Healthy Weight, Healthy Valleys
Strategy 2012-2015
Agencies:
Cwm Taf Health Board
Public Health Wales
Rhondda Cynon Taff County Borough Council
Merthyr Tydfil County Borough Council
Voluntary, Community and Independent Sector Partners
Author: Angela Jones, Consultant in Public Health
Sally Hudd, Senior Health Promotion Specialist
Cwm Taf Local Public Health Team
Date: 12 September 2012
Version: 1d
Publication/ Distribution:

Public (Internet)

NHS Wales (Intranet)

Public Health Wales (Intranet)
Review Date: July 2015
Purpose and Summary of Document:
The Healthy Weight, Healthy Valleys Strategy identifies and coordinates the
partnership approach to improving nutrition and physical activity and
maintaining a healthy weight in Cwm Taf through:

Clear leadership and coordination of action

Improving healthy eating and physical activity levels

Supporting overweight people to reduce weight and increase physical
activity

Improving the wider environment to encourage health eating and
increase in physical activity
Cwm Taf Public Health Team
Healthy Weight, Healthy Valleys Strategy 2012-15
Contents
Executive Summary
Page
3
1
Healthy Weight, Healthy Valleys Strategy – Purpose
4
2
Background – what is overweight and obesity?
4
2.1
Cause and impact of overweight and obesity
4
2.2
Body Mass Index (BMI)
4
Health Consequences
5
The facts about obesity in Cwm Taf
7
Lifestyles in Cwm Taf
11
2.4
Inequalities in Health
11
2.5
The cost of overweight and obesity
14
2.3
2.5.1 The cost to the NHS, local authorities and society
14
2.5.2 The cost to the individual
15
2.6
National and Local Strategies
15
2.7
The change in Culture
16
2.8
Addressing overweight and obesity
16
2.8.1 Clear leadership and co-ordination of action
17
2.8.2 Improving healthy eating and physical activity levels –
17
key evidence
2.8.3 Supporting overweight people to reduce weight and increase
18
physical activity – key evidence
2.8.4 Improving the wider environment to encourage healthy eating
18
and increase in physical activity – key evidence
2.9
Communication
19
2.10 Reporting
19
3
20
Recommendations
Appendix 1 – Proposed Development Plan 2012-2015
21
References
32
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Executive Summary
Obesity and physical inactivity are overtaking smoking as the largest
avoidable cause of ill health and early death in Wales and a leading cause of
inequality. Deprivation is a key component of social inequality and Cwm Taf
is the most deprived area of Wales.
The vision for the Healthy Weight, Healthy Valleys Strategy is a multi agency
commitment to act to improve healthy eating and encourage and increase
physical activity in Cwm Taf.
The way of life has changed over the last few decades. Physical activity has
declined with less manual jobs, increased car ownership and labour saving
devices plus more sedentary behaviours such as television viewing. Food is
also abundantly available through supermarkets, fast food outlets and
takeaways. Food marketing, including, pricing, branding, positioning e.g. for
impulse buying at checkouts encourage us to buy and eat more.
Foresight is headed by Professor Sir John Beddington, the Government Chief
Scientific Adviser, who reports directly to the Prime Minister and Cabinet.
Foresight 2007 reported that 1% of males and 2% of females were obese in
the 1960s and predicts that by 2050 60% of males and 50% of females will
be obese 1.
It is clear that a strategy for tackling overweight and obesity needs to be
delivered in partnership as part of an overall plan to improve the health of the
Cwm Taf population.
The Healthy Weight, Healthy Valleys Strategy is backed up by an action plan
to tackle the preventable harm that excess weight and inactivity is causing to
our communities in 4 main themes:

Clear leadership and coordination of action

Improving healthy eating and physical activity levels

Supporting overweight people to reduce weight and increase physical
activity

Improving the wider environment to encourage health eating and
increase in physical activity.
Next Steps
Consult with partners and stakeholders on draft the Healthy Weight, Healthy
Valleys strategy and action plan for their comments and feedback.
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1
Healthy Weight, Healthy Valleys Strategy 2012-15
Healthy Weight, Healthy Valleys Strategy Purpose
The vision for the Healthy Weight, Healthy Valleys Strategy is to promote an
environment where residents have access to nutritious food, regularly build
physical activity into their daily routines and have good support to maintain a
healthy weight.
This strategy requires a partnership approach which reflects the complexity of
the problem. Two workshops were carried prior to the development of this
strategy using the life course as a focus. Partners from the health board, local
authority, and voluntary and community sector, private sector attended the
events. Information gathered from the two day event has helped to inform
this strategy and action plan.
This strategy, developed in partnership, will seek to coordinate and target
action in key areas to ensure the greatest impact and efficiency.
The detailed strategic action plan, including responsibility and performance
monitoring is included at Appendix 1. The headline themes are listed below:




