Draft Milton Keynes Healthy Weight Strategy 2014-19

ANNEX TO ITEM 9

HEALTH AND WELLBEING BOARD 11 DECEMBER 2014

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www.milton-keynes.gov.uk

Draft Milton Keynes Healthy Weight Strategy 2014-19


CONTENTS

1. Foreword

2. Introduction

3. National Context

4. Local Context

5. Future Services & Service Redesign

6. Values and Guiding Principles

7. Priorities

8. How will we know we are making a difference?

9. References


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1. Foreword

The Milton Keynes Healthy Weight Strategy sets out the priorities for the next five years and

informs the commissioning of services to prevent the population of Milton Keynes from

becoming overweight and to reduce the prevalence of obesity.

The three key priorities are:

1. Reduce obesity prevalence in Milton Keynes through preventative measures.

2. Ensure there is effective support for individuals to manage their weight.

3. Encourage healthy lifestyles in the population of Milton Keynes.

This strategy reflects the Obesity Health Needs Assessment (HNA) conducted in 2013/14.

The HNA gathered insight from providers, partners, practitioners, service users and the

public, through a variety of group specific surveys and focus groups.

There are a number of other strategies in Milton Keynes that contribute to the prevention and

treatment of obesity, including specific interventions that tackle the obesogenic environment.

Physical Activity and obesity are clear priorities in Milton Keynes Council Corporate Plan.

The Milton Keynes Joint Health and Wellbeing strategy highlights the need to take action on

childhood obesity, invest in active travel and physical activity and to develop local healthy

eating initiatives in Milton Keynes. The Cycling Strategy (2013) provided a link between

cycling for active travel, recreation and sport as a mechanism for improving health (including

reducing obesity). The Sport and Active Recreation Strategy (2013) supports the

opportunities for individuals to lead an active lifestyle in Milton Keynes, thus potentially

impacting on the obesity levels locally.

This strategy does not explicitly tackle underweight issues, in relation to eating

disorders. Eating disorder care is addressed in the Milton Keynes Mental Health

Strategy (2014).


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2. Introduction

The term ‘healthy weight’ is often used when an individual’s body weight is appropriate for

their height and relates to positive benefits for their health. Being above or below the healthy

weight range can increase adverse effects on an individual’s health and wellbeing as well as

increasing their risk of a range of chronic illnesses.

Weight gain can occur gradually over time when energy intake from the food and drink

consumed is greater than energy used through the body’s metabolism and physical activity,

resulting in excess body fat.

Obesity is associated with a range of health problems including Type 2 diabetes, heart

disease and cancer. Risks of other diseases, including: angina, gall bladder disease, liver

disease, osteoarthritis and stroke, are also increased (1). One third of obese adults in

England have a limiting long term illness compared to a quarter of adults in the general

population.

It is estimated that excess weight costs the NHS more than £5 billion each year and has a

huge financial and social impact on society, estimated at £20 billion a year, once factors

such as lost productivity and sick days are included (2).

Obesity is, in most cases, a preventable condition and having strategies to reduce energy

intake through healthy diet and increase energy expenditure through physical activity are key

to achieving and maintaining a healthy weight.


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3. National Context

3.0

Tackling obesity (and excess weight) continues to be a national government priority, several

documents have been published over the last few years, the most recent being Healthy

Lives, Healthy People; A Call to Action on Obesity, published in 2011(2).

England, along with the rest of the UK, ranks as one of the most obese nations in Europe.

Efforts must be made to reduce these levels and the impact of obesity on both the health of

our nation and the costs to the economy.

‘A Call to Action’ gave a new direction to tackling obesity; empowering people and

communities to take action, building local capability – both local and national teams working

together; with national leadership and the role of the government to help people to make

healthy food and drink choices and to become more active. This includes emphasising

various ways that we can support individuals to lose weight and maintain a healthy weight.

The document sets out two national ambitions for obesity:

A sustained downward trend in the level of excess weight in children by 2020.

A downward trend in the level of excess weight averaged across all adults by 2020.

3.1

Obesity Prevalence

3.1.1

Obesity in Children and Young People

Early prevention of obesity is important for a number of reasons. The emotional and

psychological effects of being overweight are often seen as the most immediate and serious

problems by children themselves. They include teasing and discrimination by peers; low self-

esteem; anxiety and depression. Research found that severely obese children rated their

quality of life as low as children with cancer on chemotherapy (3). Obese children may also

suffer disturbed sleep and fatigue.

