Reducing Childhood

Obesity: Work Towards

the LAA Target in

Walsall

Reducing Y6 obesity is a partnership priority and a target in all of the following:

• Local Area Agreement• Children and Young People’s scorecard• Vital Signs • World Class Commissioning….and identified as a JSNA priority area

Obesity Prevalence in Walsall

RefDescription

Current position*

2009-10 2010-11 RAG Rating

VSB09_05 % of Children in Reception with Height & Weight Recorded who are Obese (also a CYPP target)

9.3 11 11 GREEN

VSB09_12 % of Children in Year 6 with Height & Weight Recorded who are Obese

22 20 20 RED

LAA % of Children in Year 6 with Height & Weight Recorded who are Obese

22 18.8 18.6 RED

Obesity in Reception Children

PCT ObeseOverweight +

Obese

Warwickshire PCT 7.50% 19.80%

Solihull Care Trust 8.80% 21.30%

Dudley PCT 9.00% 23.70%

Herefordshire PCT 9.00% 23.70%

Shropshire County PCT 9.20% 24.00%

NHS Walsall 9.30% 20.60%

Worcestershire PCT 9.40% 23.60%

England 9.60% 22.80%

North Staffordshire PCT 9.60% 23.90%

South Birmingham PCT 9.60% 22.80%

South Staffordshire PCT 9.80% 23.40%

Coventry Teaching PCT 10.60% 23.40%

West Midlands SHA 10.60% 23.30%

Birmingham East & North PCT 10.70% 22.90%

Wolverhampton City PCT 11.50% 25.90%

Telford & Wrekin PCT 11.70% 28.30%

Heart of Birmingham Teaching PCT 11.80% 22.30%

Stoke On Trent PCT 12.10% 25.50%

Sandwell PCT 12.90% 26.20%

• NHS Walsall has lower YR obesity levels than the national and regional average

• Focus clearly needs to be on school age children

• Development of services for 4-7 year olds in 2009 and targeted work for prevention and treatment in Y4 aged children

PCTOverall Participation rate

NHS Walsall 97%

South Birmingham PCT 96%

Dudley PCT 96%

Sandwell PCT 96%

South Staffordshire PCT 93%

Telford & Wrekin PCT 93%

Shropshire County PCT 92%

Stoke On Trent PCT 92%

Wolverhampton City PCT 92%

Heart of Birmingham Teaching PCT 92%

England 90%

North Staffordshire PCT 90%

Coventry Teaching PCT 90%

Worcestershire PCT 88%

Warwickshire PCT 87%

Birmingham East & North PCT 87%

Herefordshire PCT 85%

Solihull Care Trust 81%

NCMP Participation Data 2008/09

• Overall participation rate highest in WM

• Increased participation year on year since 2006/07

• Halved opt out and absence rates from 296 children (07/08) to 142 children (08/09)

•NCMP IC modelling explains that a 10% increase in participation results in a 0.6% increase in prevalence in Y6 aged children.

Year 4 Proactive Calls

• Uniquely Walsall now measure and feedback to Year 10 and Year 4 children

• Pilot January – February 2010

• 25% of parents contacted did request further support from a service

• 33% of these are now attending a weight management service

• Proactive phone calls to Y4 children identified as being overweight or obese from April 2010

PCT Name % prevalence of childhood obesity at reception age, 2007/8

% prevalence of childhood obesity at year 6 age, 2007/8

PCT Ranking - ‘better than predicted’ performance for yr6 obesity

Solihull Care Trust 0.02 2.65 1

Stoke On Trent PCT 1.57 2.39 2

NHS Walsall 1.79 0.95 3

South Birmingham PCT 1.31 0.24 4

Dudley PCT -1.07 0.13 5

Birmingham East and North PCT 0.6 0.09 6

Coventry Teaching PCT -0.62 0.03 7

Herefordshire PCT -0.35 -0.14 8

Heart of Birmingham Teaching PCT 0.7 -0.18 9

Sandwell PCT 0.44 -0.22 10

Telford and Wrekin PCT -1.54 -0.48 11

Worcestershire PCT 0.11 -0.58 12

Wolverhampton City PCT -1.43 -0.89 13

Warwickshire PCT 0.62 -1.32 14

Shropshire County PCT -2.43 -1.51 15

North Staffordshire PCT -1.47 -1.8 16

South Staffordshire PCT -0.08 -1.9 17

Actual vs. Predicted Performance on Vital Signs Obesity Targets. Positive numbers denote a performance that is ‘better than predicted’.

