Taking a Whole System Approach to

Tackling Obesity in Lewisham

Gwenda Scott, Public Health Strategist

February 2017

Where Lewisham is now on tackling obesity –

current picture

Lewisham Self Assessment Framework

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Breastfeeding

Weaning

Accessibility ofhealthy food

Journeys by foot orBike

PhysicalEnvironment

Supporting peopleto be active

SchoolsPublic &

Community Services

Health Services

Workplaces

Engagement &Commitment

Knowledge

Evaluation

Lewisham Scores 2016 and Progress Aimed for in 2-3 Years

Now Progress

National pilot status

In 2016 Lewisham Council was awarded National

Pilot status for a whole systems approach to obesity,

one of only four local authorities in the country and

the only London borough.

The pilot sites are working alongside Leeds Beckett

University on the whole systems approach.

http://www.leedsbeckett.ac.uk/wholesystemsobesity/

Three year programme.

LA commitment with senior level sign up.

• A whole system obesity project board was established

which included: senior officer representation from the

council directorates of Community Services, Children’s

Services and Customer Services; the cabinet member for

Children & Young People; and Lewisham CCG.

Whole System Approach to Obesity

Developed a whole systems approach to obesity action plan

Our Goals

• Change the impact of the obesogenic environment

&

• Increase the proportion of residents with a healthy weight

Whole system approach to obesity action plan

Overarching aims:

• Promote an environment that supports healthy

weight and wellbeing as the norm, making it

easier for our residents to choose healthier diets

and active lifestyles

• Supporting our communities and families to

become healthier and more resilient, which will

include addressing the wider determinants of

health

• Tackle the weight issues of those who are

already overweight and obese

Four Priority Areas:

Children and

Young People

Increased

Public

Awareness and

engagement

Health and

Public

Services

Environment

Work on thirteen themes under 4 priority areas

Breastfeeding

Early years

Schools

Journeys on foot or

bike

Supporting people to

be more active

Knowledge

Health services

Engagement &

commitment

Workplaces

Strategies and

policies

Access to healthy

foods

Physical environment

Public & community

settings

Wider Stakeholder Alliance

Obesity Action Plan 2016-18

Governance

8

Health and Wellbeing Board

Children and Young People’s

Strategic Partnership Board

Children and Young

People’s Joint

Commissioning Group

Promoting Healthy Weight Group

Healthy Child Programme Board

BFI and Infant

Nutrition Group

Whole Systems Obesity

Project Board

Food

Partnership

Physical

Activity

Network

NHS Health

Checks

Diabetes

Prevention

Programme

Obesity Action Plan 2016 - 18

Whole System

Approach to Obesity

Overarching aims of the Plan How We Are Going to do this

How will we measure success

Are

as o

f

focu

s

• Engage wider Lewisham partnership to ensure a

better co-ordinated approach around the wider

determinants of obesity by forming a new

Lewisham Obesity Alliance.

• Continue to build on progress across thirteen

themes under four priority areas.

• Initial focus on three cross cutting actions to

create healthier environments

1. Food - Become a Sugar Smart Borough

2. Physical activity - Implement the Daily Mile in

primary schools

3. Communities – improve access and appeal of

parks for recreation

9

Performance measure Current performance Comparator

performance Target 2017/18

Desired Direction

of travel

Who is monitoring this?

Number of pledges to Sugar Smart New New - Promoting Healthy Weight Group

Excess Weight in Children - Reception Year (%) 23.7% 21.9% Promoting Healthy Weight Group

Excess Weight in Children - Year 6 (%) 38.9% 33.2% Promoting Healthy Weight Group

Excess Weight in Adults (%) 60.7% 64.6% Promoting Healthy Weight Group

Reduce the impact of the obesogenic environment

Increase proportion of residents with a healthy weight

• Lewisham has a high prevalence of children and adults with excess weight:

over a third of 10-11 year olds, a quarter of 4-5 year olds and nearly two

third of adults being overweight or obese.

• Less than half of the adult population meet the ‘5-a-day‘ recommendation

for fruit and vegetables.

• Over a quarter of adults are classed as inactive - doing less than 30

minutes of moderate intensity physical activity per week

Overarching aims of plan

• Promote an environment that supports healthy weight and wellbeing as the

norm, making it easier for our residents to choose healthier diets and active

lifestyles

• Supporting our communities and families to become healthier and more

resilient, which will include addressing the wider determinants of health

• Tackle the weight issues of those who are already overweight and obese

Work over four priority areas:

- Children and Young People - Health and Public Services

- Increased Public Awareness and - Environment

engagement

Three key actions to create healthy environments

Draft Obesity Action Plan 2016 - 18

• Engage the wider Lewisham partnership into the whole system approach

Wider

Obesity

Alliance

Who is included in the wider audience

How will we know if we have engaged our audience?

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• Health and Wellbeing Board

• Elected Members

• Healthwatch

• Adult and child social care

• Planning and environment

• Transport

• Public health

• Lewisham Clinical Commissioning Group

• NHS partners

• Primary Care

• Local health professional networks

Local residents

Community groups

Faith groups

Third Sector

Local employers

Education (schools, colleges, adult learning)

Early years

Leisure/fitness providers

Arts and Culture

Food industry

Housing

Food Partnership

Physical Activity Network

Local, national and social media

• Long term - commitment and full engagement delivering an evidence-based whole system approach strategy

• Medium term – changes to food, physical activity and social environments

• Short term – shared learning, health outcomes embedded in policies, community led actions (e.g. pledges to sugar smart)

Annual Public Health Report

Annual Public Health Report

Focus on key work

creating healthier

environments

Featuring the

work of the wider

Lewisham

partnership

Next steps…

Consolidating new models of delivery/ new services

to maximise healthy weight outcomes

Including:

• Community Development

‘Be inspired’- community nutrition and physical activity

Participatory budgeting

• New school health service- integrating school nursing,

NCMP and child weight management

• New health visiting and children’s centres contract -

incorporating breast feeding support

• Redesigning adult weight management pathway