Sheffield Children and Young
People’s 0-19+ Partnership
H
REPORT TO THE CHILDREN AND YOUNG PEOPLE’S
0-19+ PARTNERSHIP BOARD
MEETING TO BE HELD ON 15th July 2010
(Town Hall)
REPORT FROM:
Carol Weir
Sheffield – Let’s Change4Lfe Programme Director
NHS Sheffield
DATE: 05.07.10
SUBJECT: To update the Children and Young People's 0-19+ Partnership Board on the
progress towards sustainability of the SLC4L programme beyond March 2011.
ALREADY CONSIDERED BY:
Sheffield – Let’s Change4Life (SLC4L) Programme Board
SUMMARY:
The Sheffield - Lets Change4Life Programme is key to achieving the Childhood Obesity target
over the longer term. The commissioned Watch It community weight management service will
work with 150 families per annum, therefore, in order to achieve the target over the longer term
we need a programme of obesity prevention in the whole population. The current funding
arrangements for SLC4L end in March 2011. (For further information on the obesity activity
across Sheffield see also appendix A - Update on the Progress towards achieving the
Childhood Obesity Target and the Sheffield – Let’s Change4Life (Healthy Towns) Programme,
paper presented to NHS Sheffield Executive Team, 20 May 2010).
RECOMMENDATIONS:
1. The Children and Young People’s 0-19+ Partnership Board is asked to consider how best to
guarantee partnership activity and commitment to ensuring a sustained focus on childhood
obesity.
2. The Children and Young People’s 0-19+ Partnership Board is asked to consider how best to
guarantee partnership activity and commitment to ensuring sustainability of the effective
Sheffield – Let’s Change4Life programme activities so obesity prevention, through delivery
of Sheffield – Let’s Change4Life, becomes and remains a local priority.
3. The Children and Young People’s 0-19+ Partnership Board is asked to: consider the
recommended actions, support these recommendations, and, to agree a plan to move this
activity forward towards sustainability.
4. All partners are asked to consider how this agenda can be embedded in their own strategic
development to ensure obesity becomes everybody’s business.
BACKGROUND PAPERS: Appendix A (attached)
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Executive Summary
Purpose: To update the Children and Young People's 0-19+ Partnership Board on the progress
towards sustainability of the SLC4L programme beyond March 2011.
Key Message: The Sheffield - Lets Change4Life Programme is key to achieving the Childhood
Obesity target over the longer term. The commissioned Watch It community weight
management service will work with 150 families per annum, therefore, in order to achieve the
target over the longer term we need a programme of obesity prevention in the whole population.
The current funding arrangements for SLC4L end in March 2011. (For further information on the
obesity activity across Sheffield see also appendix A - Update on the Progress towards
achieving the Childhood Obesity Target and the Sheffield – Let’s Change4Life (Healthy Towns)
Programme, paper presented to NHS Sheffield Executive Team, 20 May 2010).
Recommendations
1. The Children and Young People’s 0-19+ Partnership Board is asked to consider how
best to guarantee partnership activity and commitment to ensuring a sustained focus
on childhood obesity.
2. The Children and Young People’s 0-19+ Partnership Board is asked to consider how
best to guarantee partnership activity and commitment to ensuring sustainability of
the effective Sheffield – Let’s Change4Life programme activities so obesity
prevention, through delivery of Sheffield – Let’s Change4Life, becomes and remains a
local priority.
3. The Children and Young People’s 0-19+ Partnership Board is asked to: consider the
recommended actions, support these recommendations, and, to agree a plan to move
this activity forward towards sustainability.
4. All partners are asked to consider how this agenda can be embedded in their own
strategic development to ensure obesity becomes everybody’s business.
Background
The Sheffield-Let’s Change4Life Programme is an ambitious initiative which aims to prevent
obesity in children, young people and families through shifting attitudes and culture in the city at
all levels and by delivering a range of universal and targeted prevention activities which focus
on individuals, families, children’s centres, schools and communities across Sheffield. The
activities are underpinned by a social marketing campaign linked to Change4Life and a citywide
drive to engage third and independent sector partners in this agenda, to make the prevention of
obesity in our city everybody’s business. The headline target is to achieve:

NHS Vital Sign and public Service Agreement targets (childhood obesity in YrR & Yr6),

Local Area Agreement LAA targets - NI 55 & 56 (Childhood Obesity) and NI 53 (Increase
the prevalence of breastfeeding at 6 - 8 weeks to 52.7% by 2010/11).
Levels of Childhood Obesity & National Child Measurement Programme
Although levels of childhood overweight and obesity in Sheffield are in line with the national
average, our levels have been rising more steeply than elsewhere or the national average and if
we follow this trajectory the problem in Sheffield will move from our previous performance of
better than the national average to being significantly worse than elsewhere.
For academic year 2008/09, 18.7% (932) of Y6 children are recorded as being obese, this is
above the LAA target level of 15.1% (748). This is an additional 184 obese Y6 children above
the expected figure. The prevalence of childhood obesity has risen 3.9% from the 2006/07
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baseline (14.8%). For academic year 2009/10 we are working towards an ambitious LAA target
of 15.1%.
We may be unable to halt the rise in childhood obesity, therefore not achieving the target
because: the 15.1% LAA target was set before there was an accurate baseline, and our
attempts to re-negotiate the target with Government Office have been unsuccessful. We will not
achieve the 15.1% target, although our obesity levels compare well to other authorities and our
coverage is better. The predicted coverage for this year is expected to be much higher than
ever before reaching 93% of YR children and 97% of Y6 (last year’s performance was 92.5% in
YR and 88.7% in Y6). Anecdotally, we know it is the more overweight and obese children who
are opted out of the programme and therefore the more children we weigh the more likely our
prevalence figure will increase.
Sustaining the SLC4L programme beyond March 2011
The SLC4L programme is now in its final year when the focus needs to shift from delivery to
addressing the sustainability of this innovative programme of activities. A paper regarding
sustainability of the programme was discussed at Executive Team and Executive Management
Team in January 2010. Their recommendation was to hold an event with the senior leadership
across the city to discuss sustainability options. The event was held on 29.04.10. Unfortunately,
many of the senior leadership were not in attendance and therefore sustainability still requires
discussion at a senior level. As well as updating the Children and Young People’s 0-19+
Partnership Board this paper asks the Board to consider sustainability of SLC4L.