Prevention and Universal

Healthy Start Vouchers for fruit and vegetables

Health awareness sessions for Y4 children in schools delivered by Walsall FCCP, Walsall Council and WM Fire Service

Physical Activity Team: CAP specific Physical Activity Advisors, Family Fit sessions, Active Clubs training.

Walsall Active Youth: : Specialised sessions and programmes e.g. Skillz4Sport, Community Lifestyles, etc

Partnership work to promote Active Travel to school and use of Greenspaces

National Campaign

Change4Life Advisor Service

Based on national campaign. Over 80% mothers recognise the brand.

Supports families before and after more intensive weight management programmes to ensure behaviour changes are long term.

Advisor works one to one with families.

Assess readiness to change, monitor height and weight of the whole family, signposting, follow up.

Targeted work to reduce health inequalities.

Level 1: Identification

Calculate age-sex specific percentile in children aged 2 –15 years

Child > 91st = overweight Child > 98th = obeseSources of referral/identification: School Health, NCMP Letter and Self Referral, GP, Secondary Care, Young Persons Health Advisor, Midwife, Health Visitor, Practice Nurse, Adult Weight Management

Services, Children's Centre Staff

Level 2: First Line Weight Management for children

age 0 to 16 years

8-16 Treatment Service

Overweight and obese treatment service for children aged 8-16 years.

Make it Count Prevention and treatment programme for 4-7 years.

Overweight and obese children in Bentley aged 4-7 years.

Maternal and EY Pilot: Focus: food, activity, breastfeeding, weaning family wellbeing. Minimise weight gain during pregnancy. Mothers and children aged 0-2 years.

Early Years Intervention: children at risk of being overweight and obese. Aged 2-4 years.

1:1 Support: dietician, endocrinologist, paediatrician, PA specialist, drugs, surgery*

Level 3: Multidisciplinary

Approach

Proposed Childhood (Age 0 to 16 years) Overweight and Obesity Care Pathway

NHS Walsall and Walsall Council

• Established weight management programme for children aged 8-16 years

• First programme in Walsall 2006

• Previously funded through Active England Bid

• From 2010/11 joint funded 75/25 split between NHS Walsall and the Local Authority

• Improved recruitment methods e.g. www.fun4life.org.uk and local media

• Referrals from NCMP

NHS Walsall and Lifestyle Services

• Obesity treatment and prevention programme for children aged 4-7 years

• Pilot – April 2009

• Referrals from NCMP – Reception age

• 2010/11 over 250 children to access programme

NHS Walsall and Walsall Council

• Importance of regular physical activity gained through active travel to school

•Deprivation, Yr 6 obesity and school travel data

• 12 schools – Y3, Y4 and Y5 target year groups

• 1700 children

• Sept 2009 to Sept 2011

• Outcomes above and beyond current targets around increasing active travel e.g.

1.5% increase in active travel in these schools from 2008 census data

Active and Sustainable Transport and Road Safety Project

NHS Walsall and Walsall Council

Green spaces• Year 6 obesity data informing site consideration for the ‘Playbuilder’ Project

• Park Ranger Service being redesigned as of June 2010

• Community and School engagement

• Organising events

• Link with Healthy Schools Enhancement Model

• Community Gardens

• Involve schools and young people

• Local food production

Change4Life School Programmes

Saddlers Health Awareness Promoting

Exercise

• Schools based ‘Change4Life’ programme

• SHAPE pilot April 2009

• WM Fire Service and SLDS, Walsall Council • 2010/11 = over 800 Year 4 children

• Targeting schools with high obesity prevalence and high BME populations

• Links with 5 hour offer and Healthy Schools Enhanced Model

• 2010, Refresh Year 6 Obesity Target Action Plan (TAP) with partners to ensure whole systems approach

• 2010, Refresh Walsall Healthy Weight Strategy and Action Plan

• Workshop to consult a range of partners

• NST Visit 2008: Partnership working in Walsall was identified as a particular strength by the NST in 2008:

‘Multi-agency obesity partnership in place with strategic and operational arrangements’

Strategy and Action Plan