National Child Measurement Programme update...• 1 April 2013 – NCMP statutory public health...

National Child Measurement

Programme update

Rosie Taylor, Public Health Delivery Manager

PHE Children, Young People & Families Team

London Healthy Weight Leads Network

25 February 2014

Public Health England’s mission

“To protect and improve the nation’s health and to

address inequalities, working with national and local

government, the NHS, industry, academia, the public

and the voluntary and community sector.”

2 London Healthy Weight Network, February 2014

Outcome focused priorities for 2013/14


1. Helping people to live longer and more healthy lives by reducing preventable deaths and

the burden of ill health associated with smoking, high blood pressure, obesity, poor diet,

poor mental health, insufficient exercise, and alcohol

2. Reducing the burden of disease and disability in life by focusing on preventing and

recovering from the conditions with the greatest impact, including dementia, anxiety,

depression and drug dependency

3. Protecting the country from infectious diseases and environmental hazards, including the

growing problem of infections that resist treatment with antibiotics

4. Supporting families to give children and young people the best start in life, through

working with health visiting and school nursing, family nurse partnerships and the

Troubled Families programme

5. Improving health in the workplace by encouraging employers to support their staff, and

those moving into and out of the workforce, to lead healthier lives

A life course approach


Fair Society, Healthy Lives, 2010

CYPF team priorities


Pregnancy Early Years School-aged Adolescents

Life

sta

ge

Prio

rity

Reduce numbers

of still births and

infant deaths

Safe transfer of

Healthy Child

Programme 0-5s

Settings approach

– healthy schools

and FE

Reaching C&YP

out of school

NCMP

Adolescent public

health improvement

framework –

targeting C&YP with

multiple

vulnerabilities

Co

rpo

rate

prio

rity

Improving health outcomes

Healthy weight and tackling childhood obesity

Troubled Families

Early Intervention

Cro

ss-

cu

ttin

g Reduce number of children under 18 killed in road traffic accidents

Promote resilience / improve mental health and wellbeing

Ensure children, young people and families shape, inform and hold PHE to account

PHE Healthy Weight work plan – adults and children


PHE Offer to stakeholders

• Systems Leadership - national leadership, framing the issue and debate,

communications

• Monitoring and promoting the evidence base - NCMP & survey tools, data,

PHOF, supporting effective commissioning, commissioning research,

promoting evidence of good practice

• Support for local practice – local authorities, PHE Centres, HWB Boards,

supporting a place based approach

• Community engagement – social marketing, Change4life, campaigns

• Obesogenic environment – whole-system, place based approach, PHE/LGA

Child Obesity Peer-Challenge programme


How can we make a difference?

• Use knowledge about lifestyle issues and what builds resilience – eg NCMP

• Promote evidence and learning from practice about what works – NICE Guidance

and evidence briefings for practice

• Combine targeted help for those most at risk with universal interventions - eg. weight

management programmes and social marketing

• Take a life course and place-based approach – EY’s settings, schools, families, and

communities

• Work in partnership, taking a coordinated and collaborative approach, recognising

strengths of different partners and using resources effectively

• Listen and act on what children, young people and carers tell us


NCMP: achievements so far

• Established in 2006 and involves the weighing and measuring of all

eligible children in reception and year 6 at state-maintained primary and

middle schools including academies:

• 100% of LAs

• Over 99% of eligible schools

• 93% of eligible children – over 1 million children

measured each year

• National Statistics status

• Surveillance element: Data used nationally and locally to inform action

and bring together broad coalition of partners required to prevent and

address child obesity

• Engagement element: Opportunity for local authorities/providers to

engage directly with families through provision of results to parents


Current landscape for NCMP delivery

• 1 April 2013 – NCMP statutory public health function of local

authorities:

− Legal duty for surveillance elements of the programme


− Flexibility with approach to sharing results with parents

− Requirement to include NHS Number in data return where available

− Legal regulations define programme, LAs’ duties, and data

processing

• Data used for Public Health Outcomes Framework Indicators on Excess

weight in children aged 4-5 and 10-11 years old

Latest NCMP findings

• Prevalence of child obesity remains high, and doubles between

the ages of 4–5 and 10–11 years (from 9.3% to 18.9%).

