Agenda item

Overview of the alliance and the work they are doing across LLR. Including developing a structure to support CYP with SEND.

The Deputy Director of Public Health presented a report on Leicester’s Whole System Approach to Health Weight:

• This presentation arose from a previous presentation to the Health and Wellbeing Board on the NHS Healthy Weight Declaration. In said meeting, members requested a deeper look into the wider work being undertaken as part of the Healthy Weight Declaration.
• The project was developed as a preventative service. The goal was to stop people becoming overweight in the first place by changing the system.
•  The initiative was built on 3 key pillars: The first pillar was building a stronger system. This was through embedding healthy weight goals into the infrastructure and strategies. So that the goals of the project were known and striven for.
•  The second was changing the environments to increase opportunity. It was highlighted that society doesn’t make healthy choice easy and therefore work was needed to help combat that. The projects for this pillar were developing more cycle and walking routes to promote exercise as well as work with takeaways to offer heathier options and reduce fat and salt content.
• The final pillar focused on empowering workforces and communities. Training was provided to social care staff about healthy weight, nutrition and healthy conversations programmes. This was combined with outreach to communities to better understand and tackle the root causes behind obesity rates.  
• The excess weight stats for the City were a cause for concern. In the City, 62.8% of adults, 19.3% of reception age children and 39.1% of year 6 age children were classed as living with excess weight. It was commented that for adults and reception age children, the percentages were levelling out which shows progress was being made. However, the figure for year 6 age children was above both the regional and national average and was still increasing year on year.    
• The project was keen to focus on tackling the weight stigma and bias that can put people off from engaging with weight loss services. Focus groups were held in October and December 2025 to help inform the language and communication toolkit of the work. This was with the aim of avoiding the language of blame or lecturing which could be off putting to members of the public.
• In 2018, 23.8% of pregnant women in Leicester at appointments were defined by BMI as living with obesity. Work had been done to help support pregnant women with keeping healthy such as aqua natal and buggy fit classes. There was also myth busting such as the eating for two myth and being unable to do exercise. 
• Projects that were helping keep children healthy were detailed. The HENRY Parenting Programme, for children aged zero to five years old, had proved to be quite successful in Leeds. It was piloted in Leicester with future plans for full adoption of the programme underway. The Leicestershire Nutrition and Diet Service (LNDS) had built on the work of food for life in changing the culture in schools around food. The project targeted areas such as tuck shops in schools and children bringing in cakes and sweets for their birthdays. 
• The link of food poverty and unhealthy eating was identified, and projects were set up to reduce food insecurity through skills-based cooking sessions and support. ‘Food with Friendship’ and ‘Cooking on a Budget’, taught members of the public how to cook as well as how to reduce food waste and had a community aspect, which helped to tackle social isolation.
• Specific work had been implemented in social care as part of the learning disability collaborative. This helped to support people with disabilities who were living with excess weight. Around 70% of people with learning disabilities were living with excess weight and to help reduce this, a healthy weight toolkit was created with an LPT nutritionist. 
• Notable attention was paid to food commissioning as the City Council had 30 contracts linked to food procurement. The Public Health department spent time analysing these contracts and assessed whether making healthier food could be a requirement of the contract. There was also a drive towards engraining healthy eating into the future procurement process.
• There was also collaboration between Public Health and the Festivals and Events Team regarding food stalls at events. The main aim of this was to explore if healthier options could be offered by some of the catering businesses at events.

Comments:

• The Managing Director of LPT highlighted the topic of mental health and weight gain. It was explained that LPT was supporting people with a severe mental illness to maintain a healthy weight as the drugs supplied can cause notable weight gain. It was advised that they supported those people with dietary advice and healthy eating. The Deputy Director of Public Health responded that mental health was another target of the initiative, and they were planning to release a programme specifically targeting certain groups, including people suffering with mental health.
• There was a lengthy discussion about tackling childhood obesity and the various methods which could be implemented to lower it. The Chief Medical Officer for the ICB suggested that tackling obesity at a young was one of the most vital preventative health measures and should be prioritised. It was argued that there needs to be a shift away from the traditional methods of treating obesity towards a broader more global programme.  
• The Director for Adult Social Care & Commissioning asked the Deputy Director of Public Health about their involvement with Children’s Social Care and Education colleagues. It was mentioned that there was some work underway, but they were unsure of the progress at that time. They agreed to have a discussion regarding this in a separate meeting. 
•  Members raised concerns about schools as it was highlighted that Healthy Weight initiatives in the past have approached certain schools and been refused access. School meals were also featured as a concern as well as breakfast clubs, while it was commented that they were a good idea, there were fears of high sugar options being offered. The Deputy Director of Public Health advised that it had become easier to build relationships with schools and that they were getting much more access with breakfast clubs as schools welcome external support. It was explained that school meals was a more complex issue as this is organised by private companies and varied from school to school.
• The Chair argued that a greater focus was needed on families as parents control the vast number of meals which children eat, and the change needed to starts there. She further suggested that healthcare professionals should comment on excess weight more when assessing patients’ health and wellbeing. The Deputy Director of Public Health echoed this comment and explained that a survey was conducted last year with healthcare professionals, to check if they asked members of the public questions about their weight. It was found that most of the health practitioners surveyed did not ask patients about their weight as they felt uncomfortable raising the issue or felt unsure how to constructively discuss the matter. The Deputy Director of Public Health advised that they were conducting work with primary care workers to help address these concerns.  
• The Chair requested a further update on the initiative and how it was being implemented by LPT and UHL.

AGREED:

1. The presentation was noted by the Board.
2. The Director of Adult Social Care & Commissioning and the Deputy Director of Public Health to have a separate meeting about the Healthy Weight programme in Children’s Social Care and Education. 
3. A future update on the work progress of UHL and LPT to be brought to a future meeting.