Clear leadership and coordination of action
Improving healthy eating and physical activity levels
Supporting overweight people to reduce weight and increase physical
activity
Improving the wider environment to encourage health eating and
increase in physical activity
The purpose of this consultation is to engage with all local partners for their
comments and feedback.
2
Background
obesity?
–
What
is
overweight
and
2.1 Cause and impact of overweight and obesity
Overweight and obesity is very closely related to diet. Physical activity levels
play an important part in maintaining a healthy weight. On a very simple
level it is caused when more energy is consumed than is used.
Poor diet, including low fruit and vegetable intake along with low levels of
physical activity, often results in becoming overweight or obese. This can
result in high blood pressure and high blood glucose levels.
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2.2 Body Mass Index (BMI)
Adults
Body mass index (BMI) is used to measure weight status. BMI is a person’s
weight in kilograms divided by the square of their height in metres 2. Table 1
highlights the cut-offs used to classify adults.
Table 1: Adults BMI classification
Classification
BMI range (kg/m2)
Underweight
Less than 18.5
Healthy Weight
18.5 – 24.9
Overweight
25.0 – 29.9
Obese
30.0 – 39.9
Morbidly obese
Greater than or equal to 40
Children
The raw BMI alone should NEVER be used in the assessment of whether a
child is overweight or obese. BMI is not a direct measure of body fat, so care
needs to be taken when interpreting the results. Rapid changes of BMI may
occur in normal childhood growth, so this as well as additional factors such as
girth measurement and stature should be taken into account before
intervention is considered.
For any clinical situation, including providing BMI centile results to parents,
the clinical, as opposed to the epidemiological, classification for overweight or
obesity is used. In line with NICE clinical guidelines UK 1990 children’s BMI
centile thresholds is standard in the clinical assessment of overweight and
underweight.3
Table 2: Children‘s BMI Clinical classification
Clinical Classification
BMI Range
Overweight
≥91st <98th
Obese
≥ 98th
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In high income countries, such as Wales, the World Health Organisation has
identified the ten leading risk factors cause of death, 2004.4
Table 3: Ten leading risk factors cause of death, 2004
Risk Factor
Percentage of deaths
1.
Tobacco use
17.9
2.
High Blood Pressure
16.7
3.
Overweight and obesity
8.4
4.
Physical Inactivity
7.7
5.
High blood glucose
7.0
6.
High cholesterol
5.8
7.
Low fruit and vegetable intake
2.5
8.
Urban outdoor air pollution
2.5
9.
Alcohol use
1.6
10.
Occupational risks
1.1
It can be seen that many of the risk factors identified by the World Health
Organisation are inter-related with overweight and obesity and collectively
overtake tobacco as the leading cause of death.
Health consequences
The greatest consequences of obesity relate to the health of affected
individuals. There is good evidence that obesity is a risk factor for many
chronic diseases and is overtaking smoking as a preventable cause of disease
and premature death. These include: Type II diabetes, high blood pressure,
breathlessness, restricted breathing during sleep (sleep apnoea), gall bladder
disease, coronary heart disease or heart failure, osteoarthritis of the knees,
gout, complications of pregnancy, cancer, impaired fertility, lower back pain,
increased risk during anaesthesia and foetal defects arising from maternal
obesity.5
The above mentioned diseases are mainly of adults, but conditions such as
Type II diabetes, coronary heart disease, cancers, osteoarthritis and back
pain also affect children. There are also social and psychological
consequences of obesity such as stigmatisation, discrimination, prejudice,
poor self image, low self confidence and depression. 6
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Foresight 2007 report that was commissioned by the UK Government
highlighted that taking into account current trends by 2050 60% of men,
50% of women and 25% of children will be obese. Figure 1 highlights the
predicted increase in obesity related disease by 2030 and shows that the
incidence of Type 2 diabetes will be the greatest.
Figure 1: Predicted growth in obesity-related disease by 2030
2.3
The facts about obesity in Cwm Taf.
The majority of adults in Cwm Taf are either overweight or obese. The Welsh
Health Survey results for 2009-10 indicate that overweight and obesity rates
in Merthyr Tydfil have increased to 63%, and increased to 62% in Rhondda
Cynon Taff compared the Wales rate of 57%.7
As the Figure 2 illustrates, a higher percentage of people in Cwm Taf are
overweight and obese compared to Wales and the rates appear to be
increasing more quickly.
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Healthy Weight, Healthy Valleys Strategy 2012-15
Figure 2: Percentage of adults overweight or obese (Welsh Health
Survey 2011).
64
62
60
58
Wales
56
54
52
Merthyr Tydfil
Current
Future
50
48
In Wales, 56 per cent of adults reported a weight and height classed as being
overweight or obese ranging from 48 per cent in areas of North Wales and
Cardiff & Vale to 63 per cent in areas of Aneurin Bevan and Cardiff and Vale.
In Cwm Taf, five of the nine Upper Super Output Areas, (USOA) have
percentages statistically significantly above the average for Wales. A USOA
has an average population of around 30,000 at sub local authority level,
Figure 3. 8
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Figure 3
The percentage of adults in Wales who reported a weight and height classed
as obese ranged from 11 per cent to 26 per cent. In Cwm Taf, four out of
