Quarter 4 - March 2019 performance
Healthy weight 10-11 years old
 NCMP
NHS Digital has published the data from the 2017/18 academic year’s National Child Measurement Programme (NCMP) for England.  The NCMP is an annual record of height and weight measurements of children in state-maintained schools in reception year (aged 4-5 years) and year 6 (aged 10-11 years).
Key findings for West Sussex:
  • In 2017/18, 19.5% of children in reception year were classified as either overweight or obese in West Sussex; this remains significantly below England (22.4%).
  • Within West Sussex, Worthing had the highest prevalence of overweight and obesity among reception children (23.0%), whilst Horsham had the lowest prevalence (16.9%).
  • 7.5% of reception children were classified as obese in West Sussex (lower than England - 9.5%). Prevalence of obesity was highest in Worthing (9.8%) and lowest in Mid Sussex (5.5%).
  • Overall, a greater proportion of reception children in West Sussex were a healthy weight (79.7%), than England (76.6%).
  • In 2017/18, 28.3% of children in year 6 were classified as overweight or obese in West Sussex.
  • Within West Sussex, Arun had the highest prevalence of overweight and obesity among children in year 6 (32.1%), whilst Horsham had the lowest prevalence (22.7%).
Key messages for West Sussex:
  • There has been little change in the prevalence of overweight and obesity for both reception and year 6 children in West Sussex.
  • Prevalence of excess weight among reception children was lower in West Sussex than its nearest statistical neighbours (those local authorities most similar to West Sussex) combined. West Sussex had the second smallest prevalence of excess weight (Cambridgeshire has the lowest at 17.6%).
  • For year 6, West Sussex has a lower prevalence of excess weight than its closest statistical neighbours combined and England.
  • Prevalence of excess weight is greater for boys than girls. This difference is more apparent at year 6 than reception; this is similar to national data.
  • As in previous years, we can see a link between overweight/obesity and deprivation. For children in year 6, prevalence of excess weight was 1.6 times greater for children living in areas of West Sussex that are among the most deprived compared with those living in areas among the least deprived.
 Libraries helping families improve their health in West Sussex
The partnership between the West Sussex Public Health team and libraries has been highlighted in the Change4Life case studies on the Public Health England website.  This partnership has been developing over recent years, to help improve outcomes and reduce health inequalities in communities. 
 Libraries are a valuable link with communities as they reach into all areas of the county, including those that are deprived and hard to reach, and can be a key space from which to deliver services and useful health and wellbeing messages such as NHS health checks and Change4Life campaigns.
 By working in partnership, public health and library teams achieved the following results:
  • A 25% increase in the number of Be Food Smart packs distributed and a doubling of competition entries from 2016 to 2017.
  • Development of an aligned marketing strategy between the library service and public health campaign calendar, to ensure coordinated and consistent public health messages throughout communications channels.
  • Access to the libraries’ social media channels increased the council’s online reach to over 115,000 members of the public.
  • This activity has inspired Change4Life to create resources specifically for libraries, which launched in early 2019 with a nutrition campaign (see below).


To read this case study on the Public Health England website, please see the link below.
 
