The WM LD and Obesity Work
Programme, Findings, Resources
and Implementation
Opportunities
Karen Saunders
Senior Public Health Manager
Department of Health West Midlands
karen.saunders@dh.gsi.gov.uk
Background
• DHWM Equality Impact Assessment of the
West Midlands Healthy Weight Programme
• Identified need for a focus on the needs of
people with learning disabilities (LD) in
maintaining a healthy weight, participating in
physical activity and making healthy food
choices
.
Programme of Work: Products
• Establish context: facts and policy
• Interprofessional and multi disciplinary
approach – workshops/consultation
• Framework for action/local delivery
• Charter
• Training audit
• Data
• Case studies/good practice
• Template for collecting individual case studies
and consent forms
• Summary Papers
The Facts
• Obesity appears to be more common among people
with LD
• About one person in three with a LD is obese compared
to one in five of the general population
• Less than 10% of adults with LD in supported
accommodation eat a balanced diet, with an insufficient
intake of fruit and vegetables
• Carers generally have a poor knowledge about public
health recommendations on dietary intake
• People with more severe LD and people living in more
restrictive environments are at increased risk of
inactivity
National Context
•
•
•
•
•
•
•
•
•
•
•
The NHS White Paper, Equity and excellence: Liberating the NHS (2010) Healthy
Lives, Healthy People: Our strategy for public health in England (2010)
Social Care White Paper 'A vision for adult social care: Capable communities and
active citizens'
Public Health White Paper; Healthy Lives, Healthy People (2010) and the healthy
Lives Healthy People update and way forward document published in July 2011.
No Health Without Mental Health Strategy (2011)
The Quality, Innovation, Productivity and Prevention (QIPP) agenda
Commissioning for Quality and Innovation (CQUIN) payment frameworks.
Forthcoming Green Paper on Special Educational Needs and Disability
Sport England’s Grow Sustain Excel Strategy for 2008 – 2011 and the forthcoming
Sport England Strategy for 2011 – 2015.
The 2012 Olympic and Paralympic Legacy programme documented in the Coalition’s
programme for Government and the DCMS and Department of Health Business Plan.
Healthy Lives, Healthy People: A call to action on obesity in England
The 2011 update for the UK Physical Activity Guidelines
Public Health White Paper; Healthy Lives,
Healthy People (2010)
•
•
•
•
Increased priority for Public Health within Government plans
Life course approach to public health
Further document produced on obesity
PH moves to local government with a focus on wider determinants
of health
• The new Public Health Service to focus on key outcomes:
- Health protection
- Tackling wider determinants
- Health improvement – promoting the adoption of
health lifestyles
- Preventing ill health
- Healthy life expectancy
Healthy Lives, Healthy People: A call to action
on obesity in England
• National ambitions for a downward trend in excess
weight in both children and adults by 2020
• Wide ranging partnerships across the public, private and
voluntary sector that will be needed to make the ambition
a reality
• Partnership working
• Health inequalities
• Wider determinants
The LD & Obesity Framework
for Action
• For organisations in the West Midlands (and
elsewhere) to consider their role in supporting
people with LD to maintain a healthy weight
• High level challenges and actions to guide local
areas towards focussing on the needs of this
group of people
• Five priority areas
Priority Areas
1. Local Action and Delivery – Charter;
Framework for Action and
Commissioner Checklists
2. Research, data and evidence
3. Training and development
4. Case studies
1. The Charter
The Charter aims to:
• Promote and support prioritisation of the needs of
people with LD to inform effective commissioning and
delivery of specialist and community services to aid
weight management
• Strengthen commissioning processes and advise on
the standards expected of providers when delivering
services
• Aid the local prioritisation of services that maximise
opportunities for people with learning disabilities, their
carers and families to be supported to maintain a
healthy weight
The implementation of the Charter
should:
• Improve practice relating to the commissioning and
delivery of weight management and related services for
people with learning disabilities, their carers and families
• Standardise the services offered to people with learning
disabilities, their carers and families regarding weight
management
• Advise on the standards that are expected when
commissioning and delivering services to people with
learning disabilities to support them in maintaining a
healthy weight
Key Aspects
•
•
•
•
The Charter
Checklist for Commissioners
What staff can expect document
What service users can expect document
Target Audiences
Charter Element
Target Audience
People
with Family
Service
Service
Public Health, NHS,
Learning
and Friend Deliverers
– Deliverers
- Social
Care
Disabilities
Carers
Workforce
Management
Commissioners &
including paid
Contract Managers
Carers
Full Charter Document
Easy
read
Charter x
Document – “What you
can
expect
from
services”
Workforce guide to the
Charter
Commissioning Checklist
Commissioning
&
Contracting statements
(contained in the Full
Charter document)
Public
Health,
NHS, Social Care
Strategic
Management
x
x
x
x
x
x
x
x
x
x
x
2. Audit of Training
Needs in the West Midlands
Aim
•Establish the current training and personal development
needs of a range of professionals, family members and
carers in supporting and enabling individuals with learning
disabilities to eat more healthily, be more physically active
and achieve/maintain a healthy weight.