nine USOAs have percentages statistically significantly above the average for
Wales (20 per cent), Figure 4.
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Figure 4
Children who are obese are much more likely to be obese in adulthood.
Current national trends suggest that around 8% of obese 1–2-year-old
children will be obese when they become adults, while 80% of children who
are obese at age 10–14 will become obese adults, particularly if one of their
parents is also obese. In Wales, a feasibility study was undertaken to
measure the height and weight of children in schools. This found that the rate
of overweight or obese children:
•
Reception Year (4-5 years old)- 22%,
•
Year 4 – 27.45%
•
Children living in the most deprived areas of Wales had statistically
significantly higher rates overweight and of obesity than children living
in the least deprived areas 9
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Healthy Weight, Healthy Valleys Strategy 2012-15
The Child Measurement Programme commenced in September 2011 and will
collect information on the heights and weights of all reception aged children
in Wales.
Lifestyles in Cwm Taf
In Cwm Taf 30% of adults are meeting the guidelines for the consumption of
fruit and vegetables which is significantly lower when compared to the Wales
rate of 35%. Fruit and vegetable intake in 11-16 years old is also below the
Wales rates whereas consumption of sugary drinks is greater than the Wales
rate, Table 4.
Table 4: Eating habits of 11-16 years olds
Cwm Taf
Wales
%
%
Eat fruit daily
28
31
Eat vegetables daily
23
31
drinks 30
26
Eat breakfast daily during 56
the weekdays
56
Consume
daily
sugary
Source: Health Behaviour of School Aged Children 2010
Physical activity rates for adults are also below the Wales rate with 27% of
the adult population in Cwm Taf meeting the guidelines compared to the
Wales rate of 30%. This is also reflected in 11-16 year olds as 41% of 11-16
years in Cwm Taf are physically active at least 5 times a week compared to
the Wales rate of 44%.
2.4
Inequalities in health
Obesity is more common in areas of high social deprivation. 10 The study of
school children in Wales confirmed that there are higher rates overweight and
of obesity in children living in the most deprived areas than children living in
the least deprived areas.
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Cwm Taf has the highest rates of deprivation in Wales and associated with
this the lowest life expectancy, healthy life expectancy and disability free
years.
Life expectancy is widely used to measure the average expected years of life
of a newborn based on current observed mortality rates, healthy life
expectancy is an estimate of how long people can be expected to live in
'good’ or ‘fairly good' health and disability free life expectancy estimates the
number of years of life expected to be free from a limiting long-term illness or
disability.
Figure 5
The Welsh Index of Multiple Deprivation (WIMD), measures the amount of
people living in the poorest areas of Wales. For Cwm Taf it is nearly double
that for Wales:
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Table 5
Area
Percentage of people living in lower super
output areas (LSOAs) in most deprived 5th of
Wales, 2008
Cwm Taf
39%
Merthyr Tydfil
50%
Rhondda Cynon Taff
36%
Wales
20%
Figure 6: Higher proportion of life expectancy spent in good health in
Life expectancy, healthy and disability-free life expectancy at birth, males, Wales 2001-05
the
least deprived than most deprived areas.
and 2005-09
Produced by Public Health Wales Observatory, using ADDE/MYE (ONS), WHS/WIMD (WG)
85
LE 2001-05
LE 2005-09
HLE 2001-05
HLE 2005-09
95% confidence interval
DFLE 2001-05
DFLE 2005-09
80
75
Years
70
65
DFLE 2005-09
HLE 2005-09
LE 2005-09
HLE 2001-05
50
LE 2001-05
55
DFLE 2001-05
60
45
Least deprived
Next least deprived
Middle
Next m ost deprived
Most deprived
Y-axis truncated
Source: Public Health
WIMD/WHS(WG), 2012.
Wales
Observatory,
using
ADDE/MYE
(ONS),
Although life expectancy, healthy Life Expectancy and Disability free years
has increased across Wales from 2001-05 to 2005-09, there is a clear
gradient between the most deprived and least deprived areas.
This
demonstrates the inequalities in health suffered by those in the most
deprived areas and is a clear social injustice, Figure 6.
Cwm Taf still has the lowest life expectancy and healthy life expectancy as
illustrated in Figure 7 produced by the Public Health Wales Observatory.
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Healthy Weight, Healthy Valleys Strategy 2012-15
Life expectancy and healthy life expectancy, ranked health boards,
males, 2005-09
Figure
7
Produced by Public Health Wales Observatory, using ADDE & MYE (ONS)
Healthy life expectancy
Cwm Taf HB
60.0
75.4
ABM UHB
61.7
76.5
Aneurin Bevan HB
62.0
76.9
Hywel Dda HB
64.0
77.4
Cardiff and Vale
UHB
64.2
77.3
Betsi Cadwaladr
UHB
65.7
77.3
Powys THB
67.7
79.1
X-axis truncated
45
50
55
Life expectancy
60
65
70
75
80
85
The difference in the life expectancy between the most affluent members of
society and the poorest has increased in the last twenty years.
2.5
2.5.1
The cost of overweight and obesity
The cost to the NHS, local authorities and society
Obesity is estimated to cost the NHS in Wales over £73 million, which
increases to nearly £86 million if overweight with obese people are included.
In 2008/09, between more than £1.40 million and £1.65 million was spent
each week treating diseases resulting from obesity. This amounted to
between £25 and £29 per person in Wales and between 1.3% and 1.5% of
total healthcare expenditure in Wales.
The costs of obesity to primary care included the increased treatment costs
from drugs and investigations relating to co-morbid conditions, as well as
increased contact time necessary with primary care staff. The findings were
as follows:

Estimated that the cost of prescriptions issued in primary care for
obese people in Wales was £17,924,000 and £28,006,250 if obese and
overweight people were included.
NICE costing report 2006 estimates that there are 64% additional contacts
with the GP per year as a result of obesity, equating to approximately
£51,630,647 and nearly 12% of all costs in Wales. 11
The impact of obesity on the economy is significant. A study in Denmark
12
estimated that obesity associated healthcare costs for people aged 20 to 56
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Healthy Weight, Healthy Valleys Strategy 2012-15
years were higher than comparable costs for smokers or for healthy
individuals This suggests potential for reduced health care costs for these
age groups if obesity prevalence is reduced. However the study also noted
that the greatest lifetime expenditure was for healthy individuals due to
longer life expectancy and consequent development of other conditions in
later life.
2.5.2 The cost to the individual
The National Obesity Observatory reported that a recent comprehensive
review of 57 international prospective studies found that Body Mass Index
(BMI) is a strong predictor of mortality among adults. Overall, moderate
obesity (BMI 30-35 kg/m2) was found to reduce life expectancy by an
average of three years, while morbid obesity (BMI 40-50 kg/ kg/m2) reduces
life expectancy by 8-10 years. This 8-10 year loss of life is equivalent to the
effects of lifelong smoking.
2.6
National and Local Strategies
Since overweight and obesity is the major cause of preventable ill health and
death and a major cause of inequalities, it is no surprise that it features
strongly in national and local strategies.
Our Healthy Future (Welsh Assembly Government, 2009)13: Aims to
improve the quality and length of life and to ensure that everyone in Wales
has a fair chance to lead a healthy life, has as two of its ten priorities
reducing unhealthy eating and increasing participation rates in physical
activity.
Fairer Outcomes for All (Welsh Assembly Government 2011)14:
Improved health and wellbeing for all with the pace of improvement
increasing in proportion to the level of disadvantage
NHS Prevention and Promotion Programme: aims to reduce waste, harm
and variation within the NHS in Wales. Priority has been given to those
interventions which can impact on health and health service use in the short
to medium term, three to five years.
Creating an Active Wales Strategic Action Plan (2010) aims to
contribute to addressing the increase in obesity in combination with actions to
improve healthy eating.
Cwm Taf Local Public Health Strategic Framework (2011) Increasing
participation rates in physical activity and reducing unhealthy eating is a key
priority in the Cwm Taf Public Health Strategic Framework. A key milestone is
that by 2015 levels of overweight and obesity are no longer the highest in
Wales and participation rates in physical activity will increase and unhealthy
eating reduces 15.
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Obesity Pathway: The obesity pathway aims to encourage health boards,
local authorities and their partners in the third and private sector to work
closely together to determine how to contribute to tackling the challenge of
rising levels of overweight and obesity.
Families First - is a Welsh Government programme that promotes the
development by local authority areas of effective multi-agency systems and
support, with a clear emphasis on prevention and early intervention for
families, particularly those living in poverty. Reducing obesity levels is a key
priority for action.
Single Integrated Plan – The partnership plans at local authority area
addressing health inequalities is a key focus.
Communities First Cluster Plans – communities first cluster areas have to
develop project plans based around three themes; prosperous, learning and
healthier communities. The programme outcome for the healthier community
plans is ‘Improved health and wellbeing for all, with the pace of improvement
increasing in proportion to the level of disadvantage’.
2.7
The change in culture
The change in culture over the last 50 years also needs to be taken into
account when addressing the issue of overweight and obesity.
There has been an increase in fast food premises and takeaways, and
processed and convenience foods are much more readily available. Physical
activity is also influenced by social and cultural factors. Physical activity has
declined with less manual jobs, increased car ownership and labour saving
devices and sedentary behaviours such as television viewing and computer
games. Other behaviours such as parental fears about unsupervised play and
travel to school may also play a role.
There is evidence that lower educational attainment and socio-economic
status and mental illness are associated with obesity and that the obese
people face considerable discrimination.
2.8
Addressing overweight and obesity
In order to address the prevalence of overweight and obesity in Cwm Taf coordination of action will be required at a number of levels. These levels have
been grouped under the following themes and along with the evidence base
for action 16,17,18, 19, 20, 21, 22,23,24
2.8.1
Clear leadership and coordination of action
National Institute for Health and Clinical Excellence (NICE) sets standards for
quality healthcare and produces guidance on medicines, treatments and
procedures. The guidance is independent, authoritative and evidence-based
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on the most effective ways to prevent, diagnose and treat disease and ill
health, reducing inequalities and variation
Evidence from NICE advocates for partnership working and clear leadership to
tackle the obesity epidemic. The importance of consultation with and the
active involvement of children and young people is also advocated.
This strategy and action plan acknowledges that there are in existence local
strategies and action plans that support the philosophy of Healthy Weights,
Healthy Valleys and it does not seek to duplicate. However awareness raising
and advocacy for co-ordinated partnership action is seen as a key driver for
change.
2.8.2