By continuing to support the effective activities within this pioneering programme, both SCC and
NHSS will be helping to address the health, economic and social burden of overweight and
obesity across Sheffield, in both the short and longer-term. Embedding the programme will
ensure these activities are ‘core business’ for Sheffield City Council, NHS Sheffield and
partners.
Sustainability of the SLC4L programme will contribute to achieving the following benefits:
a. Maintaining a strategic and collective focus on obesity prevention, not just activity but activity
as part of a programme with a vision to achieve change, recognising that the value of the
SLC4L programme as a whole is greater than the sum of its parts.
b. The unique breadth and depth partnership formed during the delivery of SLC4L will be
crucial to addressing overweight and obesity across the city now and in the future by
ensuring positive change is achieved in terms of attitudes and awareness amongst the City’s
key decision makers.
c. Achieving success in preventing overweight and obesity through the SLC4L activities and
subsequent achievement of PSA, Vital Sign and LAA targets, as well as actioning the
recommendations of the Marmot Review on Health Inequalities (2010) (see diagram below
mapping SLC4L activities to the Marmot recommendations).
d. Increasing public and professional awareness and recognition of obesity.
e. Leave a legacy by investing in capital projects such as play facilities and green spaces.
f. Building staff capacity through training.
g. Building community capacity through Introduction to Community Health and Development
training, Community Health Champions, Breastfeeding Peer Support, Living Street Audits,
Public and Family Obesity Awareness Raising.
h. Ensuring the continued development of city wide multisectoral strategies promoting obesity
prevention.
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Sheffield Children and Young
People’s 0-19+ Partnership
i.
j.
Ensuring development of, and improvements to, citywide strategies, policies and procedures
which will promote healthy living, including urban planning, infant feeding, environmental and
green space strategies and parenting.
Sheffield to be recognised as leading the way in obesity prevention and treatment through
continued shared learning and good practice locally, regionally, nationally and
internationally.
We need to ensure that sustainability of effective interventions is through a process whereby all
partners examine how they can embed the successful activities into their core business, through
resource redirection or service redesign. Without partnership commitment to sustainability the
opportunity to ensure everyone in Sheffield is supported to be a healthy weight and has a
healthier future will be lost.
Sustainability – Evaluation Findings
An independent evaluation of SLC4L is being undertaken by Sheffield Hallam University. This
supports the programme’s internal assessment. The aim is to determine how to best support
children and families living in Sheffield to choose healthier lifestyles.
Evaluation to date suggests sustainability should be considered in two forms:
1) Sustaining an environment which facilitates and maintains behavioural change,
2) Allocating funding/redirecting current resource to projects demonstrating change in target
populations.
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It will be useful to refer to the SLC4L Strategy Map when considering the sustainability of a
particular activity. In terms of sustainability the following could be considered:

Identify how well it has contributed (or is likely to contribute) to the outcome measures at
the top two levels of the strategy map.

It may be that due to timescale there is limited impact on these outcome measures.
However, if it leads people to have a greater desire to adopt a healthy lifestyle, improve people's
attitudes (e.g. to breastfeeding), increasing people's confidence in their ability to change, and/or
overcoming barriers for change, the activity may be seen as successful.

We also need to consider the impact and effectiveness of activities on obesity outcomes
when deciding to sustain as part of this programme.
strategy map
Leadership from programme board
Draft: 22/03/2010
The SLC4L Board have examined the early evaluation findings and outcome and impact
measures when discussing the range of sustainability options available. These SLC4L Board
discussions have been summarised into the recommended sustainability actions as outlined
below.
Sustainability Recommendations
The SLC4L Board have discussed the programme, its successes, and options for sustainability
and recommend the following actions outlined below. The recommendations can be categorised
as follows:
a. Activities requiring mainstreaming, funding/resource redirection,
b. Activities concluded/embedded but requiring support to continue to deliver benefit,
c. Activities which have been concluded or embedded and do not require further
funding/resource,
d. Activities not requiring further obesity funding due to lack of impact but requiring wider
discussion.
N.B. This paper does not discuss all the outputs and outcomes and achievements as these
have already been discussed at SLC4L Board and in papers previously sent to this Board.
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Sheffield Children and Young
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Summary of Recommendations (outlined in detail below)
Activities requiring mainstreaming,
funding/ resource redirection
SLC4L Programme
Breastfeeding Peer Support
Healthy Early Years Scheme
Food Plan
Training & Awareness Raising
Service
Healthy Choices Award
Living Neighbourhoods
Healthy Business Coordinator
Healthy Urban Planner
Activities which have been
concluded or embedded and do
not require further funding/
resource
Schools
Healthy Open Spaces
Activities which have been
concluded or embedded and do not
require further funding/ resource
Social Marketing
ACTION RECOMMENDED
Partnership supported to continue.
Delivery integrated with all obesity activity across the
city.
Continue a more targeted service funded through joint
commissioning arrangements.
Embedded within Early Years through joint
commissioning arrangements or resource
reprioritisation.
SCC to embed roles and responsibilities for delivery
within existing post or fund delivery post.
NHSS to continue to commission as part of the Tier 1
Weight Management Service.
Sustain the project as a social enterprise, delivered by
Sheffield Wildlife Trust – feasibility study being
undertaken
SCC to embed roles and responsibilities within existing
post AND Community Assemblies to support delivery.
Roles and responsibilities of this post be embedded
within a current post in Sheffield Chamber of
Commerce & Industry.
SCC to embed roles and responsibilities within existing
post or fund Healthy Urban Planner post.
ACTIION RECOMMENDED
No more funding but the pump primed activities must be
sustained through the schools, supported by the
Healthy Schools Team.
Schools to prioritise obesity within their plans.
No further funding required. The community garden will
become self managed with support from SCC.
The learning from the play sites will influence future
play provision decisions across the city.
ACTIION RECOMMENDED
No further funding required. The interventions are
sustainable as they will be routed in service changes
bringing about behavioural changes.
