www.hertfordshire.gov.uk

Developing a whole systems

approach to obesity in Hertfordshire

Piers Simey, Oliver Mytton & Maneka Kandola

Hertfordshire County Council Public Health Service

www.hertfordshire.gov.uk

Three Presentation Aims

• Give an overview of the practical steps taken

• Be clear that the process is iterative, takes time & resource, and needs local adaptation: no “lift and drop” blueprint

• Set out potential next steps

www.hertsdirect.org

London

Cambridgeshire

Buckinghamshire

Essex

Suffolk

Northamptonshire

Oxfordshire

Bedfordshire

Berkshire

Luton

10 District &

Borough

Councils

2 CCGs

Population -

1.2 million

This is Hertfordshire!

1 University &

4 FE colleges Number of Leisure

Providers

www.hertsdirect.org

Our starting point• Obesity rates relatively low, but common

• “Pioneer” second wave for the national programme

– East Herts District Council

– Hertsmere District Council

• National resources ‘ready’ but needed adaptation

• Range of relevant initiatives across the county

• No new cash

Action on obesity hits the headlines!

www.hertfordshire.gov.uk

Some considerations before you start• Is the organisation ready to progress this?

• Tackling obesity can resonate with politicians

• People value direction in this process

• Tendency to focus on individuals, education & awareness - rather than systems structures

• Cross department working may not be in place

• Takes time to build relationships – people resource

• People resource is vital

www.hertfordshire.gov.uk

Insight opportunity:Deprived wards in East Herts have higher levels of child obesity

6.0%

8.0%

10.0%

12.0%

14.0%

16.0%

18.0%

20.0%

0 2 4 6 8 10 12 14 16 18

Ob

esit

y P

reva

len

ce (

Year

6)

Deprivation (IMD score)Least deprived Most deprived

Hertford Sele

Hertford Bengeo

Data based on National Child Measurement Programme (averaged from 2008 to 2015) for all wards in East Hertfordshire

Gap: 10.1%

8

www.hertfordshire.gov.uk

Challenges & trade offs• Range of different interests ready to engage

• Influence: senior decision makers vs operational leads?

• “Crowd sourcing” approach vs evidence focus

• Health vs economic trade offs, e.g

– Restricting catering contracts in Leisure Centres?

– EHOs stretch from food safety into food quality?

– Further traction with planning & developers?

www.hertfordshire.gov.uk

Key learning & next steps• Don’t underestimate staff time to do this well

• Vital to engage with & get the right people in the room

• Big challenge: moving from workshops to key actions

• Also: blending bottom up approach, with evidence/direction

• Current/next steps

– Progress identified priorities in the Districts

– Embed learning & progress in District strategies

– Update Hertfordshire’s Healthy Weight Strategic Plan