Improving healthy eating and physical activity levels – key
evidence
2-5 years is a key age at which to establish good nutritional habits,
especially with parents involved. Parents and carers should be
encouraged to offer infants aged 6 months and over home prepared
foods without added sugar, salt or honey and snacks free of salt and
added sugar between meal times
Use a whole-school approach to develop life-long healthy eating and
physical activity practices
Ensure school policies and the school environments encourage physical
activity and a healthy diet. This includes policies relating to building
layout and recreational spaces, catering (including vending machines)
and the food and drink that children bring into school, the taught
curriculum (including PE), school travel plans and provision for cycling
School based interventions can result in cost effective health gains
Ensure high-level strategic policy planning for children and young
people supports the physical activity agenda
Current projects to improve healthy eating and physical activity levels
include the healthy start voucher scheme, weaning parties, breastfeeding
welcome scheme, healthy schools scheme, school and community sport
programmes.
2.8.3



Supporting overweight people to reduce weight and increase
physical activity – key evidence.
Evidence-based weight reduction includes: Realistic weight loss, focus
on long term lifestyle changes, multi component (diet and physical
activity) and behaviour changes methodology.
Multi component weight management programmes are more effective
than standard self help programme
Tailoring physical activity advice to address potential barriers is key to
the effectiveness of interventions
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




