1. Obesity Management with associated risk factors programme Presentation To Health & Well-being Partnership board Meera Sharma BPharm (Hons), MRPharmS, PGDip Professional Services Manager

2. Objectives Background Pharmacy & pharmacist selection Service process Training & Communication Skills Progress to-date Future Vision

4. Obesity & Coventry Teaching PCT Coventry’s population 300,848 50% adult population overweight 23% clinically obese = 51,622 60% eat less 5 portions of fresh fruit & vegetables Only 22% travel to work by foot bicycle public transport Coventry’s vision for public health Improve people’s dietary habits and increase physical activity To provide weight management services to reduce mortality and morbidity Improving the health of the local population

5. Aim of Service To provide a weight management service for patients with a BMI (30- 38kg/m 2 ) with at least ONE diagnosed or established risk factor. Risk factors include: –Hypertension –Type -11 Diabetes –Hyperlipidaemia –Increased waist circumference – Male 102cm (40 ins) Female 88cms (35ins) Why Community Pharmacy? Ready accessibility for advice & support Ideally located for improving public health Part of primary healthcare team & inter-professional working Community pharmacy contract provides foundation for quality, cost- effective patient services

6. Pharmacy and Pharmacist Selection Criteria included: Pro-active pharmacist and support staff enthusiastic about opportunity presented by programme, Pharmacy has consultation area that has been verified during monitoring visits to meet contract specification Consultation area has sink available for use Pharmacy has achieved a satisfactory contract monitoring report 2006-7 Pharmacist is HEI accredited for providing MUR service Pharmacist is providing MUR service (> 10 MURs completed, claimed and documented) Pharmacy has demonstrated through past performance that it will actively engage and support local intimates and services Suitable pharmacy location (to ensure good geographical distribution) Selection was carried out jointly by Coventry Teaching PCT & LPC

7. Equipment training for measuring the following parameters: Acknowledgements To all who were involved in the development of this programme Dr Terry Maguire HbA1cBlood Pressure BMI Weight Height Total Cholesterol

8. Pharmacist and support staff training 1- day training programme provided by Dr Terry Maguire, which covered: Behavioural change Facilitating healthy choices by patients Techniques to change dietary, lifestyle and exercise habits Sustainable, realistic and gradual modification Motivational interviewing technique skills: Patient ‘wins’ & ‘challenges’ Patient’s typical day in terms of diet, lifestyle and exercise Provision of tailored, bespoke information Working towards target systematically Facilitating decision making, without jumping in with answers

9. Successful engagement with patient Express empathy with patient Develop structured, personalised plans Avoid confrontations/challenges with the patient Roll with patient resistance to change Work within boundaries that the patient is comfortable with Active listening Planning with the patient Create a tailored plan Be realistic 2lbs per week Old habits die hard!!! Small Changes Big Benefits Aim for a 500 calorie reduction in calorie intake per day to achieve a 1-2lb weight loss per week

10. Resources available Local resources Expert Patient Programme Exercise Specialist Dietician Coventry Teaching PCT personnel Expert resources GPs & nurses UniChem Professional Services Team – project facilitation Equipment suppliers and pharmaceutical Industry support Academic experts e.g. Dr Terry Maguire, Department of Health guidance National resources Websites e.g. Diabetes UK, British Heart Foundation etc. National publications e.g. NICE guidance, Skills for Health National Workforce Competency Frameworks

12. Progress to-date 29 patients enrolled onto service since launch on 10 th January 2007 1 peer-review meeting held, which was productive and allowed all pharmacists to feedback on successes/challenges Future vision To gather programme data and outcomes for academic research and evaluation of service for publication To develop a Weight Management Programme for Children and Adolescents Pharmacy to be seen as first port of call for patients and GPs to see pharmacy as a valuable patient referral pathway To provide a sustainable and cost effective programme through out Coventry PCT for the people of Coventry

13. Implications for Health & Well Being Partnership Estimated obesity rate for West Berkshire is 21.5%, which is higher than the regional average The above Coventry Teaching PCT model can be adapted for roll-out within West Berkshire Similar selection, training and recruitment process Can adapt patient inclusion & exclusion criteria according to local needs Engagement with local healthcare professionals can be built into the model for seamless patient care

14. Pharmacist GP Expert Patient Group Partner organisations Exercise Expert Dietician PCT Together Everyone Achieves More Patient Supporting the patient

15. Thank you Questions?