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Activities not requiring further
obesity funding due to lack of
impact but requiring wider
discussion
Introduction to Community
Development and Health
Community Health Champions
ACTION RECOMMENDED
Difficult to assess the impact on obesity. If funding to
continue, wider discussion to be had as to where
funding could be sourced from, given the outcomes of
the programme.
Difficult to assess the impact on obesity. If funding to
continue, wider discussion to be had as to where
funding could be sourced from, given the outcomes of
the programme.
Sustainability Recommendations (in detail)
ACTIVITIES REQUIRING MAINSTREAMING, FUNDING/RESOURCE REDIRECTION
1. Sheffield – Let’s Change4Life Programme and Partnership
a. This programme has been recognised as a model of good practice across the region and
nationally, with the programme director invited to regional, national and international
conferences to present on the prevention activities in Sheffield. These prevention activities will
be how Sheffield can reverse the rising tide of overweight and obesity in the population in the
medium and longer term.
ACTION RECOMMENDED: The SLC4L Board recommend that the unique SLC4L partnership
continue to address obesity prevention across the city. THE SLC4L Board ask that this
recommendation be supported and the strategic partners across the city sign up to the SLC4L
Programme, brand and actions to ensure sustained visibility and partnership working to ensure
obesity is everybody’s business.
ACTION RECOMMENDED: Delivery of the programme as a whole to be integrated with the
delivery of the obesity treatment programmes across the city. This will ensure joined up action
to both prevent and treat obesity. The SLC4L programme director has been undertaking this
role since February 2010 and will continue until the end of the funding for the post in March
2011(see model below). NHSS to seek sponsorship for the SLC4L programme director post half
time and fund a half time post to deliver the obesity programme from within current resource.
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Examples of/
types of
services
PROPOSED SHEFFIELD OBESITY
MODEL
Healthy Weight, Healthy Lives
Primary,
Secondary care,
Residential
Community
Camps,
Bariatric surgery Services, Social
Services
Multidisciplinary
Team Service
Watch It,
MEND
SHINE
GP,
Health Visitor,
School Nurse
CHILDREN
TIER 3
Highly
Specialist
Services
Primary,
Secondary care,
Community
Services, Social
Services
TIER 2
Specialist MDT Services
TIER 1
Community Weight Management
TIER 0
Advice from Front line Services
Whole Population Prevention Activity
Sheffield – Let’s Change4Life
Examples of/
types of
services
Bariatric
Surgery
Multidisciplinary
Team Service
Adult
Community
Weight
Management
GP,
Leisure Services,
Pharmacy
over the
counter
options
via
Pharmacists,
financial
incentive
programmes,
on-line diets/
Support,
Commercial
Slimming
Organisations
ADULTS
2. Breastfeeding Peer Support and Healthy Early Years Scheme.
a. The Breastfeeding Peer Support Service offers a comprehensive service to all pregnant
women and new Mums in Sheffield. A core and enhanced offer is provided by workers in every
Children’s Centre across the city as well as at Jessop Wing. This includes antenatal information
to encourage women to consider breast feeding as an option once their baby is born and
support to help establish and maintain breastfeeding once the baby is born. New Mums are
contacted within 48 hours of discharge from the maternity unit (or a home birth) and offered
appropriate information and support including a home visit and breastfeeding groups to support
women to breast feed for longer.
In 2009/10 we achieved our Vital Sign and LAA target for breastfeeding at 6-8 weeks 50.9%
(target 50.7%), the highest within Yorkshire & Humber. This increase can be attributed to the
Peer Support Service across the city.
ACTION RECOMMENDED: This service is currently funded through SLC4L (£500K) and the
Sure Start Grant (£400K). We recommend continuing a more targeted service across the social
gradient as opposed to a universal Peer Support Service commissioned jointly across NHSS
and SCC through resource reprioritisation. (NB Sure Start Grant also to continue approx £400K).
No impact will result as the Service will continue as currently established. We would hope to
have this completed by December 2010 to ensure continuity of service and achieve our NI 53
LAA Target for 6-8 weeks breastfeeding in 2010/11 of 52.7%.
b. The Healthy Early Years Scheme (HEY) is an accreditation scheme which is recognised as
assuring quality, health early year’s settings. The programme will ensure that Early Years
settings can demonstrate to Ofsted, and their clients, their investment in health. It will enable
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parents to know which settings are providing a healthy setting for their children and will be
encouraged to look for this quality mark when choosing their childcare provider. HEY’s will also
deliver the ‘Being Healthy’ section recommendations of the Every Child Matters: Change for
Children (2004).
ACTION RECOMMENDED: Once the programme is embedded into early years this role could
be amalgamated into an already existing role. It would need to be supplemented by project
support, possibly 0.5 wte (£10,000, and a small budget for resources would be required.
(£5,000) Training of staff should have happened where required but this needs to be ongoing
within mainstream services.
Funding could/should be identified through inclusive learning service (SCC) as it impacts on the
quality within early years settings. Sustainability after March 2011 will ensure that all settings in
Sheffield will have the opportunity to undertake the award and receive accreditation. We
recommend that this service be commissioned jointly across NHSS and SCC through resource
reprioritisation to ensure best value from early years provision.
3. Food Plan
The Food Plan project is currently being delivered from the Council’s Health Improvement
Team. Having a full time project officer funded post 2011 will mean the Food Plan is more likely
to achieve its longer term outcomes. The Food Plan aims to be ‘recession proof’, and many of
the actions involve mainstreaming and using existing resources differently. Delivery of the Food
Plan for the city will be key to the local wellbeing agenda.
ACTION RECOMMENDED: SCC to fund the delivery post to drive forward the actions of the
plan - approx £40K pa. Discussions will need to be had within SCC to move this forward, as to
date SCC discussions have led to the conclusion that SCC do not feel they have the resource to
undertake this. NHSS Health Improvement Practitioner (lead for Food & Nutrition) could support
this post and delivery of the food plan.
4. Obesity Training & Awareness Raising Service
Evidence shows that parents and professionals struggle to accurately assess overweight and
obesity in children. Consultation across Sheffield confirmed these findings and indicated a huge
demand for training for professionals and awareness raising for the public. Building collective
responsibility with workforces to tackle the issue cross sector may reduce NHS spend and
increasing awareness of services currently available may make for more effective use of
resources as the current children’s community weight management service is not delivering to
capacity.