New Change4Life campaign
 A new Change4Life Nutrition Campaign for 2019 has been launched. The campaign aims to encourage families to cut back on sugar by making a few simple swaps to their everyday food and drinks. Children in England are having around 2,800 sugar cubes more than they should each year, more than double the maximum recommended amount.
 Retailers and manufacturers are supporting the campaign by highlighting healthier options and many will be using a new Change4Life ‘good choice’ badge in-store and in their own advertising and communications.
 4.2 million activity packs will be made available for free via primary schools and local authorities and teachers will receive new free teaching resources and can visit the School Zone to download materials to teach healthy eating.
 A sugar swap toolkit is also available for professionals to use with families, which includes:
  • Information on the range of Start4Life and Change4Life resources available to order and download.
  • An activity book with fun ideas for teaching healthier eating messages to parents and children. Activities use the magic of storytelling, rhyming and counting to relay memorable healthy eating and dental health messages. 
Quarter 3 - December 2018 performance
Change for Life
 The Change4Life summer campaign was ‘Train like a Jedi’ (TLAJ).
 West Sussex County Council’s Health Promotion Resource centre loaned out the TLAJ kit to Southdowns Leisure (both Davison Leisure Centre and Worthing Leisure Centre) for their Summer Holiday Programme. 
 Worthing Leisure borrowed a number of additional healthy eating/physical activity resources to support their Summer Programme and it was so successful that they have requested them again in February.
 Sugar Reduction Win
 At the most recent Public Health England (PHE) Conference in Warwick, West Sussex County Council’s Public Health team was crowned National Award Winners for the West Sussex Sugar Smart Dental Toolkit; this was one of only four projects recognised out of 300. The project aimed to raise awareness of the harms of sugar on teeth and its effect on general health, and patients were also directed to healthy lifestyle services within their local wellbeing hub for more support if required.
 Government Consultations
 In August the Government began a consultation on ending the sale of energy drinks to children. This was announced as part of “Childhood Obesity: a plan for action, chapter 2”. The aim of the policy is to prevent excessive consumption of high-caffeine energy drinks by children.
 While many larger retailers and supermarkets have voluntarily stopped selling energy drinks to under-16s, there are still many who continue to sell these drinks to children. It is felt that legislating to end the sale of high-caffeine energy drinks to children would create a level playing field for businesses and create consistency, helping ensure that children do not have access to energy drinks in any shop.
 As well as asking for views on a proposed ban on selling energy drinks to children, the consultation also asked for views on:
  • what products should be included in any restrictions
  • what age limit a ban should apply to
  • whether sales of energy drinks from vending machines should be restricted
  • whether there are any changes that would be more appropriate than a ban on sales to children or that could be applied as well as a ban.
 Energy drinks are soft drinks that contain higher levels of caffeine than other soft drinks, and may also contain a lot of sugar. Evidence suggests that excessive consumption of energy drinks by children is linked to negative health outcomes such as headaches, sleeping problems, irritation and tiredness.
 This consultation is now closed and the feedback is currently being analysed; the Government’s response will be published in due course.
Quarter 1 – June 2018 performance.
Filling the gap: West Sussex Sugar Smart Dental Toolkit
The West Sussex Sugar Reduction Programme (which started in January 2015) recently launched the West Sussex Sugar Smart Dental Toolkit pilot in local dental practices; it provides hard-copy and online resources to make it easier for dental teams to promote sugar reduction and a healthy diet amongst their patients.
Aligned to the national Change4Life campaign and ‘Top tips for teeth campaign’, it is designed to involve the whole dental team in raising sugar reduction awareness amongst patients. The resources include badges, stickers, promotional material, social media links, and prescription pads encouraging dental teams to signpost patients to healthy lifestyle services within their local Wellbeing Hub.
 A four week pilot ran from Tuesday, 29th May (Monday, 28th May was a bank holiday) and ending on Friday, 22nd June. This coincided with half-term at the end of May when lots of families tend to attend dental surgeries, so it was hoped that this would maximise the impact of the toolkit.
 The toolkit is currently in the evaluation phase.
 Change4Life
Public Health England (PHE) and Disney UK have launched a brand new national Change4Life programme – “Train Like A Jedi” – to help children to becomes more active.
Taking inspiration from everyone’s favourite Star WarsTM characters Rey and Luke, it encourages children to become more active as they learn to master the ways of the Jedi with a fun play along video. The video features British Taekwondo athlete and double Olympic gold medalist Jade Jones, who alongside a special appearance from BB-8, leads children through a series of Jedi inspired moves.
