongside the Strategy there are a set of Action Plans which detail how each department and partner will work towards the reduction of excess weight across Central Bedfordshire. This is monitored quarterly across the life of the strategy.
- Planning issues 1 – Public Health are working with the Planning Department to develop a Supplementary Planning Document which restricts the development of new HFTs in areas where excess weight levels are highest. The opening times can also be restricted. i.e. near schools. Ward data from the NCMP and locality profile data will support this initiative. The planned outcome is ‘Helping people to make healthier choices’.
- Planning issues 2 – Public Health are also working with planning on incorporating a Health Impact Assessment as part of the planning process for new housing developments. Most of the staff in the planning department at CBC have been trained in HIA to support this new element of the work. Public Health will be consulted on planning requests of 100+ dwellings in new developments.
- Environmental Health – As part of the Excess Weight Partnership Strategy, Public Health are working with Environmental Health to provide a ‘Healthy Options’ Food Award Scheme. The 1 year post is funded by Public Health and the officer will work alongside Environmental Health to promote healthier ways to prepare, cook and promote food in Hot Food Take aways and small restaurants. The award will be given to the establishment when they meet the pledges they have signed up to. The food award scheme will also be rolled out to all Leisure Centres across CBC and in the cafes at local authority parks and visitor centres.
- Leisure Providers – Following the new leisure services contract, which was awarded to Stevenage Leisure Ltd, there have been some changes and improvements with the Health and Wellbeing element of the provision. The vending machines in all 6 leisure centres contain 25% healthy options and all the cafes will work towards achieving the ‘Healthier Options’ food award in partnership with Environmental Health. The planned outcome is ‘Helping people to make healthier choices’.
- Change4lfe sports clubs for Yr 5,6,7, pupils.- Public Health jointly commissioned this programme in 2015 to be delivered in 5 middle schools in Leighton Buzzard. The schools had high levels of excess weight as identified through NCMP data from 2013/14. The programme is delivered by School Games organisers who work with the schools to promote and facilitate physical activity in the curriculum and extra curricular clubs.
Feedback from evaluation of the programme in May 2016.
- 83 children took part in the programme, 42 boys and 41 girls.
- 96% of children felt their fitness levels had improved since joining the “ENERGIZE CLUBS”
- 30% of children enjoyed the Small Games
- 84 % of the children preferred taking part in the sessions outdoors
- 92% of the children said they enjoyed attending the clubs
- 88% of children have started to eat more healthily since joining the clubs
- 80% of the children have been promoting the club to other students.
- 90% of the children have increased activity levels at home since attending the clubs
- 65% of the children have tracked activity levels since being part of the club
[i] Childhood Obesity Plan Sept 2016: https://www.gov.uk/government/publications/childhood-obesity-a-plan-for-action/childhood-obesity-a-plan-for-action
[ii] Nice Guidelines Published May 2014 – Managing overweight and obesity in adults – lifestyle weight management services.
Last updated Thursday, 11th May 2017