• For Reception: a stabilisation of obesity and excess weight, and a possible

downward trend

• For Year 6: early signs of a possible halt to the trend of increases previously

seen in obesity and excess weight prevalence

• Strong social deprivation gradient: obesity prevalence double in the most

deprived areas compared with the least deprived


Prevalence of excess weight among children National Child Measurement Programme 2012/13


Child overweight (including obesity)/ excess weight: BMI ≥ 85th centile of the UK90 growth reference

One in five children in Reception is overweight or obese (boys 23.2%, girls 21.2%)

One in three children in Year 6 is overweight or obese (boys 34.8%, girls 31.8%)

24

.3%

21

.5%

33

.2%

30

.0%

24

.0%

21

.1%

34

.3%

30

.7%

24

.0%

21

.5%

34

.5%

30

.7%

24

.3%

21

.8%

35

.0%

31

.6%

23

.9%

21

.3%

34

.9%

31

.8%

23

.5%

21

.6%

35

.4%

32

.4%

23

.2%

21

.2%

34

.8%

31

.8%

Reception boys Reception girls Year 6 boys Year 6 girls

2006/07 2007/08 2008/09 2009/10 2010/11 2011/12 2012/13

13 London Healthy Weight Network, February 2014 Child excess weight: BMI ≥ 85th centile of the UK90 growth reference

95% confidence intervals are displayed on the chart

Prevalence of excess weight by school year,

sex, and year of measurement National Child Measurement Programme 2006/07 to 2012/13

BMI distribution: Reception children National Child Measurement Programme 2012/13


BMI z score

Girls

Boys

1990 baseline

2nd centile

85th centile

91st centile

95th centile

98th centile

BMI distribution: Year 6 children National Child Measurement Programme 2012/13


BMI z score

Girls

Boys

1990 baseline

2nd centile

85th centile

91st centile

95th centile

98th centile

11.7%

14.2%15.6%

16.4%

17.9%19.3%

20.5%

22.2%

23.7%24.3%

5.9%6.9% 7.4% 7.9% 8.5%

9.2%10.2% 10.4%

11.5% 11.9%

0%

5%

10%

15%

20%

25%

Least deprived

Most deprived

Ob

esi

ty p

reva

len

ce

Index of Multiple Deprivation 2010 decile

Year 6

Reception

Obesity prevalence by deprivation decile National Child Measurement Programme 2012/13


Child obesity: BMI ≥ 95th centile of the UK90 growth reference

17 London Healthy Weight Network, February 2014 Child obesity: BMI ≥ 95th centile of the UK90 growth reference

Obesity prevalence by deprivation decile

and year of measurement

National Child Measurement Programme 2006/07 to 2012/13

Children in Reception (aged 4-5 years)

0%

2%

4%

6%

8%

10%

12%

14%

Least

deprived

Most

deprived

Ob

esi

ty p

reva

len

ce

Index of Multiple Deprivation (IMD 2010) decile

2006/07 2007/08 2008/09 2009/10 2010/11 2011/12 2012/13

Obesity prevalence by deprivation decile

and year of measurement

National Child Measurement Programme 2006/07 to 2012/13

18 London Healthy Weight Network, February 2014 Child obesity: BMI ≥ 95th centile of the UK90 growth reference

Children in Year 6 (aged 10-11 years)

0%

5%

10%

15%

20%

25%

30%

Least deprived

Most deprived

Ob

esit

y p

reva

len

ce

Index of Multiple Deprivation (IMD 2010) decile

2006/07 2007/08 2008/09 2009/10 2010/11 2011/12 2012/13

Obesity prevalence by ethnic group National Child Measurement Programme 2012/13



Children in Reception (aged 4-5 years)

9%10% 10%

9%

11%

13%

11%

17%

13%12%

8% 8%9%

8%

10%12%

9%

16%

14%

10%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

20%

Wh

ite

Bri

tish

Wh

ite

Oth

er

Mix

ed

Ind

ian

Pak

ista

ni

Ban

glad

esh

i

Asi

an O

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r

Bla

ck A

fric

an

Bla

ck O

the

r

An

y o

the

r eth

nic

gro

up

Wh

ite

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tish

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ite

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Mix

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ian

Pak

ista

ni

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i

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r

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fric

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the

r

An

y o

the

r eth

nic

gro

up

BOYS GIRLS

Ob

esit

y p

reva

len

ce

Obesity prevalence by ethnic group National Child Measurement Programme 2012/13



Children in Year 6 (aged 10-11 years)

18%

24%22%

25%27%

31%

27% 27%26%

28%

16%18%

21%

16%

21% 22%

16%

28% 27%

19%

0%

5%

10%

15%

20%

25%

30%

35%

Wh

ite

Bri

tish

Wh

ite

Oth

er

Mix

ed

Ind

ian

Pak

ista

ni

Ban

glad

esh

i

Asi

an O

the

r

Bla

ck A

fric

an

Bla

ck O

the

r

An

y o

the

r eth

nic

gro

up

Wh

ite

Bri

tish

Wh

ite

Oth

er

Mix

ed

Ind

ian

Pak

ista

ni

Ban

glad

esh

i

Asi

an O

the

r

Bla

ck A

fric

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Bla

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the

r

An

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the

r eth

nic

gro

up

BOYS GIRLS

Ob

esit

y p

reva

len

ce

BMI status of children by age National Child Measurement Programme 2012/13


This analysis uses the 2nd, 85th and 95th centiles of the British 1990 growth reference (UK90) for BMI to classify children as underweight, healthy weight, overweight and obese. These thresholds are the most frequently used for population monitoring within England.