Combined together, the 12 moves become one special Jedi training routine that helps children learn and master six key skills – technique, strength, stamina, speed, agility and mastery.
 Visit the Change4Life website for more details:
Child Obesity:  a plan for action
Childhood Obesity: a plan for action chapter 2 was released in June.  This document sets out the Government’s renewed approach to tackling child obesity and outlines their plan to halve child obesity and significantly reduce the gap in obesity between children from the most and least deprived areas by 2030; children who are obese or overweight are disproportionally from low-income households
For more information, please see the link below:
Child Obesity:  a plan for action
Childhood Obesity: a plan for action chapter 2 was released in June.  This document sets out the Government’s renewed approach to tackling child obesity and outlines their plan to halve child obesity and significantly reduce the gap in obesity between children from the most and least deprived areas by 2030; children who are obese or overweight are disproportionally from low-income households
 For more information, please see the link below:
Quarter 4 - March 2018 Performance
Sugar Tax Introduced
From Friday 6th April, the Soft Drinks Industry Levy (commonly referred to as the “sugar tax”) comes into effect. This levy is part of the plan to tackle child obesity, aiming to encourage companies to reduce the amount of sugar in their soft drinks. The rates companies will need to pay are as follows: 
  • 24p per litre of drink if it contains 8 grams of sugar per 100 millilitres
  • 18p per litre of drink if it contains between 5 – 8 grams of sugar per 100 millilitres
 The levy doesn't cover pure fruit juices or milk-based drinks.
The money raised, currently estimated to raise around £240 million per year, will go towards doubling the Primary Sports Premium, the creation of a Healthy Pupils Capital Fund to help schools upgrade their sports facilities, and give children access to top quality PE equipment, and also to give a funding boost for healthy school breakfast clubs.
Sue Carmichael, Public Health Lead for Healthy Lifestyles spoke to Spirit FM and said:
“As part of a wider, whole-system approach to tackling obesity, it has an important part to play.”
“If the cost that's being put onto the drinks manufacturers is being passed onto the consumer, it will be enough for some people to change their purchasing behaviour."
Tackling Child Obesity in West Sussex.
Work to tackle child obesity in West Sussex is currently taking place as part of a wider integrated service approach for 0-19/25 year olds.
Workforce Development - Using an audit of baseline skills, a workforce development plan is being formulated to provide support and training, for both Council and NHS staff, to help them to:
  • Deliver consistent messages regarding Healthy Weight
  • Use motivational interviewing techniques
  • Ensure earliest identification of those at risk of becoming overweight and obese, with early intervention and appropriate referral to healthy eating programmes.
 Sugar Debate
Primary school sugar debates took place at Easebourne Primary School on 27th February. 34 pupils took part. There were 4 debates, and a range of fun activities in the afternoon focused on raising awareness of sugar reduction.
South West Whole Systems Obesity Network: What works in promoting healthy weight: a learning seminar for professionals.
This event took place on 22nd February in Taunton and was attended by Alison Thomson from Public Health, who gave a presentation on the West Sussex approach to sugar reduction in primary school meals (in partnership with the West Sussex County Catering Service and Chartwells, primary school meals provider).
Public Health England was keen for West Sussex to share our successful approach with this network, and the presentation received lots of interest from the audience who were keen to implement a similar approach in the south west.
Change4Life 
 Healthier Snacking Challenge
A new Change4Life campaign launched at the end of January aiming to help families choose healthier snacks and reduce their child’s sugar intake. 
 As part of this campaign, West Sussex Libraries encouraged families to think more about the sugar, saturated fat and salt in their diets by inviting them to take part in The Healthier Snacking Challenge, run in partnership between Public Health and the library service, which took place in all 36 libraries across West Sussex from Monday, 22nd January to Saturday, 24th February. It was focused on promoting the new Change4Life campaign and encouraging healthier snacking through a ‘treasure hunt’ style quiz; the library service provided the prizes (12 healthy eating cookbooks). 
378 people took part and the winners are currently being informed. 
Stepper Activity:
 As part of an Eat Right Stay Bright roadshow at the end of January, Chartwells (who deliver the programme as part of the school meal contract) used a Change4Life stepper activity kit.
Feedback was very positive: the children loved the kit.  They were given 30 seconds to compete against another child on the stepper to see who could get the most steps in.  The older children loved the competitive element of the game, with the adults also showing a slightly competitive side!  The younger children seemed happy to try and beat their personal best. 
 A total of 150 visitors attended the event (90 children and 60 adults) and a total of 800 steps were taken.
 