Healthy Weight, Healthy Valleys Strategy 2012-15
Weight loss programmes should be endorsed only if they meet NICE
best practice standards
All action aimed at preventing excess weight gain and improving diet
and increasing physical activity levels in children should involve parents
and carers
Physical activity brings important reductions in risk of mortality and
morbidity for those who are already overweight or obese
Physical activity is important for helping people to maintain weight loss
over several months or years. Those who include physical activity as
part of their weight plan have a better chance of long –term success
The benefits of weight loss at key postnatal check should be discussed
with all women, advice on healthy eating and physical activity should
also be provided and breastfeeding promoted
Community weight management programmes based on NICE guidance are
being developed throughout Cwm Taf, other support mechanisms include
the National Exercise Referral Scheme Plus and dietetic services. There are
also commercial programmes widely available that meet NICE guidelines
e.g. Weight Watchers and Slimming World.
2.8.4









Improving the wider environment to encourage healthy
eating and increase in physical activity – key evidence
Minimise sedentary activities during play time, and provide regular
opportunities for enjoyable active play and structured physical activity
sessions
Workplace policies should help to increase activity e.g. promoting
walking and cycling to work and between work sites, provision of
shower facilities. Out of hours activities, such as lunchtime walks and
the use of local leisure facilities should be supported
In workplaces healthy choices in restaurants, hospitality, vending
machines and shops should be provided in line with Food Standards
Agency advice
Promote physically active and sustainable travel
Active and sustainable school travel plans
Multi component school and community programs addressing physical
activity
Any incentive schemes should be sustained and part of a wider
programme
Physical activity programmes can help reduce the risk of falling, and
therefore fractures, among older people
Ensure planning applications for new developments always prioritise
the need for people (including those whose mobility is impaired) to be
physically active as a routine part of their daily life. Ensure local
facilities and services are easily accessible on foot, by bicycle and by
other modes of transport involving physical activity. Ensure children
can participate in physically active play.
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Current projects to encourage healthy eating and physical in the wider
environment include food co-ops, healthy options schemes, cycle paths,
allotments and school travel plans.
2.9
Communication
Co-ordination of communication strategies will be a key component in
ensuring that the success and progress of this strategy and action plan is
communicated with the public, staff and other stakeholders, and that views
are effectively incorporated.
2.10
Reporting
How will we know if this is making a difference?
There will be a need to monitor and evaluate the Strategic action plan to
ensure it is progressing and addressing the overall vision of the strategy.
This will be done by:




Consultation and multi-agency/partnership sign up to the action plan
Reporting through the Single Integrated Plans for Rhondda Cynon Taff
and Merthyr Tydfil and the Local Public Health Strategic Framework
The high level population indicators will include overweight and obesity
and obesity prevalence in Cwm Taf as reported by the Welsh Health
Survey.
Other indicators such as referrals, programmes delivered and surveys
of young people’s attitudes and access to services will also be key to
monitor and feedback success or areas for improvement.
It is essential that these indicators are embedded into the performance
management frameworks of partner organisations to ensure accountability.
3
Recommendations