In the 2012/13 data from the National Child Measurement Programme (NCMP) reported that

1 in 10 of reception year children (4-5 years old) and 1 in 5 of year 6 children (10-11 years


4

old) in England were classed as obese. When including the figures for excess weight in

children (overweight and obese) these figures increase to 22.2% of all children at Reception

Year and 33.3% of all children at Year 6 (4).

Children with BMI in the overweight and obese range are more likely to become overweight

or obese adults, and have a higher risk of morbidity, disability and premature mortality in

adulthood. Although many of these serious consequences will not be apparent until they are

older, some obesity-related conditions can develop during childhood such as Type 2

diabetes, high blood pressure and cholesterol.

3.1.2

Obesity in Adults

The increasing levels of adult obesity are clear from the data, the 2013 Health Profile of

England (5) estimated 1 in 4 of adults (25.3%) are obese (BMI over 30 and above). The

most recent data on excess weight in adults (BMI over 25 and above) from the Activity

People’s survey (6) reported nearly 2 in 3 adults (63.7%) in England were classified as

overweight or obese.

There are many complex behavioural and societal factors that combine to contribute to the

causes of excess weight and obesity. The Foresight Report (7) identified seven themes,

biology, physical activity, social influences, individual psychology, food environment and

consumption.

Lifestyle and behaviour choices are important factors in influencing weight status. Unhealthy

diets and physical inactivity are major risk factors for overweight and obesity as well as

chronic health conditions.

3.2

Healthy Diet

Consumption of excess calories is often due to over consumption of high energy foods and

drinks such as processed or fast food, sweetened and alcoholic drinks, or large portion

sizes. There is also evidence that eating habits are perpetuated through families and

cultures, and are often maintained from childhood through to adulthood (2).


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Malnutrition is a serious condition that occurs when a person’s diet does not contain

the right amount of nutrients. The best way to prevent malnutrition is to eat a healthy,

balanced diet (8).

Adults are more likely to maintain a healthy weight if they reduce consumption of high

energy-dense foods and drinks and consume a lower-fat, high fibre diet.

The ‘5 a day’ measure, reports that 1 in 4 adults (25.6%) eat more than five portions of fruit

and vegetables per day, within the remaining population, 1 in 4 adults (23.6%) eat less than

2 portions of fruit and vegetables per day. This demonstrates a wide spread of variation

within healthy eating across the country (9).

3.3

Physical Activity

Physical inactivity is the fourth leading risk factor for global mortality accounting for 6% of

deaths globally. People who have a physically active lifestyle have a 20-35% lower risk of

cardiovascular disease, coronary heart disease and stroke compared to those who have a

sedentary lifestyle. The estimated direct cost of physical inactivity to the NHS across the UK

is over £1.6 billion per year (1).

There is a strong relationship between sedentary behaviour and being overweight or obese.

Evidence suggests that aerobic physical activity has a positive effect on achieving weight

maintenance and therefore should be promoted as part of weight management services. The

Sport England Active People’s survey measured levels of activity across the country and

reported for 2012 that 56.0% of adults are physically active in England (6).

3.4 Breastfeeding

Breastfeeding helps secure the best start in life for new-born infants. It promotes health,

wellbeing and prevents disease in both the short and long term for both the infant and the

mother. Breastfeeding can also support the mother to return to a healthy weight after birth.

There is strong evidence that infants who are not breastfed are more likely to suffer with

conditions such as gastroenteritis and respiratory disease which requires hospitalisation

(10). The evidence also shows that breastfeeding reduces the risk of high blood pressure,

raised blood cholesterol in adulthood, type 2 diabetes and obesity. Obese women are at


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increased risk of miscarriage, gestational diabetes, pre-eclampsia and they are less likely to

initiate or maintain breastfeeding. In 2012/13, 73.9% of mothers in England initiated

breastfeeding in the first 48 hours after delivery. Breastfeeding rates decrease significantly at

6-8 weeks after birth, when only 47.2% mothers are still breastfeeding. Evidence shows that

Baby Friendly Accreditation can increase breastfeeding rates by 10% (10).