 

Quarter 3 - December 2017 performance

NCMP Figures Published

NHS Digital published the most recent National Childhood Measurement Programme (NCMP) figures in October; these are the results for the 2016/17 academic year. In West Sussex, the number of children who are classified as obese in Year 6 has been consistently lower than the figures for England since 2006/07, and this remains the case for 2016/17.

In Year 6, 28.6% of children in West Sussex were classified as overweight or obese, a decrease from 2015/16. 70.3% of Year 6 children were classified as healthy weight, higher than the prevalence for both the South East and England. This percentage is higher than the previous three years, and the percentage of children classified as healthy weight for Year 6 has been consistently higher than England since 2006/07. 70.3% places West Sussex at green compared to target. The prevalence of obesity was lowest in Horsham (10.2%) and Mid Sussex (12.2%) but highest in Arun (19.8%).

The prevalence of children in Year 6 (derived from the postcode of the school) classified as overweight and obese combined, as a percentage.

Change4Life

A newChange4 Life campaign launching in January 2018 aims to help families choose healthier snacks. It will introduce the new simple tip of “Look for 100 calorie snacks, two a day max”

The campaign will be supported by the Change4Life “ Food scanner App” which will show how much sugar, salt and saturated fat is inside snack foods and drinks This app will replace the previous Be Food Smart app and will provide calorie information, will have an improved results layout and constantly improving product data.
Public Health is working with its colleagues in West Sussex Libraries and leisure centres from the end of January to promote the Family Snack challenge.

Quarter 2 - September 2017 Performance

Eat Right Stay Bright ( ERSB) is delivered to schools in West Sussex as part of the school meal contract with Chartwells. It aims to increase uptake of the school meals and impact upon obesity rates and the attainment gap between the most advantaged and disadvantaged. It is a Fun in to Food programme tackling nutrition education with a whole school approach.

The first year of the programme in West Sussex has seen 32 schools engage with ERSB with 68 different workshop sessions run. Twelve schools have had repeat visits. Approx 1,904 children have taken part in the workshops and parent events have also been held 57 times.

Feedback from the workshops in one school is below.

Reception Teacher – ‘We in particular had a very positive experience for one boy who has an issue with eating that comes with associated health issues. He was happy to try some of the fruit and salad that he previously has not wanted to try. As a whole class we were very proud of this achievement and he received a 'wow' moment certificate to take home to his mum with photos of what he had done that day. We feel he was happy to try these foods as it was done in a relaxed and fun manner. He has now been a little more willing to try more new foods in class at snack time.’

Reception Teacher – ‘The children had a lovely time with yourself and your colleague learning about healthy eating and the opportunity for some food tasting. This was a lovely experience for the children to try a variety of fruit or salad that they may not have tried before.’ -

Year 2 Teacher – ‘It’d be wonderful to have you in again for a different topic with the children. I know that many in my class do struggle to eat the vegetables but they also only know about the typical vegetables. They wouldn’t know what a rhubarb is for example and it seems such a shame.’

Parent – ‘I’m actually really surprised that these contain that much sugar. Why is it allowed? My husband will be horrififed.

The Eat Right Stay Right workshops in West Sussex support the county’s sugar reduction programme.

Year 5 Pupil– ‘I think I eat too much chocolate after Easter I want to try stopping eating it but I will have all my easter eggs’. After discussion with the ERSB coordinator and classmates the child opted to try giving up chocolate for lent.

Year 5 Teacher–‘It’s great to teach them all about what can happen later on in life with heart disease and diabetes. They often just think about the effect on their teeth because it’s something they can physically see and probably have seen on children their age.’

Year 6 Pupil– ‘My dad drinks this quite a lot (Monster Energy Drink) and it’s twice the amount of sugar he’s allowed. I’m going to tell him’.

Year 5 Pupil– ‘You said tomato ketchup was really sugary; is it worse than these drinks?’ ERSB coordinator encouraged the pupil to look at the labels of his bottle at home.. 

Teaching Assistant– ‘I have one of those milkshakes in my fridge. I might throw it out now’. Future conversations with TA revealed the children reminded the TA to throw out the drink.

Living Streets deliver Walk Once a Week programmes in schools in West Sussex. They have a list of schools to target, that fit with the West Sussex Strategic development sites, plus public health priority areas. 5 out of 10 new primary schools are enrolled to WOW, the year-round walk to school challenge.

These are:

Chidham Parochial Primary

Ashurst Wood Primary, East Grinstead

Durrington Junior School

Sheddingdean Primary, Burgess Hill

Heene Primary School, Worthing

…all if which are on the targeted list of expanding schools, or have works scheduled. Four of these schools have launched and are using Travel Tracker to log their daily journeys to school.