The Healthy Weight, Healthy Valleys Strategy is adopted, supported
and implemented by all agencies and partnerships in the area.
The actions and targets for organisations, partnerships and individual
post holders are integrated into appropriate performance management
mechanisms at the appropriate levels.
The Healthy Weight, Healthy Valleys Strategy is communicated
publicly.
Population level outcomes are regularly evaluated and reported.
Local Strategic leads within the target holding departments need to
understand the relevance of obesity prevention in their own agenda.
Local roles and responsibilities need to be clarified using local planning
structures.
There should be local health board and local authority champions for
addressing overweight and obesity.
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Healthy Weight, Healthy Valleys Strategy 2012-15
Local delivery agents need to target programmes at those most at risk
of overweight and obesity.
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Appendix 1 – Proposed Development Plan 2012- 2015
The following development plan has been developed following consultation events held with partners and stakeholders.
It is envisaged that some of the key partnership action areas will require detailed action plans and will align with
existing multi agency groups whereas other actions will require small task and finish groups. A 3 year cycle has been
suggested, but the key partnership actions will be reviewed after an 18 month period and then realigned with the
implementation of the Single Integrated Plans for Merthyr Tydfil and Rhondda Cynon Taff Local Authorities.
Theme: Leadership and co-ordination of action.
Aim: To develop a strategic and effective Healthy Weight, Healthy Valleys strategy and action plan.
What do we want to achieve
What are we already doing
Key Partnership Action
1.
Consultation events with partners and
stakeholders have been held to inform
the development of the strategy and
action plan
Production of an agreed
multi
agency
Healthy
Weight,
Healthy
Valley
strategy
A strategic and effective strategy and
programmes
of
work
to
reduce
overweight and obesity prevalence in
Cwm Taf
Consult and take to all
relevant, boards, councils
and partnerships.
Partners to adopt and
support the strategy and
action plan
Cwm Taf Public Health Team
Healthy Weight, Healthy Valleys Strategy 2012-15
Actions are included in the
strategic plans of partner
agencies
2.
Co-ordinate communication strategies to
support the delivery of the Healthy
Weights, Healthy Valleys action plan
Develop a communication
strategy to accompany the
action plan
Establish a multi agency
task and finish group to
support communication of
the strategic action plan,
key actions, progress and
successes.
3.
Engage multi agency partners in an
annual workshop to provide leadership
and accountability for Healthy Weights,
Healthy Valleys
Local Public health Team to
host multi agency annual
conference day
4.
overarching
Comprehensive reporting mechanisms – Partners already have in existence Joint
outcome
indicators
related
to
their
own
monitoring
group
to be
utilise existing data sources more
plans
developed so that they
efficiently to reduce inequalities
report back into Single
Integrated Plans for both
Local Authorities
Outcome measures should
also be included in the
performance management
and reporting cycles for
Local
Public
Health
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Cwm Taf Public Health Team
Healthy Weight, Healthy Valleys Strategy 2012-15
Strategic
Framework,
single integrated plans
Theme: Improving healthy eating and physical activity levels.
Aim: To have a co-ordinated approach to generic multi disciplinary, holistic health improvement programmes for all
ages and families.
Population indicators: % increase of fruit and vegetable consumption (WHS), % increase in physical activity levels
(WHS).
What do we want to achieve
What are we already doing
Key Partnership Action
1.
Improved food skills and knowledge for Agored Cymru Community food and
all ages by training local partners
nutrition skills courses that focus on
early years, general population and
older adults
2.
Family based support programmes for Range of family support programmes Develop mechanisms for
those who wish to make changes to for all ages e.g. weaning parties
promoting and sign posting
family diet and physical activity levels
to
local
services
and
opportunities
targeting
physical
activity
and
healthy eating in areas of
deprivation by:
Date: 12 September 2012
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Working with communities
first partnerships to deliver
local courses and improve
skills
Cwm Taf Public Health Team
Healthy Weight, Healthy Valleys Strategy 2012-15
Forming a multi agency
task and finish group
Use information provided
by Public health Wales on
deprivation to target key
geographical areas
Link
with
partners
to
maximise potential such as
new
communities
first
clusters, family information
services, flying start and
health visiting services
3.
Meet national and local targets for Established Healthy Schools Scheme Partnership approach via
healthy schools and preschool schemes
and steering group
the
existing
steering
groups to ensure that the
Roll
out
of
preschool
scheme number
of
schools
commenced March 2012
achieving food and fitness
NQA increases
Established
Designed
to
Smile
programmes
No. of preschool settings
addressing nutrition and
oral health
4.
Local
Authority
school
catering Schools meals working towards Welsh Appetite for Life – all
departments to conform to appetite for Government
Appetite
for
Life Primary Schools to conform
life legislation for primary and secondary guidelines
by September 2012 and all
school meal provision
secondary schools, Special
schools and pupil referral
units by September 2013
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Cwm Taf Public Health Team
Healthy Weight, Healthy Valleys Strategy 2012-15
5.
To support the development of increasing
opportunities for physical activity within
and outside of school, including children
and young people with disabilities
6.
Provide a range of physical activity
opportunities in the community for all
ages
with
particular
emphasis on
children, teenage parents, men and older
people
Target in the community,
communities first clusters
Existing plans that incorporate this