•Identified learning for future training delivery
Approach
• 15 questions asked survey monkey focusing on
i. individuals current experience and expertise in supporting
individuals with learning disabilities to make healthier
lifestyle choices;
ii. relevant training and personal development previously
undertaken; and
iii. the views and opinions of individuals supporting people
with learning disabilities as to what further resources and
support might be required in order to maximise the healthy
lifestyles support that they provide to people with learning
disabilities.
Key Findings
• Professionals would benefit from further support and
development, particularly in relation to working with
people with learning disabilities on healthy weight
• Establish a core criteria for the local delivery of training
relating to learning disabilities, healthy eating, physical
activity and weight maintenance.
3. Health Data Sets
• A review of the datasets and metrics that relate to LD
and Obesity to support the framework for action priorities
of improving data and research:
• Develop a better understanding of what is happening to
prevent/tackle obesity for people with LD
• Develop a better understanding of the healthy eating and
physical activity needs of people with LD and their carers
Health Data Sets: Recommendations
• Locally develop systems to determine the number and
type of organisations providing physical activity, healthy
eating and weight management services for people with
LD to enable gap analysis to be undertaken
• Develop effective links to the Improving Health and Lives
Learning Disability Observatory to ensure that effective
methods of data collection are shared across the country
4. Case Studies: LD and Obesity
Projects
A bank of case studies detailing projects that support people with
Learning Disabilities to become more active, eat healthily and manage
their weight can be found at
http://www.obesitywm.org.uk/panlist.aspx?id=OBESITY_GOOD_PRAC
TICE_LD
Case Studies: templates and
consent forms for individuals
Aim: To support local partners in
collating good news stories and
promoting LD and Obesity projects
and individual’s successes to provide
the “someone like me” angle
Linked to the following elements of the
Framework for Action
• Work with partners to develop an
understanding of the myths
surrounding people with learning
disabilities and develop a
campaign and related programme
to dispel these myths.
• Develop a bank of inspirational
case studies and individual stories
to advocate and raise the profile of
healthy eating and physical activity
success stories for people with
learning disabilities
How to Implement
• Using the resources provided local areas are
encouraged to determine which actions align
with their programmes of work and to
determine which additional actions could be
embedded into programmes of work within
current resources to meet the needs of people
with LD
How to embed the approach:
Legislation and Reasonable Adjustments
• Disability Discrimination Act (1995 & 2005)
• Equalities Act (2010) Disability Equality Duty
Example reasonable adjustments:
•
•
•
•
•
•
•
•
•
•
•
Larger print
Easier to understand words, pictures and symbols
Clear and easy to understand information and signs
More time to explain and listen
First or last appointments
A different place to wait for appointments
Involvement of carers/family but talking and listening to the person with learning
disabilities
Not speaking jargon or delivering complex information
Familiarisation visits and adjustments to timings where needed
Extended sessions
Adjustments in procedures
Healthy Lives, Healthy
People update and way forward (2011)
• New responsibilities for Local
Authorities include:
- Obesity and community nutrition initiatives
- Increasing levels of physical activity in the local
population
- Behavioural and lifestyle campaigns to prevent
cancer and long term conditions;
- Local initiatives to tackle social exclusion.
- Public mental health services;
PH Reforms and the Local Context
• The context for the local delivery of the programme
should be determined by local partners working on
joint priorities
- Learning Disability Partnerships
- Health & Well Being Boards
- Clinical Commissioning Groups
- Health Watch
- Scrutiny
- JSNA
- Health and Wellbeing Strategy
- Political will – elected members
PH Outcomes Framework
• A set of supporting public health indicators to help
focus understanding of progress year by year
nationally and locally on those things that matter
most to public health
• Excess weight in 4/5 and 10/11 year olds
• Excess weight in adults
• Proportion of physically active and inactive adults
• Self reported wellbeing
•
http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digita
lasset/dh_132410.pdf
Disseminating the Work
Copies of all of the West Midlands Learning Disability and Obesity
programme documents can be downloaded from
http://www.obesitywm.org.uk/panlinks.aspx?id=OBESITY_LEARNING_
DISABILITIES
• The LD and Obesity Charter, Framework for Action and associated
documents will be disseminated through the local LD Partnership
Boards, health, local government and voluntary sector networks
locally. The Framework will also be shared nationally.
• 2 summary papers have been developed to provide an overview of
the WM LD & Obesity resources and reports.
• LD Partnership health sub groups (these groups comprise of
strategic health facilitators who have created links to local Clinical
Commissioning Groups and GPs as well as linking to specialist LD
services working in the community and acute sectors) and other key
partners will be encouraged to embed the approaches documented
into the health inequalities action plans that are being developed.