This report presents a ‘deep dive’ into the current situation in relation to overweight and obesity across Kent and Medway. The report references national policy and initiatives and covers the prevalence data for Kent and Medway and the range of services and interventions.
The Director of Public Health for Medway Council presented the Joint Board with a detailed review of the prevalence of overweight and obesity in Kent and Medway. He noted that this was a significant problem caused by complex personal, social and environmental factors. He explained that a whole system approach to weight management was required, including different interventions targeted at different segments of the population.
The importance of considering factors such as making adaptations to the physical environment and facilitating other means of transport, like cycling, to encourage individuals to increase their physical activity levels was emphasised. He added that it was important to make a healthy choice the easy choice. An example of how the Local Authority could assist in this endeavour was by prohibiting fast food establishments from opening within 400m of a school.
He drew the Joint Board’s attention to the data set out in section 3 of the report, which provided a review of the prevalence of overweight and obesity in children and adults in Kent and Medway, benchmarked against national performance. It was noted that prevalence was generally higher in disadvantaged communities. The Director of Public Health also highlighted trends in relation to bariatric surgery admissions in Kent and Medway. It was noted that nationally the rate of bariatric surgery admissions had decreased from 2011/12 to 2016/17. The same trend had been observed in Kent whilst in Medway, the rate had remained statistically stable.
The Joint Board was advised that weight management services were categorised into four tiers. Examples of Tier 1 and 2 services and interventions implemented in Kent and Medway were drawn to the attention of the Joint Board and were set out at paragraphs 3.26 to 3.46 of the report. Tier 4 services included bariatric surgery. It was recognised that there was a pressing need to focus on Tier 3 specialist weight management services.
Members raised a number of points and questions, including:
Workplace - A Member observed that there was a disconnect between leaving full time education and taking up employment. It was explained that at school there was an expectation that young people would engage with sports, but once individuals left school and entered the workplace, the opportunity for this was reduced. As such, there was an argument to persuade employers to help create active habits. In response, Medway’s Director of Public Health explained that the impact of work on health was well recognised and employers were encouraged to support a healthy workplace. He added that Medway Council’s Public Health Team ran a workplace health award scheme which encouraged employers to improve staff physical activity by, for example encouraging staff to change the way they travel to work and encouraging staff to use stairs. He noted that Kent County Council also employed workplace initiatives. It was recognised that more could be done.
Accessibility - In response to concerns expressed regarding accessibility to physical activity and leisure services for children and young people with Special Educational Needs (SEN), Medway’s Director of Public Health recognised that children with SEN were more likely to be overweight or obese. Members were advised that further information would be presented to the Joint Board in the report on Learning Disabilities Health Checks and the outcome of the review set out at paragraph 3.39 of agenda item 6 (NHS Health Checks). It was noted that Medway Council’s School Health Service would work with Leisure Services on practical solutions to improve accessibility.
Challenges - Kent County Council’s Director of Public Health set out three key challenges in relation to tackling obesity. These were:
1. Healthy diet - he emphasised the importance of a healthy diet as well as physical activity. It was explained that in some instances people did not know how to cook, what was in their food or where it came from.
2. Effective weight management services - it was explained that being overweight or obese could bring physical, emotional and psychosocial health problems which could cost the Health Service a significant sum of money in the long term, owing to ongoing treatment costs. Acute and chronic mental health issues were particularly evident in individuals accessing Tier 3 weight management services. It was noted that there were no Tier 3 services in place across Kent and Medway to support eligible 5-19 year olds and a view was expressed that NHS partners needed to address this. He stated that it was important that Tier 1, 2 and 3 services were functioning effectively and that interventions were joined up and systematic.
3. Targeting interventions – using the example of the Kent One You Service, he advised Members that on reflection, whilst the marketing campaign was considered to be very good, aspects, such as the form which was required to be filled in to establish whether individuals meet the entry criteria, were too complex. He expressed a need to change the language of interventions to target different populations.
Interventions - A Member highlighted the importance of encouraging individuals to be active and make healthier choices and stressed the positive impact participation in sport can have on this. Kent County Council’s Director of Public Health agreed with this position and explained to the Joint Board that if individuals are told what to do, they most likely would not listen. Referring to Sevenoaks District Council as an example, he explained that social marketing had been used effectively to convey simple messages and people had responded positively. Medway’s Director of Public Health reiterated that a number of approaches were required to tackle obesity and he explained that interventions which worked well in one locality would need to be tweaked or shaped to ensure a good outcome in a different area.
The Kent and Medway Joint Health and Wellbeing Board:
a) noted the report; and
b) requested a detailed report which provides more information on programmes available to support weight management and effective ways to communicate this.