To achieve sustainable behaviour change and a cultural shift within the population, general
awareness raising needs to be sustained.
ACTION RECOMMENDED: Continue funding a level of activity, depending on level of funding
available. Funding required:
 Professional Training Development: Full Day: £130 - £150/person, 1 hour: £50 £80/person
 Public Sessions:1 hour: £50- £80 per person
 Public Open Display Events: £4,000 for an audience of 1,000
 Workplace health sessions to be offered through the Sheffield Chamber of Commerce.
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Public awareness raising will seek to stimulate the market and demand for services. NHSS to
continue to commission this service as part of the Tier 1 Weight Management Service to be
commissioned this year.
5. Healthy Choices Award
The Healthy Choices Award is an award for restaurants across the city ensuring – healthy
options are promoted, establishments are breastfeeding friendly, where possible fair-trade
products promoted and food locally sourced. This award is delivered by the Sheffield Wildlife
Trust.
ACTION RECOMMENDED: Sustain the project as a social enterprise whereby businesses and
possibly suppliers would pay to be members of the scheme. The costs of such a membership
would need to be calculated on the basis of the added value that an organisation would gain
from the scheme including increased advertising, business support and promotional materials. It
would also potentially need to be assessed in terms of size or turnover of the businesses.
This is all speculative; however a feasibility study has been instigated to understand whether or
not this is a viable option.
6. Living Neighbourhoods
6a. Street Audits
The aim of Street Audits is to bring the streets back to life and make walking and cycling the
most natural options for travel, reconnecting people with their local communities to identify the
perceived and actual barriers to walking, cycling, access and use of green and open spaces
and active play.
ACTION RECOMMENDED: All 11 areas which have received the audit training will continue to
use the audit tool to re audit, and, through the process of cascade training involve new
members of their community each time.
Community assemblies represent a number of areas; much wider than the small communities
we have been able to work with. It is hoped that they will recognise the benefits of the audit
work (this is a validated way of identifying need in an area and should help with bidding
processes) and will encourage the people who have taken part to assist other community
groups in using the audit tool.
There would be no additional cost, however, support would be required from Community
Assemblies to facilitate this and discussions need to be had at this level to gain support.
6b. Walking Maps
10 walking maps have been developed to identify accessible walking routes and encourage
more adults, children and young people to walk to school, university or work rather than drive or
be driven.
ACTION RECOMMENDED: Sheffield City Council employed a Travel Plan Officer who has
been instrumental in the development of these maps. We would recommend mainstreaming this
post or embedding the roles and responsibilities of this within an existing post. Discussions will
need to be had with SCC regarding the feasibility of sustaining this.
6c. Schools Travel 4 Life
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This programme aims to encourage schools to adopt a consistent approach to active travel,
encourage parents and children to consider the alternative options to car use (particularly for
short journeys), and, to encourage children to be active for life.
ACTION RECOMMENDED: Schools who have already been involved with the work are being
encouraged to timetable the programme into the school calendar as part of Healthy Schools/
Travel Plan work. There are resources available that can be used for subsequent years, to
support this, at no additional cost. If there is no additional funding available, the school travel
officers would continue to go into schools and disseminate the information and provide a
reduced programme of activities, whilst encouraging schools to consider investing in the total
programme.
Community Assemblies should embrace this work as it is a validated way of identifying need,
takes into account the people’s voice and gives ownership to the community, who have an
interest in sustaining the improvements. Support would be required from Community
Assemblies to facilitate this and discussions need to be had at this level to gain support.
6d. Bike It
This project, promoting cycling in schools, is lead by the Bike It officer within the first year, but
then progressively the organisation and coordination becomes the responsibility of the school;
though the connection between the school and the Bike It officer is still maintained. This can
also be assisted by the Bike It School mark; an accredited scheme that the school can follow
over a three year period, ensuring that even after Bike It has left the school, the legacy of a
culture of cycling is sustained.
ACTION RECOMMENDED: One of the Community Assemblies (North East) has agreed to
contribute towards Bike It in return for intensifying the project in their area. The aim is to make
a presentation to all Community Assembly managers and chairpersons, with a view to seeking a
contribution to expand the Bike It project. Discussions will need to take place with SCC and
Community Assemblies to gain support for this option.
7. Healthy Business Coordinator
The role of the Healthy Business Co-ordinator is to raise awareness of Sheffield Let’s
Change4Life in the business community and identify opportunities where the private sector can
contribute to reducing obesity levels. The role has also developed the Healthy Business
Champion model where business identify how to ‘Healthy Employers’ and receive support to
implement changes. So far, 8 of the large companies across Sheffield, employing between the
over 3000 people, have signed up and are not only Healthy Business Champions but sharing
good practice business to business.
ACTION RECOMMENDED: A current NHSS or SCC employee could be seconded into the
Sheffield Chamber of Commerce and Industry (SCCI) for a day a week to raise the awareness
of opportunities and NHS/SCC services across the members and non-members. This could be
cost-effective if NHS/SCC can identify capacity.
A more costly option would be to implement a full ‘Healthy Business Package’ a full-time
position that works between NHS Sheffield, Sheffield City Council and Sheffield Chamber,
including a full training programme for local HR professionals delivered directly into those
businesses who can really benefit from healthier practices.
The preferred option would be that the roles and responsibilities of this post be embedded
within a current post in SCCI. SCCI have discussed this and feel there is neither funding nor
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opportunity to embed this role within a current post. Further discussions to be had across SCC,
NHSS and SCCI to progress this.
NHSS and SCC should also sign up to this model to be leading the way in the city and be
exemplars.
8. Healthy Urban Planner
The Healthy Urban Planner element of the programme focuses on making sure that health is an
integral part of planning policies and planning decision making. SLC4L funding has enabled the
creation of a full time post with a specialist health remit within Planning.
ACTION RECOMMENDED: The preferred option would be that the roles and responsibilities of
this post be embedded within a current post in SCC (approx £55K pa). SCC have discussed this
and there is neither funding nor opportunity to embed this role within a current post. Further
discussions to be had within SCC to progress this option.
