Healthy weight in children (health and wellbeing needs in South Tyneside)

The following is a list of some of the initiatives provided for schools and families by South Tyneside Council, with partners that may contribute to a reduction in obesity

• Change 4 Life (C4L) is the new wellbeing programme  launched recently and includes a website where residents can self refer to gain advice on how they can take small steps to live healthier and longer lives. Information on a number of lifestyle issues including stopping smoking, cutting back on alcohol, tips for healthier eating, getting more exercise or where to get an NHS Health Check is available from the Change4Life South Tyneside Programme. Health Professionals including GPs are also able to refer people into the programme which is aimed at tackling health inequalities by taking a life course approach working with children, adults and families. 
• In order to build capacity, C4L also offers a training programmewhich is open to all C4L deliverers and is delivered by an external provider(s) commissioned by Public Health. Modules enable participants to develop skills in addressing the wellbeing needs of the local population in key Public Health areas across the life-course and include, among other things: Every Contact a Health Improvement Contact, NHS Health Checks, Health Eating, Emotional Health and Wellbeing and Children and Young People (incorporated into a life-course approach / model of delivery). Target participants include School Nurses, all school staff, Children Centre staff. Gaps in provision are also being looked at and the training will target those staff / localities first.
• The council's C4L team also provide other teams with their own healthy eating resources box along with training. All primary schools, Children's Centres, Sports Development staff , the Matrix, Family Support and School Nurses recently attended training on how to deliver session on healthy eating and were provided with lesson plans and a box of evidence based resources to do so. 
• Public Health has commissioned a Training Course on adult and childhood obesity to enable front line staff to identify and raise the issue with families. So far 74 staff have attended the four 3 day training sessions offered in 2015. Trained staff include teachers, social workers, sports development, family workers and outreach staff
• South Tyneside Council are committed to a number of Public Health England campaigns including those linked to Best Start in Life and Change4Life. A new Change4Life Schoolzone campaign is about to be launched and will potentially provide schools with readymade resources including lesson plans, power points, publicity materials.
• In April 2013, Local Authorities took on the statutory responsibility to deliver the National Child Measurement Programme, which is delivered in schools. Children in Reception (aged 4 - 5) and Year 6 (aged 10 - 11) have their heights and weights measured by School Nurses who are commissioned to deliver the programme. The programme provides Local Authorities with robust public health surveillance data on child weight status to aid planning and provides parents with feedback on their child's weight status. In 2013 / 14 there was a 97% uptake from all those eligible across the age ranges.
• 4 UPP (Understanding Parental Perceptions)is a project being carried out by Newcastle University in conjunction with the Local Authority. Parents of children measured via the NCMP in 2013 - 14 were asked to give consent to be contacted by the University for further questioning, should their child be measured as overweight or very overweight. The University are currently looking at the parental attitudes/beliefs and understanding of obesity, its causes and effects. The have produced a tool to use with parents that will help demystify some of the perceptions of what constitutes childhood obesity. It is intended that  this will  be widely available once clinical trials have taken place.
• In terms of support for families, currently all families are offered School Nurse (SN) support when they receive their NCMP results. A review of the service has recently taken place and future plans include increasing the public health role of the school nurse, which will include closer involvement in NCMP follow up. Currently, NCMP feedback letters to parents to inform them that School Nurses are able and available to offer individual advice and support to young people and their families on healthy diet and lifestyle issues. It is intended that in future, SNs will also signpost families to any Families Lifestyle Programmes on offer in South Tyneside, leisure services and other nutrition (eg cooking skills) and or physical activity opportunities in the borough.
• In addition School Nurses offer advice, and support at their drop- ins which are offered in all secondary schools and negotiated with the Head Teacher in primaries.