development
include
Leisure
strategies, Local Area Partnership
Agreement plans, play strategies and
environmental plans
Multi agency approach to
review existing plans to
ensure that they cater for
specific groups and have a
targeted
approach
to
reduce inequalities.
Utilise
existing
data
provided by Public Health
Wales
to
target
interventions effectively
Utilise local developments
such as walking and cycling
pathways
effectively
to
maximise potential for a
range of users and groups
7.
To improve the health of the workforce in Corporate Health Standard
Cwm Taf by workplaces participating in
the corporate health standard and small Small workplace award
workplace award
Partners
to
maximise
opportunities
in
the
workplace
to
promote
access to healthy foods,
physical activity measures,
sustainable environments.
Organisational
developed
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policies
and
Cwm Taf Public Health Team
Healthy Weight, Healthy Valleys Strategy 2012-15
implemented to support
these opportunities
Date: 12 September 2012
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Cwm Taf Public Health Team
Healthy Weight, Healthy Valleys Strategy 2012-15
Theme: Supporting overweight people to reduce weight and increase physical activity levels.
Aim: To develop service provision in communities, level 2 and level 3 of the obesity pathway.
Population Indicators: % of adults overweight or obese (WHS), % of adults obese (WHS), % of overweight and
obesity in four year olds.
What do we want to achieve
1.
What are we already doing
To develop community based prevention MEND programme
and early intervention (self care)
weight
management
provision for overweight and obese for Community
groups
in
communities
first
areas and
children, young people and adults.
through registered social landlords
Key Partnership Action
To increase referrals
MEND programme.
to
All partners to increase
referrals
to
community
weight
management
groups.
Continue
role
out
of
community
weight
management training for
Communities First clusters,
Registered Social Landlords
and workplaces.
To
provide
behaviour
change training for health
and non health workers
with a role in delivering
Date: 12 September 2012
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Cwm Taf Public Health Team
Healthy Weight, Healthy Valleys Strategy 2012-15
weight management
National Childhood weight
and measures - Develop
referral mechanisms and
support for children classed
as overweight or obese.
2.
To develop community and primary care
weight
management
services
for
children, young people and adults who
wish to lose weight and have been
identified as being at increased risk of
obesity.
National Exercise Referral Scheme
3.
Cwm Taf Health Board Dietetic Services
Specialised support for obese patients Weight
management
with associated illness
programmes
for
obese
people with complex health
needs
4.
Specialist weight management services Primary Care dietetics obesity services To
evaluate
pilot
for obese children, young people and
programmes
and
Pilot
Programmes
adults who have one or more codetermine next steps.
morbidities
Specialist
Services
–
Lifestyle
Date: 12 September 2012
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Ensure
overweight
and
obesity is embedded into
GPs are now required to record BMI for all
care
pathways
for
patients.
children and adults in Cwm
Taf Health Board
District nurses have been trained to
measure and record BMI for all Consider
investment
in
patients and factor this clinical Community
Weight
information into their care planning.
Management programmes
as a treatment option for a
range of specialities e.g.
orthopaedics.
Use
a
targeted
approach
to
identify potential clients
Page: 28 of 34
Cwm Taf Public Health Team
Healthy Weight, Healthy Valleys Strategy 2012-15
programme , one to one specialist
service until June 2012
Pharmacological interventions initiated
by physicians, supported by above
programmes
National Exercise Referral Scheme with
nutritional component
Theme: Improving the wider environment to encourage healthy eating and increase physical activity levels.
Aim: To ensure consistent availability of healthier food and physical activity opportunities in all public places
Population Indicators: Physical activity levels of children, young people and adults through local and national
surveys.
Date: 12 September 2012
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Cwm Taf Public Health Team
Healthy Weight, Healthy Valleys Strategy 2012-15
What do we want to achieve
What are we already doing
1.
Healthy Options
Cynon Taff
Improved access to healthier food
provision in the community through
wider legislation and regulation of
unhealthy food, and increased provision
of healthy food.
Award
–
Key Partnership Action
Rhondda Multi agency group focus to
develop the following:
Healthy Schools Scheme - Food and To conduct mapping of
fitness policies in schools and healthy density of fast food outlets
vending
and area deprivation. Use
mapping exercise results to
Food co-ops
target areas for food coops, healthy start voucher
Healthy Start Voucher Scheme
scheme, healthy options
award and healthy vending
Breastfeeding Welcome Scheme
schemes.
Baby Friendly Initiative
Rhondda
Cynon
Taff
Trading standards to take
into consideration mapping
results when developing
their sampling protocol.
Develop with Merthyr Tydfil
Trading Standards.
Merthyr Tydfil to consider
adopting
the
healthy
options award scheme.
Planning
Date: 12 September 2012
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departments
to
Cwm Taf Public Health Team
Healthy Weight, Healthy Valleys Strategy 2012-15
consider applications for
any
new
food
developments
alongside
mapping information and
prevalence of obesity in the
area.
2.
Physical environment – focus on the
obesogenic
environment
and
infrastructure. Create safe environments
that encourage physical activity for all
ages.
Date: 12 September 2012
Version: 1d
There are a number of strategies in
place that are addressing this issue.
They include: Local Area Partnership
Agreement Plans, Play strategies,
Leisure Strategies, Travel plans and
the Merthyr Tydfil access forum,
Rhondda Cynon Taff version
Page: 31 of 34
Partnership approach to
develop
active
environments, protection of
open/green spaces e.g.
walking
and
cycling
networks.
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