ACTIVITIES CONCLUDED/EMBEDDED BUT REQUIRING SUPPORT TO CONTINUE TO
DELIVER BENEFIT
9. Schools
The SLC4L schools at the heart of healthy communities strand, is delivered through the Healthy
Schools Programme across SCC and NHSS, supporting schools to prevent obesity in children
and young people through a whole school approach.
At the April SLC4L Summit, the Quizdom Evaluation which was carried out overwhelmingly
identified professional’s views that the Schools Strand should be sustained and it was
recognised as one of the delivery strands which makes significant impact.
The activities offered in schools across the city include:
Cooking, Growing, Activities to increase school meal uptake, Free Fruit in Yr7, Stay on Site
Policy in Secondary Schools, School Nutrition Action Groups, Young People's food and cookery
scheme, Social, Emotional and Cultural Aspects of Food Parent course, and, Promoting
Physical Activity.
There are a number of areas which will be challenging to continue without further investment.
These include:
 Cooking activities in a sustained manner rather than ad hoc and reliant on volunteers,
 School stay on site in secondary schools, which requires investment to improve the
dinning environment and stay on site opportunities,
 Free fruit for year 7.
ACTION RECOMMENDED: The funding was granted on the basis of schools indicating how
any funding/activities could be sustained. We would recommend there be no more funding but
the pump primed activities sustained through the schools, supported by the Healthy Schools
Team. Due to the success of stay on site, a guide to promoting stay on site in secondary schools
should be produced to share learning across schools that will not benefit from the funding to
demonstrate how to implement these activities with little or no funding, although some schools
may be able to identify their own funding for this.
THE SLC4L Board would also recommend schools prioritise obesity and the actions to address
it within their plans, recognising the impact obesity can have not just on the physical health of
young people, but on the psychosocial elements of their wellbeing, such as educational
attainment, bullying, self esteem and truancy.
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10. Healthy Open Spaces
a. The Sheffield Family Community Garden aims to engage families in improving their health
through growing their own food and being physically active through gardening.
ACTION RECOMMENDED: No further funding required. The aim is that the community garden
will become self managed with a committee of local people taking ownership of running this site.
SCC Parks and Countryside will need to continue working towards support for this option.
10b. Active Play
The long term effect of this strand is to increase opportunities for children and families to enjoy
safe active and healthy recreation in our parks and open spaces through natural landforms and
inclusive and accessible play equipment. The outcome will be a 20% increase in the proportion
of Sheffield’s parks and green spaces that offer high quality opportunities for safe and active
play for children and families.
ACTION RECOMMENDED: No further investment required. The capital works that have been
carried out through this work will remain beyond the life of the project with maintenance of sites
being incorporated into existing Parks and Countryside budgets. The learning that has been
gained from delivering these new spaces and the outcome of the evaluation will guide us in the
future when deciding on the most appropriate play equipment to install in Sheffield’s parks.
There is still work to do to improve more play sites across Sheffield to improve the offer to
children young people and their families. Funding for this work could come from a variety of
sources which could include planning gain and national funds.
ACTIVITIES CONCLUDED
FUNDING/RESOURCE
OR
EMBEDDED
–
NOT
REQUIRING
FURTHER
11. Social Marketing
The social marketing strand is about supporting the other activities to deliver social marketing
work.
ACTION RECOMMENDED: No further funding required. The interventions are sustainable as
they will be routed in service changes bringing about behavioural changes.
ACTIVITES NOT REQUIRING FURTHER OBESITY FUNDING BUT REQUIRING WIDER
DISCUSSION
12. Introduction to Community Development & Health Course (ICDH)
This course offers individuals the knowledge and skills to take control of the factors affecting
their health and wellbeing and to make effective change in their community. Learners gain an
accreditation that can enable entry to further/higher education, training and employment.
ACTION RECOMMENDED: It has been difficult to assess the impact of this programme on
obesity and especially childhood obesity, therefore although the programme offers health,
education and employment benefits/opportunities, if funding to continue, a wider discussion will
need to be had as to where funding could be sourced from, given the outcomes of the
programme.
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13. Community Health Champions
The Community Health Champions programme engages and empowers people in Sheffield’s
least healthy communities, to make lifestyle changes around healthy eating and physical activity,
and improve mental wellbeing. By March 2011 240 volunteers will have been recruited working
with over 3600 people. £150,000 each year is needed to continue. This will pay for the
recruitment of 75 CHCs per year who will support more than 1000 people to lead healthier lives
(£150/year/person benefiting).
ACTION RECOMMENDED: It has been difficult to assess the impact of this programme on
obesity and especially childhood obesity, therefore although the programme offers health,
education and employment benefits/opportunities, if funding to continue, a wider discussion will
need to be had as to where funding could be sourced from, given the outcomes of the
programme.
Conclusion
Continued support from NHS Sheffield and Sheffield City Council will help to address the health,
economic and social burden of overweight and obesity across Sheffield, in both the short and
longer-term. We want everyone across Sheffield to be involved to ensure that by 2012
overweight and obesity levels in the city are falling and that Sheffield becomes internationally
recognised as leading the way in preventing obesity.
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Sheffield Children and Young
People’s 0-19+ Partnership
Appendix A
Childhood Obesity:
Update on the Progress towards achieving the Childhood Obesity Target and the Sheffield –
Let’s Change4Life (Healthy Towns) Programme
Executive Team Meeting
20 May 2010
Lead Director: Jeremy Wight, Joint Director of Public Health
Paper prepared by: Carol Weir, Sheffield – Let’s Change4Life Programme Director
On behalf of: Sheffield Let’s Change4Life Board
Date: 18th May 2010
Approved by: Jeremy Wight, Joint Director of Public Health
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Executive Summary
Purpose: To update the Executive Team on the progress towards meeting the childhood
obesity target locally and the progress of the Sheffield – Let’s Change4Life Programme.