• The Healthy Schools Programme, is available to all schools and has physical activity, healthy eating and emotional health criteria included. Schools are asked to complete an audit of their relevant work and the 'distance travelled' in meeting the criteria. In 2014 - 15 the focus on obesity was increased in the next levels / Badges of the Healthy Schools Programme. Currently, any primary school that wishes to progress with the Badges must  focus firstly on the Healthy Weight Badge. They may also choose to work on another Badge of their choice, based on need if they wish to do more. Currently 8 primary schools are working on their Healthy Weight Badges and are focusing, for example on the school environment, a lunchtime charter, snack provision and rewards etc
• The Council's Sports Development team offer an extensive programme of physical activities to schools across the borough. After school clubs and holiday clubs are also provided at a small cost to parents. Staff have recently attended training on obesity in order to help them discuss the issue with children and their families, when appropriate
• As previously stated, an initiative has taken place that looked at the planning and numbers of hot food takeaways in South Tyneside as there is a correlation between the number of takeaways per ward and the levels of adult and childhood obesity. Work will take place looking at beliefs, attitudes and behaviours in relation to takeaways to inform future training and campaigns targeting families.
• All current training offered around nutrition includes a section about takeaways and will be amended accordingly
• In the past Free School Meal (FSM) entitlement has been used as a deprivation indicator, deprivation having a close link to obesity.  Local data  for 2013 - 14 does indicate that the higher the FSM entitlement, the higher the obesity levels in schools . In terms of uptake in South Tyneside, an average of 90% of those eligible, take up the offer. However, this fluctuates greatly across primary schools from between 80% to 98%. In 2015 - 16, schools with lower uptake will be targeted by the Education Catering team.
• In South Tyneside, the school meals are provided in such a way, that should a child wish, they could access their 5 a day in one sitting. All Catering Team Leaders have received training on promoting a healthy balanced meal to children which they practice at all sittings. 
• The Fitness Challenge was a project set up to get Year 4 pupils to be more active by engaging them in monitoring their individual/class team activity and it enabled competition against other schools in South Tyneside. The project ran for 10 weeks in the Summer Term and pupils were provided with an accelerometer and measured and recorded their steps / activity online each day. An evaluation report is underway and will include recommendations for a way forward
• There is clear evidence (Unicef) that that breastfeeding for the first six months has a number of health benefits to baby eg reduction in chest infections, gastroenteritis, ear infections, urinary infections, diabetes, allergies, sudden infant death syndrome (SIDS), childhood cancers and heart disease. There is the recognition that diabetes and heart disease are linked to adult obesity and that this link to obesity can be reduced by prolonged breastfeeding (Renfrew el at 2012).Long term health benefits to women include reduction of breast cancer, ovarian cancer and osteoporosis.  This correlates to the length of time women breastfeeding ie the longer breastfeeding continues the longer protection happens. In South Tyneside work is taking place to ensure implementation of the UNICEF Baby Friendly Initiative standards . Maternity staff, health visiting, neonatal unit and children's centres staff have all been offered and are taking up training implement these standards. There is also ongoing training of breast feeding peer supporters (women who have breastfed their own children and wish to support other women who chose to breastfeed). Breastfeeding support groups and infant feeding workshops are also held in the local Childrens' Centres across the borough. The above information is to be provided to schools and promoting breastfeeding as the preferred option has recently been written into the Healthy School Award criteria.
• The Hebburn Early Help pilot took place with high impact families and focused amongst other things, on healthy weight. An evaluation is currently being carried out by Durham University and future plans will be dependent on this.
• From a strategic point of view, Local Government Association (LGA) makes a number of recommendations for Local Authorities  to tackle the issue, many of which are addressed  via an  obesity action plan, which was the product of a Scrutiny review in 2013
• Since Scrutiny, South Tyneside Council have or are in the process of carrying out a number of Health Impact Assessments  on their regeneration programme, South Shields 365 eg on the relocation of Central Library to The Word, the new Library and Media Centre.  These assessments will ensure maximisation of the health benefits of such programmes and mitigate against any negative health effects.
• As recommended by the LGA, data included in this report will form part of a JSNA section on obesity in the future
• In addition, when tackling childhood obesity, the  LGA makes a number of other recommendations for councils, including promoting local leadership at all levels - such as local leadership through elected members, strategic leadership through the Health and Well-being Board and health leadership via Clinical Commissioning Groups, wider NHS partners and public health teams
• They also recommend commissioners (CCG and Council) listen to the views of children, young people, adults, families and communities and involve them in commissioning decisions and the design of health services and programmes.
• For Local Councils they advocate creating a network of community champions from the likes of teachers, pupils, school canteen staff and youth club leaders and getting schools on board. There is a wealth of opportunities from cooking lessons, gardening clubs and PE where the importance of preventing obesity can be incorporated in a fun way.