3.5

Support for individuals and families

The implementation of the Health and Social Care Act 2012 imposed a number of changes

to the commissioning of health and social care services from 1st April 2013. The reforms

generated changes in how obesity prevention and management services are commissioned.

This is described by the National Obesity Forum, Model of Obesity Pathway (11). The model

adopts a four tier structure below:

Local Authorities acquired a new public health function in April 2013 and are responsible for

ensuring provision of tier 1 and tier 2 services in the obesity model. Tier 1 is described as

primary activity, which focuses on population-wide basic intervention and prevention. Tier 2

is described as community weight management services, focusing on diet, nutrition, physical

activity and lifestyle changes.


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Clinical Commissioning Groups are responsible for commissioning of Tier 3 services in the

obesity model. Tier 3 is described as specialist multi-disciplinary team (MDT) interventions,

led by clinicians providing specialist dietetic, physiotherapy/physical activity and

psychological support.

NHS England is responsible for commissioning Tier 4 services in the obesity model. Tier 4 is

described as specialist morbid obesity services including Bariatric surgery and Very Low

Calorie Diets (VLCDs).

3.6

Whole Population Healthy Lifestyle

Overweight and obesity are a direct consequence of eating and drinking more calories and

using too few up (2). The 21st century environment and busy lives often make it hard for

individuals to make healthy choices. The environment, behavioural and physiological factors

all contribute to excess weight gain. As a nation the UK is too inactive and spends long

periods of time sedentary. There are clear health inequalities with regard to obesity. The

Marmot review (12) showed that income, social deprivation and ethnicity have an impact on

the likelihood of becoming obese. For example women and children in lower socio-economic

groups are more likely to be obese than those who are wealthier (2). Many people who are

overweight and obese have a poor diet, low activity levels but also other lifestyle risks

(smoking, excess alcohol consumption), surrounded by other social issues such as lower

educational attainments, poor housing or crime (2). Obesity can effect and reduce an

individual’s quality of life, it can reduce an individual’s self-esteem, mental health and ability

to gain and maintain employment. Efforts must be made to reduce these levels and the

impact of obesity in both the health of our nation and also the costs to the economy.

In recent years policy changes in England have had a significant impact on the nutritional

quality of school lunches. The impending introduction of free school meals for all infant

pupils in England in September 2014 is a way of supporting and helping all schoolchildren

enjoy a better, healthier start to their primary education. Children from lower income

households are more likely to be overweight or obese. Schools offer a unique opportunity to

influence the food choices of all children with the potential to reduce inequalities (12). The

government’s review of school meals in England was published in July 2013 (13). The

School Food Plan reports actions needed to improve school children's diets and how to

improve the nutrition and taste of the food available in schools (13).


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4. Local Context

4.1

Reduce obesity prevalence in Milton Keynes through preventative measures.

4.1.1

Obesity Prevalence in Children and Young People

There are over 58,000 children under 16 years old in Milton Keynes. The 2012/13 NCMP

data, reported that 9.8% of children at reception year (4-5 year old) and 18.5% of children at

year 6 (10-11 year old) were classed as obese (4). The table below highlights the

percentage of children classified as underweight, healthy weight, overweight and obese in

2012/13.

The increase in childhood obesity levels between Reception Year and Year 6 mirrors the

trend in England. Almost double the number of children are obese when they reach age of

10-11 years old. Over time, we have seen an increase in the prevalence of children classed

as overweight and obese at Year 6 (increase of 0.5%, since 2006/07). However the

prevalence of children classed as overweight and obese in Reception Year has decreased

during same period by 2.2%.

In Milton Keynes the rate of obesity at ward level is widely spread, this also varies between

reception year and year 6. At reception year the highest prevalence of obesity is reported in

Sherington (17.9%) and Eaton Manor (16.7%) and the lowest level in Newport Pagnell North

(4.5%) and Middleton (6.2%). For year 6, the highest prevalence of obesity is in Whaddon

(26.2%) and Bradwell (25.5%) and lowest prevalence was reported in Olney (9.0%) and

Newport Pagnell South (11.8%).


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4.1.2

Obesity Prevalence in Adults

The 2013 Health Profile for Milton Keynes (5) reports that an estimated 25.3% of adults are

obese compared with England average of 24.2%. These numbers increase when

considering overall excess weight in adults – the number of adults with a BMI classified as

overweight (including obese) in Milton Keynes in 2012/13 was estimated as 72.5%

compared to national figure of 63.8%.