Underweight0.9%

Healthy weight76.9%

Overweight

13.0%

Obese

9.3%

Reception(aged 4-5 years)

Underweight1.3%

Healthy Weight65.4%

Overweight14.4%

Obese18.9%

Year 6(aged 10-11 years)

23 Children & Young People- Insight Day

http://fingertips.phe.org.uk/profile/national-child-measurement-programme Screenshot of webpage

http://fingertips.phe.org.uk/profile/national-child-measurement-programme







PHE’s role in the NCMP

• Leadership and support for local delivery of the programme through the

development and provision of guidance, case studies, etc

• Support effective use of NCMP data locally to inform action, analystica

guidance, school feedback tool, slidesets, etc

• Develop the evidence base for sharing results with parents and best

practice approaches

• Commission HSCIC to provide IT system, user support, collate, analyse

and publish annual report


New IT system • DH and PHE commissioned, developed and hosted by the HSCIC with users

• Provides a secure environment to NHS standards for processing identifiable records,

and data submission to the HSCIC

• DPHs nominate primary user, role-based access then set up locally

• Lead user confirms final data submission, approves HSCIC data purge, and receives

validated enhanced dataset

• Allows for data validation at point of entry

• LAs will receive validated enhanced dataset earlier

• 15 August 2014 – last day to submit NCMP 2013/14 data to HSCIC – one per LA

• http://www.hscic.gov.uk/ncmpsystem

• HSCIC contact 0845 3006016 [email protected]

25 NCMP regional engagement event London 21st November 2013

http://www.hscic.gov.uk/ncmpsystem

http://www.hscic.gov.uk/ncmpsystem

mailto:[email protected]?subject=NCMP IT system

Other resources to support delivery • Briefings for Elected Members

• Operational delivery and schools guidance

• Revised template letters

• External stakeholder group – to input to resource development and allow dialogue between PHE and LAs /

providers / schools

• BI team scoping options for testing different approaches to feedback

• Build understanding of delivery issues areas of support need

• Analytical reports

• Fingertips tool

• Slide sets

• Briefing papers

26 NCMP regional engagement event London 21st November 2013

Future work plan for NCMP • Continued provision and development of the IT system, guidance and key template letters

• New stakeholder communications pack

• Redevelopment of resource to support sharing of results with schools

• New school feedback resource

• Publish a more detailed analysis of the trends in early 2014, and will look at geographical

areas achieving sustained falls in prevalence and areas not achieving this to understand

possible reasons

• Development of case studies

• Developing evidence base and resources to support commissioning of feedback to parents


PHE/LGA Child obesity peer-challenge


• Sector-led improvement approach

• Short on-site visit by a team of experienced ‘peers’ and experts.

• Free-standing child obesity module or integrated into Health & Wellbeing peer

challenge

• Findings, feedback and recommendations made to enable councils and HWBBs

to focus on key issues and take child obesity agenda forward

• Adopting a ‘whole systems’ approach to child obesity

• Pilot sites – Bath & North East Somerset, Peterborough, West Cheshire and

Cheshire, and Blackpool

• Evaluation and roll-out offer to other local authorities during the 2014/15 year

Other child obesity workstreams

• Promote the evidence base through briefing papers, working with

PHE Knowledge & Intelligence, NICE and others

• Change4Life,

• Working closely with the School Food Plan, Youth Sports Trust, Play

England and Natural England to promote healthy weight in children

• Transform health visiting services to ensure increased support for

infant feeding and healthy eating for all families

• Promote breastfeeding and support mothers to feed babies as long

as they choose, particularly in deprived areas where breastfeeding

rates are lower

• Physical activity framework


Take home messages

• Tackling child obesity remains a priority for DH and PHE

• National ambition to “achieve a downward trend in child obesity by

2020”

• Public Health Outcome Framework – child excess weight as

measured by NCMP data as an indicator

• PHE has a key role in supporting local delivery through provision of

tools and resources, and evidence base, and through PHE Centres

working with local Government

• Developed 2014/15 work plan based on priorities identified through

regional stakeholder engagement events


Further information

• www.gov.uk/phe: 2013/14 NCMP operational guidance, template letters,

leaflets, briefing for elected members

• www.noo.org.uk (now part of PHE): NCMP analysis reports, local analysis

guidance, mapping tool with data shown down to Ward level, NCMP data

slide sets, and wider info on tackling obesity across the LA, Standard

Evaluation Framework

• www.hscic.gov.uk/ncmp : IT system, guidance and FAQs

• www.nice.org.uk Obesity pathway and new child lifestyle weight

management guidelines

• PHE Bulletin (email [email protected] requesting to be added to the PHE

Bulletin subscriber list, and giving name, organisation, job title and role)

• PHE Twitter accounts: @PHE_uk , @PHE_obesity, @PHE_Children,

@DrKevinFenton

• Contact: [email protected]


http://www.gov.uk/phe

http://www.hscic.gov.uk/ncmp

http://www.nice.org.uk/

mailto:[email protected]

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