Key Messages:
a. Primary Care Trusts are expected to weigh and measure all children in Reception Year
(age 4-5) and Year 6 (age 10-11) as part of the National Child Measurement Programme
(NCMP). The weighing and measurement programme is within the academic year SeptJuly with the measurement undertaken Easter until end of summer term. The reporting of
results for 2010-11 will be in December 2010 with measurement undertaken between
Easter and July 2010. Therefore we may be unable to achieve this year’s target as we
are weighing and measuring children now for this years programme and therefore it is
the activity that has already occurred and is on going that will impact on their weight
status. However, activity is on going to ensure these targets are met for future years.
b. For academic year 2008/09, 18.7% (932) of Yr 6 children are recorded as being obese;
this is above the LAA target level of 15.1% (748). This is an additional 184 obese Y6
children above the expected figure. The prevalence of childhood obesity has risen 3.9%
from the 2006/07 baseline (14.8%). For 2009/10 we are working towards an ambitious
LAA target of 15.1%, however, the vital sign target is 18.0% (to be confirmed by
Performance).
c. We may be unable to meet the 87%+ coverage targets because: children may be opted
out by parents, children in Yr 6 opting themselves out, potential difficulties implementing
the new DH data collection and feedback tool and aligning this with the School Nursing
QSM system, and issues with accurate school level data on school entrants. Anecdotally,
it is the more obese children who are opted out, if they are not encouraged to be weighed
and measured we are unlikely to meet the coverage target, however, as coverage
increases, increasing rates of obesity will be identified.
d. We may be unable to halt the rise in childhood obesity, therefore not achieving the target
because: the 15.1% LAA target was set before there was an accurate baseline, and our
attempts to re-negotiate the target with Government Office have been unsuccessful. We
will not achieve the 15.1% target, although our obesity levels compare well to other
authorities and our coverage is better.
 Key Actions
i) The NHS Sheffield WATCH IT Childhood Obesity Family Intervention Programme is now
mobilised but is underutilised (Current activity: 78 families vs target 135) despite our best
efforts, and the current funding arrangements end in May 2011.
ii) The Sheffield - Lets Change4Life Programme is key to achieving this target over the longer
term as the Watch It service will work with 150 families per annum but in order to achieve the
target we need a programme of obesity prevention in the whole population. One element of
the SLC4L programme is looking at ways of increasing Y5 and Y6 referrals into the weight
management services available in Sheffield via obesity awareness raising activity with parents
and professionals across the city, as well as targeted interventions with these age groups. The
current funding arrangements for SLC4L end in March 2011.
iii) The obesity prevalence task group is to be re-established to identify and drive a
comprehensive action plan of activity to support delivery of the target.
Recommendations
1. The Executive Team (ET) is asked to consider how best to guarantee partnership
activity and commitment to ensuring a sustained focus on childhood obesity.
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2. The Executive Team (ET) is asked to consider how best to guarantee partnership
activity and commitment to ensuring sustainability of the SLC4L programme so
obesity prevention becomes and remains a local priority.
3. The Executive Team (ET) is asked to consider how we can work together to ensure
we achieve the Childhood Obesity Performance Target.
4. All partners are asked to consider how this agenda can be embedded in their own
strategic development to ensure obesity becomes everybody’s business.
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People’s 0-19+ Partnership
1. Background & Context
1.1 Obesity
Obesity is one of our most important long term health challenges. If we fail to reverse the rising
tide of overweight and obesity, by 2050 at least 50% of the local adult population will be
classified as obese with as many as two thirds of children and nine tenths of adults being
classified as overweight and obese. The consequences for the population of Sheffield’s long
term health, and the burden of increasing ill health and disease on the NHS and Local Authority,
are extreme.
It is likely that within a few years being overweight or obese will overtake smoking as the major
cause of preventable ill health. Obesity is an important risk factor for many chronic diseases,
including heart disease, stroke, osteoarthritis, back pain and some cancers. It is a major cause
of Type 2 diabetes, and the psychological and social burden of obesity can be significant. Social
stigma, low self-esteem and a generally poorer quality of life are common experiences for many
obese people. Those with a Body Mass Index (BMI) greater than 30 (obese) can expect to die 9
years earlier than those with a BMI of under 25 (healthy weight), independent of smoking status
or gender.
Recent surveys indicate that almost 60% of all adults are either overweight or obese and
around one in four children in Reception Year (aged 4 and 5 years) are overweight or obese,
rising to one in three in Year 6 (aged 10 and 11). Obese children are more likely to become
obese adults, and children of obese adults are significantly more likely to become obese –
creating the potential for an upward spiral in levels of obesity.
Being overweight can also cause psychological stress. Teasing and bullying about appearance
can affect a child’s confidence and self esteem; it can lead to isolation and depression which
can in turn impact on their school attendance and attainment levels.
1.2 Childhood Obesity Prevalence Target (LAA NI 56a)
High Risk Action Plan available
Target Description: The Public Service Agreement (PSA 12) target is ‘to reduce the rate of
increase in obesity among children under 11 as a first step towards a long term national
ambition by 2020 to reduce the proportion of overweight and obese children to 2000 levels in
the context of tackling obesity across the population.’
Primary Care Trusts are expected to weigh and measure all children in Reception Year (age 45) and Year 6 (age 10-11) as part of the National Child Measurement Programme (NCMP).
The weighing and measurement programme is within the academic year Sept-July with the
measurement undertaken Easter until end of summer term. The reporting of results for 2010-11
will be in December 2010 with measurement undertaken between Easter and July 2010.
Target Definition: Percentage of primary school age children in Year 6 with height and weight
recorded (NI 56a). Percentage of primary school age children in Year 6 who are obese, with
height and weight recorded (NI 56b).
Good performance
• A minimum of 88% coverage of pupils being measured and a halt or reduction in the number
of obese and overweight children (Vital Sign 18%, Local Area Agreement target 15.1%).
Table 1. Current performance:
Sheffield
Reception Year
2005-06
Coverage
% of children overweight 9.31
% of children obese
6.64
Sheffield
2006-07
81%
9.7
6.9
Sheffield
2007-08
90.8%
12.0
8.1
Sheffield
2008-09
92.5%
13.0
9.0
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Year 6
Coverage
% children overweight
%children obese
2005-06
12.64
16.13
2006-07
82%
12.5
14.8
2007-08
89.1%
13.2
17.5
2008-09
88.7%
13.0
18.7
For academic year 2008/09, 18.7% (932 children) of Yr 6 children are recorded as being obese; this is
above the LAA target level of 15% (748 children). This is an additional 184 obese Y6 children above the
expected figure. The prevalence of childhood obesity has risen 3.9% from the 2006/07 baseline (14.8%).