Across the wards of Milton Keynes obesity rates vary greatly, the highest rates are found in

Eaton Manor (31.8%) followed by Denbigh (31.3%). Whereas the lowest obesity rates are

found in Olney (20.2%) and Danesborough (20.5%).

4.2

Ensure there is effective support for individuals to manage their weight.

The diagram below outlines the pathway and existing services in Milton Keynes in line with

the National Obesity Forum, Model of Obesity Pathway (11).

Milton Keynes HALO (Community Dietetics) AMKERS (Exercise Referral)

Milton Keynes GP's/PN's/HW surgery leads

Leisure Services Reactivate MK

Pharmacy Community Dietetics

ADULTS IN MILTON KEYNES CHILDREN IN MILTON KEYNES

Milton Keynes Motiv 8

Let's Get Healthy with Henry

Milton Keynes GP's/PN's/HW surgery leads

HV's/SN's Let's Get Healthy with Henry

Community Dietetics

TIER 4 Specialist

Intervention

TIER 3

Specialist MDT Obesity Service (REFERRAL ONLY)

TIER 2

Community Weight Management Service (diet/nutrition/lifestyle/physical activity/education)

TIER 1

Primary Activity Population wide basic intervention & prevention

Milton Keynes Bariatric Surgery

(Luton & Dunstable)

Milton Keynes Currently no available service Milton Keynes

Milton Keynes N/A for Children & Young People

Currently no available service


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4.2.1

Children and Young People

Tier 1

Community Dieticians deliver sessions to educate children and their families around

healthy eating and nutrition with a mixture of practical and theory based sessions. In 2013/14

1498 children took part in a minimum of one session.

HENRY (Health, Exercise, Nutrition for the Really Young) is preventative programme

focussing on under 5’s, which aims to initiate healthy behaviours in the early years. In

2013/14, 32 families completed the HENRY programme.

Tier 2

Motiv8’ is a community weight management programme for children aged 5-16 and their

families. The programme focusses on lifestyle and behaviour change to eat more healthily

and be more physically active with behavioural support. In 2012/13, 66 families completed

the Motiv8 programme.

Tier 3

There are currently no Tier 3 services for children and young people in Milton Keynes.

4.2.2

Adults

Tier 1

Community Dieticians offer practical sessions such as cooking on a budget and Cook4Life

in variety of community venues, as well as running ‘train the trainer’ sessions for

organisations to disseminate key messages. In 2013/14, 1696 adults took part in a minimum

of one session.

Reactivate Milton Keynes is a programme to encourage all adults to participate in sport

and physical activity. In 2013/14 the programme had a through put of 3,668 attendances and

an additional 13,457 attendances through Health Walks.

Tier 2

HALO is a 12 week lifestyle programme, in which individuals are taught ways to manage

their weight through a healthy balanced diet and physical activity. In 2013/14, 133 adults

accessed the HALO programme.


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The Active MK Exercise Referral Scheme (AMKERS) is 12 week programme for tailored

exercise for inactive adults with an identified health condition or issue. In 2013/14, 262

patients were referred to AMKERS as ‘overweight’, with 371 referrals in total.

Tier 3

There are currently no Tier 3 services for adults in Milton Keynes.

Tier 4

Bariatric surgery is available as the final treatment option through Luton & Dunstable

Hospital. In 2012/13, 28 procedures were conducted on Milton Keynes patients.

4.3

Encourage healthy lifestyles in the whole population of Milton Keynes.

4.3.1

Breastfeeding

There is work to be done in Milton Keynes in order to see further increases in breastfeeding

initiation and duration. Currently work taking place around breastfeeding is predominantly

through the Health Visiting and Midwifery teams. There is a network of support peers

through the work at the hospital and Children’s Centres provide supportive environments for

women who are breastfeeding. Milton Keynes Hospital Foundation Trust is working towards

full Baby Friendly Accreditation. In 2012/13, 73.3% of mothers in Milton Keynes initiated

breastfeeding in the first 48 hours after delivery; this is significantly lower than the England

average (3). Breastfeeding rates decrease significantly at 6-8 weeks after birth, when only

53.1% (2011/12) mothers are still breastfeeding, which is significantly higher than the

English average (4).