3 street audits are planned, 2 of them with Parklands Residents Association in Chichester, a large housing estate with around 1,500 residences, on the edge of the city centre with 2 primary schools, a secondary school, an NHS doctors surgery and a parade of shops within its boundary. We will run 2 audits, at different times of year, and are talking to Bishop Luffa School, Parklands Community Primary and Central School about their potential involvement in the audit process. We hope to simultaneously involve residents around the estate who will undertake their own ‘street scale surveys’ to ensure that the audit process is as inclusive and holistic as possible. The Residents Association will then be able to map the results to inform priorities for the estate. This will be a trial approach for Living Streets and will be very interesting to see the outcomes and how it can evolve.

Quarter 1 - June 2017 Performance

Sugar reduction programme - Further sugar reduction has occurred in the school meals provided through the Chartwell contract and they now contain 65% less sugar than they did two and a half years ago. In total 30,000 West Sussex children per day are benefiting. The daily sugar consumption has reduced from the 18.5g to 6.6g per child.

1. The Executive Child Obesity Task and Finish Group (TFG) which completed in March 2017 made a number of resolutions including:-Develop a County Council charter supporting signup to the national healthy rating of schools scheme, including a local award scheme to encompass all West Sussex nurseries, schools ( including special schools), looked after children,children and family centres and including leisure centres where appropriate.

2. That when they become available, the national guidelines for implementation of healthier food in leisure centres are provided to the Cabinet Member and guidance and support is offered to the District and Boroughs, as commissioners of leisure, to help this sector achieve these standards.

3. To maintain a long term commitment to the County Council Charter including a “health impact assessment”to ensure that any changes to planning and policy within each establishment, considers the wider impact on the health and wellbeing of young people.
4. The Public Health Team arrange for a group of young people to test and comment on the PHE/SAPHNA app once it is launched, alongside other apps which address healthy eating habits and physical activity, to evaluate whether one should be recommended by the Team to West Sussex Schools.

5. The Public Health Team coordinate communication and closer working with schools to help increase demand for the available Bike ability Courses and liaise with other County Council Departments on a method for evaluating the intervention, should the resources become available.

Quarter 4 - March 2017 Performance

NHS Digital published the most recent release of the NCMP in November 2016. These results are for the 2015/16 academic year.

In West Sussex 30.4% of year 6 children are measured as overweight or obese. 1.1% of this age group is underweight, resulting in 68.5% of children being a healthy weight. The percentage of children with a healthy weight is higher in West Sussex than England. There is no significant difference between these figures and those of 2014/15.

This places us at amber compared to target, at year end, as predicted at the start of the year.

Final figures from the specialist service (Weight Management Centre) for 2016/2017 are as follows

1. Two hundred and fifteen families enrolled on the Alive N Kicking programme for children.

2. Just over 80% completed the programme and 48% maintained or reduced their BMI.

Change4Life Be Food Smart Campaign

West Sussex Public Health Directorate supports the national Change4Life campaign, which launched Be Food Smart in January. This campaign highlights the surprising amount of sugar, saturated fat and salt found in everyday food and drink.

Be Food Smart Team visited Crawley!
The Public Health England (PHE) Be Food Smart Team visited Tesco Extra in Hazelwick, Crawley on Friday, 17th March 2017 to raise awareness of the Be Food Smart campaign and to encourage shoppers to download the free Be Food Smart app, which is available from the iTunes store or Google Play. The team provided advice to shoppers about the amount of sugar, saturated fat and salt found in popular family foods, and in some instances, shoppers decided to exchange their purchases for healthier options. The stand was in an area of high footfall in the store and the team had given out over 800 packs by lunch time.

Horsham Junior Citizens Event

Members of the Public Health Team and Horsham Wellbeing led ‘Be Food Smart’ Challenge, at this event which took place in early April. The annual event aims to teach essential life skills to over 1200 primary school children aged nine to eleven years old who attend schools within the Horsham district, through a number of fun and thought-provoking scenarios.