For 2009/10 we are working towards an ambitious LAA target of 15.1%, however, the vital sign target is
18.0% (to be confirmed by Performance).
Progress towards LAA target of limiting rise in obesity to 15.1% by
academic year 2009/10
25
19.1
19.1
18.5
20
18.7
16.1
17.5
18.3
18.3
17.4
15
14.9
15
15.1
14.8
10
5
0
% Obesity
2005/6
2006/7
2007/8
2008/9
2009/10
Academ ic Year
Sheffield
National Average
Statistical Neighbours
LAA Target
1.21 Risk to achievement of Targets
We may be unable to meet the 87%+ coverage targets because:
 Children may be opted out by parents or in Yr 6 opt themselves out.
 Potential difficulties implementing the new DH data collection and feedback tool and
aligning this with the School Nursing QSM system.
Although Sheffield performs well in comparison to the rest of Yorkshire & Humber, the national
average, and, our statistical neighbours, we have seen a sharp increase. We may be unable to
halt the rise in childhood obesity, therefore not achieving the 15.1% (LAA) and 18% (Vital Sign)
target because:
 The LAA target was set before there was an accurate baseline, and our attempts to renegotiate the target with Government Office have been unsuccessful. We will not achieve
the target, although our obesity levels compare well to other authorities and our coverage
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



is better. The investment made and the streams of work under the SLC4L programme
are expected to show their impact in the longer term.
The weighing and measuring takes place from Easter until last day of term in July. We
are weighing and measuring children now for this years programme and therefore it is
the activity that has already occurred and is on going that will impact on their weight
status. However, activity is on going to ensure these targets are met for future years.
As coverage increases, increasing rates of obesity will be identified.
Anecdotally, it is the more obese children who are opted out; if they are not encouraged
to be weighed and measured we are unlikely to meet the target.
The WATCH IT Childhood Obesity Family Intervention Programme is now mobilised but
is underutilised (Current activity: 78 families vs target 135). The current funding
arrangements end in May 2011.
1.22 Key Actions
There is a significant risk that this target will not be met. A table of actions that will address childhood
obesity in the short, medium and longer term is below. The key points to note are:
1. The Sheffield Watch It Programme has been commissioned to support overweight and obese children
(7-14 year olds). Recruitment and engagement of families is challenging given the sensitivity of the
issue. Last year over 1000 letters were sent to families regarding their child’s weight status and Watch It
offered, however, only 15 families contacted the service.
2. The Sheffield - Lets Change4Life Programme is key to achieving this target over the longer term as
the Watch It service will work with 150 families per annum but in order to achieve the target we need a
programme of obesity prevention in the whole population.
3. The obesity prevalence task group is to be re-established to drive a comprehensive action plan of
activity to support delivery of the target - High Risk Action Plan available.
4. All actions report to the Weight Management Planning and Commissioning Group.
1.3 Sheffield – Let’s Change4Life Programme (SLC4L)
The Sheffield-Let’s Change4Life Programme is an ambitious initiative which aims to prevent obesity in
children, young people and families through shifting attitudes and culture in the city at all levels and by
delivering a range of universal and targeted prevention activities which focus on individuals, families,
children’s centres, schools and communities across Sheffield. The activities are underpinned by a social
marketing campaign linked to Change4Life and a citywide drive to engage third and independent sector
partners in this agenda, to make the prevention of obesity in our city everybody’s business.
In November 2008 Sheffield City Council (SCC) and NHS Sheffield (NHSS) were awarded
nearly £5m from Department of Health (DH) Cross Government Obesity Unit and NHSS and
SCC identified match funding, taking the total programme value locally to £9,626,022. The
programme commenced in April 2009, with funding ending in March 2011.
The programme has 8 key areas: breastfeeding, healthy urban planning, green space usage,
early years initiatives, school activity and cross sector innovation to ensure that by 2012 the
obesity rates in Sheffield will be falling.
The headline target is to achieve:
 Vital Sign and Public Service Agreement targets (childhood obesity in YR and Y6),
 Local Area Agreement LAA targets - NI 55 & 56 (Halt the rise in childhood obesity by 2011)
and NI 53 (Increase the prevalence of breastfeeding at 6 - 8 weeks to 52.7% by 2010/11).
1.31 Sustaining the SLC4L programme beyond March 2011
The SLC4L programme is now in its final year when the focus needs to shift from delivery to
addressing the sustainability of this innovative programme of activities. A paper regarding
sustainability of the programme was discussed at Executive Team and Executive Management
Team in January 2010. Their recommendation was to hold an event with the senior leadership
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across the city to discuss sustainability options. The event was held on 29.04.10, unfortunately,
many of the senior leadership were not in attendance and therefore sustainability still requires
discussion at a senior level. As well as updating ET this paper asks the following:


The Executive Team to consider how best to guarantee partnership activity and commitment
to ensuring sustainability of SLC4L so obesity prevention becomes and remains a local
priority.
All partners to consider how this agenda can be embedded in their own strategic
development to ensure obesity becomes everybody’s business.
By continuing to support the effective activities within this pioneering programme, both
SCC and NHSS will be helping to address the health, economic and social burden of
overweight and obesity across Sheffield, in both the short and longer-term. We need to
ensure that sustainability of effective interventions is through a process whereby all
partners examine how they can embed the successful activities into their core business,
through resource redirection or service redesign. Without partnership commitment to
sustainability the opportunity to ensure everyone in Sheffield is supported to be a
healthy weight and has a healthier future will be lost.
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Sheffield Children and Young People’s 0-19+ Partnership Board
2. Short, Medium and Long term Actions to Address Childhood Obesity
Actions yet to be implemented in italics
Short Term Actions (impact on academic year 09/10 Risks and Mitigation
target)
Better recruitment of Children and Young People to the R - Underutilisation of the service – current users = 78 vs target 135.
Sheffield Watch It Community Based Weight Management M - Training & Awareness Raising now mobilised.
Intervention Programme.
R - Funding for Watch It ends May 2011.
M – plans to commission community weight management for families and adults
post 2011.
Better joint working between all providers of community R – underutilisation of all services.
weight management activity across Sheffield (SHINE, MEND, R – SHINE & MEND not funded by NHSS therefore difficult to identify how long
Watch It).
programmes will run.
