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 Ref Description Current position* RAG Rating VSB09_05 % of Children in Reception with Height & Weight Recorded who are Obese (also a CYPP target) GREEN VSB09_12 % of Children in Year 6 with Height & Weight Recorded who are Obese 2220 RED LAA % of Children in Year 6 with Height & Weight Recorded who are Obese RED

Obesity in Reception Children PCTObese Overweight + Obese Warwickshire PCT7.50%19.80% Solihull Care Trust8.80%21.30% Dudley PCT9.00%23.70% Herefordshire PCT9.00%23.70% Shropshire County PCT9.20%24.00% NHS Walsall9.30%20.60% Worcestershire PCT9.40%23.60% England9.60%22.80% North Staffordshire PCT9.60%23.90% South Birmingham PCT9.60%22.80% South Staffordshire PCT9.80%23.40% Coventry Teaching PCT10.60%23.40% West Midlands SHA10.60%23.30% Birmingham East & North PCT10.70%22.90% Wolverhampton City PCT11.50%25.90% Telford & Wrekin PCT11.70%28.30% Heart of Birmingham Teaching PCT11.80%22.30% Stoke On Trent PCT12.10%25.50% Sandwell PCT12.90%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

PCT Overall Participation rate NHS Walsall97% South Birmingham PCT96% Dudley PCT96% Sandwell PCT96% South Staffordshire PCT93% Telford & Wrekin PCT93% Shropshire County PCT92% Stoke On Trent PCT92% Wolverhampton City PCT92% Heart of Birmingham Teaching PCT92% England90% North Staffordshire PCT90% Coventry Teaching PCT90% Worcestershire PCT88% Warwickshire PCT87% Birmingham East & North PCT87% Herefordshire PCT85% Solihull Care Trust81% 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 % 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 Stoke On Trent PCT NHS Walsall South Birmingham PCT Dudley PCT Birmingham East and North PCT Coventry Teaching PCT Herefordshire PCT Heart of Birmingham Teaching PCT Sandwell PCT Telford and Wrekin PCT Worcestershire PCT Wolverhampton City PCT Warwickshire PCT Shropshire County PCT North Staffordshire PCT South Staffordshire PCT 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 > 91 st = overweight Child > 98 th = 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 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. and local mediawww.fun4life.org.uk 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