Reducing Childhood Obesity: Work Towards the LAA Target in Walsall

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Reducing Childhood Obesity Work Towards the LAA
Target in Walsall
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Obesity Prevalence in Walsall
Ref Description 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

• Reducing Y6 obesity is a partnership priority and
  a target in all of the following
• Local Area Agreement
• Children and Young Peoples scorecard
• Vital Signs
• World Class Commissioning
• .and identified as a JSNA priority area

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Obesity in Reception Children
PCT Obese Overweight 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

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NCMP Participation Data 2008/09
PCT Overall 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

• 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.

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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

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Actual vs. Predicted Performance on Vital Signs
Obesity Targets. Positive numbers denote a
performance that is better than predicted.
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
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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
Proposed Childhood (Age 0 to 16 years) Overweight
and Obesity Care Pathway
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.
11 Support dietician, endocrinologist,
paediatrician, PA specialist, drugs, surgery
Level 3 Multidisciplinary Approach
Level 2 First Line Weight Management for
children age 0 to 16 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.
8-16 Treatment Service Overweight and obese
treatment service for children aged 8-16 years.
Early Years Intervention children at risk of
being overweight and obese. Aged 2-4 years.
Make it Count Prevention and
treatment programme for 4-7 years.
Level 1 Identification Calculate age-sex
specific percentile in children aged 2 15
years Child gt 91st overweight Child gt 98th
obese
Sources 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
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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

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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

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NHS Walsall and Walsall Council
Active and Sustainable Transport and Road Safety
Project

• 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

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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

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Change4Life School Programmes

• 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

Saddlers Health Awareness Promoting Exercise
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Strategy and Action Plan

• 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