4.3.2

Healthy Eating in Children, Young People and Adults

A range of healthy eating services to promote healthy food choices and prevent disease by

increasing awareness of the link between nutrition and health, including promoting ‘5 a day’,

reduced salt consumption and balanced dietary intake. A variety of sessions are delivered in

children centres including Smile Plus+ award, infant and weaning, cooking and healthy

eating. The promotion of Change4life (14) is widely used in Milton Keynes, key messages


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and campaigns encourage communities and schools to sign-up and adopt a healthy lifestyle

approach.

Using both local and national data, a synthetic estimate of fruit and vegetable consumption

for Milton Keynes was made. This showed that an estimated 24.8% of adults in Milton

Keynes (9) eat more than five portions of fruit and vegetables per day, compared to the

England average of 25.6% and 24.6% of adults in Milton Keynes eat less than 2 portions of

fruit and vegetables per day, compared to England average of 23.6%.

4.3.3

Physical Activity in Adults

Sports participation in Milton Keynes continues to improve on the number of people regularly

participating in sport and has one of the highest rates in England. The top five sports in

Milton Keynes are gym, swimming, cycling, athletics and football, and 56.6% of people

would like to do more sport than they currently do. The most popularly specified sports are

cycling and swimming. Regular physical activity is beneficial to health and wellbeing,

according to Sport England data (5), 57.4% of adults in Milton Keynes are physically active.

Milton Keynes provides a variety of settings where an individual can be physically active,

ranging from the parks and open spaces to the various leisure trust facilities and private

health clubs. In addition to this here are a plethora of projects and initiatives designed to

encourage greater participation in physical activity, this includes Health Walks, which have a

through output of approximately 12,000 walkers per year, and the Return to Sports courses.

Pushchairs in the Park, Waggy Walks, Parks and Run, Fitness in the Parks and Women’s

Walking Network are all ongoing initiatives, as well as annual events like the MK Marathon,

Walking festival, Sports Relief and Sky Ride in the calendar.


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5. Future Services & Service Redesign

The existing service provision has been reviewed and there is a need to greatly increase

capacity and the coverage of services to support and manage overweight and obese

individuals, as well as providing extensive whole population prevention activities and

services. All services will be developed in line with NICE guidance for Obesity and Weight

Management (15,16,17) as well as the use of the National Obesity Observatory, Standard

Evaluation Framework for Weight Management Interventions (18).

Tier 1 will include the development of a Brief Intervention and Health Promotion Service to

support local Lifestyle services. The service will provide brief advice and behaviour change

support on four key lifestyle areas - weight management, physical activity, alcohol and

smoking, through structured sessions as well as delivering health promotion campaigns to

the population of Milton Keynes. Alongside this service, projects and interventions will be

continued and developed to address breastfeeding support, healthy eating and physical

activity.

Tier 2 will provide comprehensive weight management support to overweight and obese,

children, young people and adults across Milton Keynes. The services will be developed to

significantly increase the number of individuals and families who are able to access weight

management support, as well as providing improved accessibility to services across Milton

Keynes.

It is clear from the obesity pathway there is a considerable gap in tier 3 services in Milton

Keynes for both children and young people and adults. Therefore we plan to address the

gap by developing a Tier 3 service to provide further support to obese individuals who have

not responded to tier 2 interventions. There is a need for a multi-disciplinary team in order

that individuals receive specialist support.

For adults only, there is a need to address the access to the tier 4 services such as bariatric

surgery and ensure clear guidelines and support for patients both before and after tier 4

interventions.


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6. Values and Guiding Principles

Focus our resources on evidence based approaches related to weight management

promotion, advice and support.

Focus our resources on the prevention of obesity, as well as treatment of obesity for

adults and children.

Target our work towards groups of the population we know are at higher risk of

obesity and weight related issues.

Ensure continued working between provider and partner organisations and the local

community.

Keep service users and their families at the heart of our work to tackle obesity.

Ensure that all services, projects and initiatives demonstrate value for money.


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7. Priorities

Priority 1: Reduce Obesity Prevalence in Milton Keynes through Preventative

Measures.