R - Currently >200 families supported by other programmes pa, these could fold
at anytime due to lack of resource.
M – quarterly meetings between NHSS and all providers to foster better
partnership working.
SLC4L Training & Awareness Raising Service - Increasing R – SLC4L - short term funded, ends March 2011.
awareness among professionals and parents of overweight M – training is sustainable.
and obesity.
High Obesity Prevalence Schools identified and offered extra R – SLC4L - short term funded, ends March 2011.
support and targeted physical activity in Yr5 and Yr6 through M – training offered will be sustainable and actions targeted that can be
SLC4L (meeting to be held 16.6.10 of all heads).
sustained.
R – obesity may not continue to be seen as a priority in these schools.
M – need sustained obesity focus.
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Sheffield Children and Young People’s 0-19+ Partnership Board
Medium Term Actions (impact on academic year
10/11 target)
Better recruitment of Children and Young People to the
Sheffield Watch It Community Based Weight
Management Intervention Programme.
Risks and Mitigation
R - Funding for Watch It ends May 2011.
M – plans to commission community weight management for families
and adults post 2011.
Better joint working between all providers of community R – underutilisation of all services.
weight management activity across Sheffield (SHINE, R – SHINE & MEND not funded by NHSS therefore difficult to identify
MEND, Watch It).
how long programmes will run.
R - Currently >200 families supported by other programmes pa, these
could fold at anytime due to lack of resource.
M – quarterly meetings between NHSS and all providers to foster
better partnership working.
SLC4L Training & Awareness Raising Service - R – SLC4L - short term funded, ends March 2011.
Increasing awareness among professionals and parents M – training is sustainable.
of overweight and obesity.
High Obesity Prevalence Schools identified and offered R – SLC4L - short term funded, ends March 2011.
extra support and targeted physical activity in Yr5 and M – training offered will be sustainable and actions targeted that can
Yr6 (meeting to be held 16.6.10 of all heads)
be sustained.
R – obesity may not continue to be seen as a priority in these schools.
M – need sustained obesity focus.
SLC4L Activity within schools – cooking, growing, R – SLC4L - short term funded, ends March 2011
physical activity, stay on site, free fruit etc
M – training offered will be sustainable and actions targeted that can
be sustained.
R – obesity may not continue to be seen as a priority in these schools.
M – need sustained obesity focus.
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Sheffield Children and Young People’s 0-19+ Partnership Board
Longer term actions (impact on academic year 11/12 Risks and Mitigation
target and beyond)
SLC4L Breastfeeding Activity – Peer support in every R – SLC4L - short term funded, ends March 2011.
children’s centre, workplace and public place award, M – training offered will be sustainable and actions targeted that can
UNICEF Baby Friendly Accreditation, Training.
be sustained.
R - Peer support service will not be sustained without funding.
M – actions on going to address sustainability.
SLC4L Training & Awareness Raising Service - R – SLC4L - short term funded, ends March 2011.
Increasing awareness among professionals and parents M – training is sustainable
of overweight and obesity.
SLC4L – Healthy Early Years Activity in Childcare R – SLC4L - short term funded, ends March 2011.
Settings
M - Once the programme is embedded into early years this role could
be amalgamated into an already existing role within SCC. Needs
further discussions with SCC.
SLC4L – City wide Food Plan and Food Festival
R - SLC4L - short term funded, ends March 2011. Food Plan actions
will need to be driven forward.
M – Sustainability plan discussions ongoing, possibly SCC to embed
responsibilities within an existing post.
SLC4L Activity within schools – cooking, growing, R – SLC4L - short term funded, ends March 2011.
physical activity, stay on site, free fruit etc
M – training offered will be sustainable and actions targeted that can
be sustained.
R – obesity may not continue to be seen as a priority in these schools.
M – need sustained obesity focus.
SLC4L – Living Neighbourhoods Activity – Street R – SLC4L - short term funded, ends March 2011.
Audits, Bike It, Travel4Life and Walking Maps
M – training offered will be sustainable and actions targeted that can
be sustained.
M – more support required from Community Assemblies to sustain
activities.
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Sheffield Children and Young People’s 0-19+ Partnership Board
SLC4L – Healthy Open Spaces Activity – Play Sites and R- SLC4L - short term funded, ends March 2011.
Community Garden
M – play sites will not require further funding and community garden
will become self managed and self sustained.
SLC4L – Social Marketing activity to address
breastfeeding rates, physical activity and healthy eating
in schools, dad as positive role models for healthy
weight and preconception healthy weight.
R – SLC4L - short term funded, ends March 2011.
M –By investing in social marketing we are committing to changing
behaviours in the longer term. The interventions should be sustainable
as they will be routed in service changes bringing about behavioural
changes of not just individuals but influential interest groups,
organisations, the media and potentially policy makers. This means
they would not need further funding in the future.
SLC4L - Community Health Champions recruiting 240 R – SLC4L - short term funded, ends March 2011.
volunteers to volunteer 100 hours to work with their M – training offered will be sustainable.
friends, families’ and neighbours to encourage healthier M – actions on going to address sustainability.
lifestyles
SLC4L – Healthy Business Coordinator within Sheffield R – SLC4L - short term funded, ends March 2011.
Chamber of Commerce and Industry (SCCI) R - Peer support service will not be sustained without funding.
implementing the Healthy Business Champion M – actions on going to address sustainability. The preferred option
programme
would be that
the roles and responsibilities of this post be embedded within a current
post within SCCI. SCCI have discussed this and there is no funding
nor opportunity to embed this role within a current post.
SLC4L - Healthy Urban Planner
R – SLC4L - short term funded, ends March 2011.
M – actions on going to address sustainability. The preferred option
would be that
the roles and responsibilities of this post be embedded within a current
post within SCC. SCC have discussed this and there is no funding nor
opportunity to embed this role within a current post.
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Sheffield Children and Young People’s 0-19+ Partnership Board
Fully mainstreamed community weight management
service
Obesity continues to be recognised as a priority within
schools
Additional Information available on request:
For further information please see:
Childhood Obesity High Risk Action Plan
The Sheffield – Let’s Change4Life Quarter 4 RAG rated report
The Sheffield – Let’s Change4Life Delivery Plan
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