Further Information

Alive N Kicking

The Weight Management Centre has continued to deliver Alive N Kicking weight management programme to children and young people throughout the year. To date 140 families have engaged with the programme, with half of them reducing or maintaining their weight. The majority of referrals into Alive N Kicking continue to come from the school programme STOP, and school nurses.

Testimonial from a mother of a young person who attended Alive N Kicking

"Since attending the Alive n Kicking programme I have found that as a parent I have noticed a huge difference in my daughters personality. Before the course she hated school and was bullied due to weight related issues. She seemed so unhappy I took her to the Doctors because I thought she may be depressed. Since regular exercise and losing some Weight there has been a massive difference in her behaviour at school and at home. It seems like a weight has been lifted, she has more enthusiasm towards exercise, eating and even going to school. She used to lay around and didn't want to leave the house now it's hard to keep her indoors! This has also had a knock affect into my life as a mum, I am much happier. My daughter is happy after what seems like a lifetime! Alongside side helping her I have also done extremely well and losing 6kgs in 8 weeks and I would highly recommend this programme to any kids suffering from being overweight, she has lost 2kg."

Be Food Smart

The Public Health England (PHE) BE Food Smart campaign launched nationally on 3rd January 2017, with the news stories that children are eating more than half of their daily sugar intake in their breakfast.

http://www.bbc.co.uk/news/health-38467861

The campaign feedback from PHE showed that 115 new registrations from West Sussex were logged onto the Change4Life website during the campaign period. 24,051 emails were sent from Change4Life to West Sussex residents with an average 12.8% open rate. Further changes to primary school meals provided by Chartwells have resulted in more sugar being removed.

Promotion of the Public Health England Sugar Smart campaign has increased the awareness of the messages around sugar reduction, and advice on lower sugar swaps. Additional school based sugar reduction debates have occurred in the Chichester District.

A pilot 6 week weight management programme for children with special educational needs and disabilities has run in Mid Sussex. At the end of the programme the fitness level of the young people had increased. weight had been maintained, and they were reporting changes that they had made to their food intake.

Educational sessions to primary care staff from Coastal West Sussex CCG have been delivered by the public health team on identification of overweight children and young people. The team also delivered a sugar reduction display in the market place at the same event attended by over a hundred professionals.
A school based competition to design a West Sussex sugar reduction logo was won by a pupil from Storrington First School, The winning design is shown on the left.

Educational sessions to primary care staff from Coastal West Sussex CCG have been delivered by the public health team on identification of overweight children and young people. The team also delivered a sugar reduction display in the market place at the same event attended by over a hundred professionals.

Awards

West Sussex Public Health and County Catering won an award for their poster presented the national Public Health England Conference in Warwick early September for their work on reducing sugar in school meals. To date the equivalent weight of three London double decker buses of sugar has been removed from West Sussex primary school meals in the last 20 months. This work is continuing with Chartwells- the school meal provider.

Why Weight

Being overweight as a child increases the risk of being overweight as an adult. It also can affect a child’s health, ability to take part in an lively life and school performance. To help children and families think about their diet and being active there is help and support available in West Sussex. Tried and tested programmes which provide an effective way to manage weight and encourage adopting healthier habits for life are funded by West Sussex County Council.

For further information call the WhyWeight helpline on 0300 123 0892.

www.whyweightwestsussex.co.uk

Background

Through its Public Health role, West Sussex County Council provides leadership to a county wide healthy weight network with representatives from many organisations regularly attending. The network acts as a support for key local partner organisations delivering the actions in the West Sussex Healthy weight operational plan 2014-17 (the refresh of the earlier report ‘Critical Mass’). Both prevention and management of overweight and obese for all age groups fall within scope for the network. The network oversees and maintains pathways (across a number of separate commissioning and provider organisations) to improve how effectively they meet the needs of families, children and young people. This includes training frontline staff to identify individuals in need of additional support and referral.

National Child Measurement Programme data provide a proxy for population prevalence of healthy weight, overweight and obese in two school year groups and are refreshed annually.

The national Child obesity action plan was published in August 2016. It identifies 14 actions for national or local progression. https://www.gov.uk/government/publications/childhood-obesity-a-plan-for-action. It places a lot of emphasis on the role of schools to promote physical activity and healthy eating.