Create positive environments that actively promote and encourage a healthy weight across

Milton Keynes. Tackle the influential factors that contribute to obesgenic environments, as

well as population level programmes and interventions.

What we will do for Everyone

Develop and promote consistent messages about physical activity

Support the local regulatory services, food industry and retailers to promote healthy

eating choices.

Promote active travel across Milton Keynes.

Widen access to physical activity opportunities in areas of deprivation and for priority

groups.

Support the development of sustainable active community events and groups.

What we will do for Children and Young People

Adopt a life course approach from before, during and after pregnancy onwards

including breastfeeding, early nutrition and development.

Positively influence lifestyle factors to ensure healthy nutrition and growth at all

stages of development.

Address the ‘whole family’ to ensure that parents have the knowledge, confidence

and means to adopt healthier lifestyles for themselves and their children.

Encourage local organisations to adopt and work towards the UNICEF Baby Friendly

Initiative Accreditation.

Support schools to develop travel plans to encourage walking and cycling to and

from school.

Support the introduction of free school meals.

Review and relaunch the Healthy Early Years Award.

Review the School Nursing Service with a focus and input to a healthy schools

approach.

What we will do for Adults


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Support the delivery of the NHS Healthcheck programme and ensure referral

pathways are established to support individuals identified as at risk.

Maintain the physical activity programmes and introduce additional support for

targeted campaigns.

Maintain and develop the exercise referral scheme.

Support the workforce (public, private and voluntary) in local communities to have the

knowledge, skills and confidence to work with parents and adults to raise the issue of

obesity, healthy eating and physical activity through the Making Every Contact Count

(MECC) programme.

Priority 2: Ensure there is effective support for individuals to manage their

weight.

To ensure that there are sufficient services and support to meet the needs of adults and

children and young people who are already overweight or obese. The aim will be to develop

a consistent, evidenced-based pathway for the management and treatment of obesity.


Commission effective and appropriate provision of weight management services

available to children, young people and adults who are overweight or obese.

Ensure sufficient capacity and access to services to support children, young people

and adults to achieve and maintain a healthy weight.

Identify barriers and issues to managing and achieving a healthy weight

Recognise the needs of groups at greater risk of excess weight issues, for example

deprived, certain ethnic minority communities and specific conditions/illnesses,

and commission appropriate and accessible services.

Develop clear mechanisms for signposting and referrals from tier 1 services to tier 2

services.

Work with the Clinical Commissioning Group (CCG) and key health partners to

develop a tier 3 service model.


Support children and their families who are identified as underweight, overweight or

obese through the National Child Measurement Programme.


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Commission effective Tier 2 weight management services for children and young

people and their families, who are overweight or obese.

Continue the development of the preventative programmes for under 5 year olds

and their families.


Provide support for overweight and obese pregnant women, in order for them to

make healthier lifestyle choices.

Commission effective Tier 2 weight management services for adults who are obese.

Priority 3: Encourage healthy lifestyles in the population of Milton Keynes.

Ensure a targeted community based approach, focusing on lifestyle changes to increase

physical activity and improve diet and eating more healthily. Maintaining and developing

interventions to support individuals and communities most at risk of obesity to intervene

earlier and reduce inequalities in obesity.


Ensure that individuals have access to information to enable to them to make

informed healthy lifestyle choices.

Support individuals and families to eat more healthily in line with national guidelines

on healthy eating.

Develop further Health education initiatives to encourage healthy cooking and food

preparation in the community.

Increase the number of adults, children and young people who are physically active

in Milton Keynes

Create safer environments for walking and traveling routes.

Develop and implement training packages, support and resources for health and

social care professionals to access correct information and guidance on healthy

eating and physical activity.


Ensure the provision of healthy food in early years, schools and colleges.

Promote the provision of active play and physical activity opportunities in early years,

schools and colleges.

Develop support for weaning and introducing children to solid foods.


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Continue the running and further development of the National Child Measurement

Programme (NCMP).


Develop community based interventions to help individuals become physically active

and eat healthily.

Support the development of work place health schemes and policies.

Promote physical activity in the workplace.


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8. How will we know we are making a difference?

A detailed strategy implementation plan (the actions we will take forward in Milton Keynes)

will be developed and used to measure the progress and effectiveness of the strategy. The

implementation plan will be regularly monitored and reviewed by the Healthy Weight

Strategy Group (to be developed).

The commissioned services and additional programmes implemented will be assessed using

the National Obesity Observatory, Standard Evaluation Framework for Weight Management

Interventions in order to support high-quality, consistent evaluation of interventions in line

with the evidence base.

Key performance indicators will be in place reflecting the Public Health Outcomes

Framework and local related indicators within the Health and Wellbeing Strategy. Progress

will be monitored and reviewed regularly.

The Public Health Outcomes Framework (PHOF) sets out the desired outcomes for public

health and supporting indicators to measure progress. The following high level indicators will

be used:

Breastfeeding Initiation

Breastfeeding Prevalence at 6-8 weeks after birth

Excess Weight in 4-5 year olds

Excess Weight in 10-11 year olds

Excess Weight in Adults

Percentage of Physically Active and Inactive Adults - Active Adults

Percentage of Active and Inactive Adults - Inactive Adults

Some outcomes are more difficult to quantify, yet it is expected that achievement of the

strategy’s targets will also contribute to:

Reduction in health inequalities

Reduction in the number of people with Type 2 diabetes and associated

complications

Reduction in maternal and infant mortality

Reduction of CVD, cancer & premature mortality


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Improved mental well-being

Improved health & development of children contributing to better academic

achievement

9. References

1. Department of Health (2011). Healthy Lives, Healthy People – Our Strategy for Public Health in England

2. Department of Health (2012). Healthy Lives, Healthy People: A Call to Action on Obesity

3. Schwimmer, J.B., Burwinkle, T.M and Varni, J.W. (2003) Health-Related Quality of Life of Severely Obese Children and Adolescents. JAMA 289: 1813-1819

4. Public Health Outcomes Framework (2014) [www.phoutcomes.info] 5. Public Health England (2013) Local Health Profiles

[www.apho.org.uk/default.aspx?QN=P_HEALTH_PROFILES] 6. Sport England (2013) Active People Survey [www.sportengland.org/research.aspx] 7. Government Office for Science (2007) Foresight Tackling Obesities: Future Choices

– Report [www.gov.uk/government/uploads/system/uploads/attachment_data/file/287937/07-1184x-tackling-obesities-future-choices-report.pdf]

8. NHS Choices (2014). [www.nhs.uk/conditions/Malnutrition/Pages/Introduction.aspx]

9. Public Health England, (1993-2011) Health Survey for England [www.noo.org.uk] 10. UNICEF (2013) The Evidence and the Rational for the UNICEF UK Baby Friendly

Initiative Standards [www.unicef.org.uk/Documents/Baby_Friendly/Research/baby_friendly_evidence_rationale.pdf]

11. The National Obesity Forum (2009) Model of Obesity Pathway [http://www.nationalobesityforum.org.uk/media/PDFs/NOFobesitystrategynewformat.pdf]

12. The Marmot Review (2010), Fair Society, Healthy Lives. [http://www.instituteofhealthequity.org/Content/FileManager/pdf/fairsocietyhealthylives.pdf]

13. Department of Education, (2013) The School Food Plan [https://www.gov.uk/government/publications/the-school-food-plan]

14. Change for life [www.nhs.uk/change4life/Pages/change-for-life.aspx] 15. National Institute for Clinical Excellence (2006), Clinical Guidance for the

Identification, Prevention and Treatment of Obesity in adults and children. CG43. 16. National Institute for Clinical Excellence (2010), Public Health Guidance 27. Weight

Management Before, During and After Pregnancy. PH27. 17. National Institute for Clinical Excellence (2012), Public Health Guidance 42. Obesity:

Working with local communities. PH42.

18. National Obesity Observatory (2009) Standard Evaluation Framework for Weight Management Interventions [www.noo.org.uk/uploads/doc/vid_3534_NOOSEFreportJuly09.pdf]

http://www.nhs.uk/conditions/Malnutrition/Pages/Introduction.aspx

http://www.noo.org.uk/

http://www.instituteofhealthequity.org/Content/FileManager/pdf/fairsocietyhealthylives.pdf

http://www.instituteofhealthequity.org/Content/FileManager/pdf/fairsocietyhealthylives.pdf

Draft Milton Keynes Healthy Weight Strategy 2014-19

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Transcript of Draft Milton Keynes Healthy Weight Strategy 2014-19