1. Healthy Child Weight (CHW) Heather Donald September 2011

2. The Scottish Health Survey (SHeS) -2009 1 28.2 % of children classed overweight or obese (≥85 th Centile) Rates increase with age Rates in girls and boys appear similar (27% and 29.4% respectively) ≥ 85 th Centile Significant associations between SIMD quintile and obesity

3. National Policy Drivers for Tackling Child Overweight and Obesity in Scotland Preventing Overweight and Obesity in Scotland: A Route Map towards Healthy Weight 2 Early Years Framework 3 Improving Maternal and Infant Nutrition: A Framework for Action 4

4. NHS Scotland Healthcare Quality Strategy 5 Quality Ambition 1: –Mutually beneficial partnerships between patients, their families and those delivering healthcare services which respect individual needs and values and which demonstrate compassion, continuity, clear communication and shared decision making

5. Quality Ambition 2: –There will be no avoidable injury or harm to people from healthcare they receive, and an appropriate, clean and safe environment will be provided for the delivery of healthcare services at all times.

6. Quality Ambition 3: –The most appropriate treatments, interventions, support and services will be provided at the right time to everyone who will benefit, and wasteful of harmful variation will be eradicated

7. Sources of evidence for guidance 2011-2014 SIGN 115 (2010) 6 NICE (2006) 7 NHS Health Scotland Evaluation of the Implementation of HEAT 3 8 Data from the impact of HEAT 3 Interventions from individual boards

8. Integrated systems approach to child overweight and obesity prevention and management Obesity prevention Overweight and obesity management Specialist assessment

9. Qualifying interventions – key requirements Intervention components –Behaviour change –Family-based –Decrease overall dietary energy intake –Increase the levels of physical activity –Decrease the amount of time spent in sedentary behaviours

10. BMI Criteria –BMI at or greater than the 91 st centile for BMI (based on the UK 1990 Reference Growth charts) –Participate at Tier 2 level programme –Complete at least 75% of the Programme

11. Weight management/intervention goals –Key goal for child healthy weight interventions is to achieve a stabilisation or reduction in a child or young person’s BMI and BMI standard deviation score (SDS- BMI) (also known as BMI z-score)

13. Duration of programmes (one-to-one/group) –Number of Sessions –Duration of Sessions –Timing of sessions

14. Age range – 2-15 years Inequalities – 40% of CHW completions should be achieved by children/families in the two most deprived SIMD quintiles, 1 and 2 by local SIMD datazone

15. Integrated Care Pathway – Child Healthy Weight Scottish Government require each board to have a care pathway that embeds CHW into practice NHS Grampian ICP for CHW –Pilot initially to 3 areas

17. Identified problems Training for Staff 9 Measurements Equipment Raising the Issue 10

18. Tier 1 Expectation of preventative work from all Schools are delivering “Grow Well Choices” Resources Social Marketing

24. Tier 2 Intervention is “Eat Play and Grow Well” For those with a BMI above the 91 st Centile How do you refer?

25. Contact Details Community Dietetics, Westholme, Woodend Hospital – 01224 556304 Moray Dietetic Dept, Dr Gray’s Hospital – 01343 567350 Email:- nhsg.communitydietitians@nhs.net

26. Thank you

27. References 1Scottish Health Survey (SHeS) (2009). http://www.scotland.gov.uk/Publications/2010/09/23154223/0 http://www.scotland.gov.uk/Publications/2010/09/23154223/0 2Scottish Government (2010) Preventing Overweight and obesity in Scotland: A route map towards healthy weight. http://www.scotland.gov.uk/Resource/Doc/302783/0094795.pdf http://www.scotland.gov.uk/Resource/Doc/302783/0094795.pdf 3 The Scottish Government. (2008) http://www.scotland.gov.uk/Resource/Doc/257007/0076309.pdf 4 Improving Maternal and Infant Nutrition: A Framework for Action (2011) http://scotland.gov.uk/Resource/Doc/337658/0110855.pdf 5 The Health Care Quality Strategy for NHS Scotland (2010) http://www.scotland.gov.uk/Resource/Doc/311667/0098354.pdf 6Scottish Intercollegiate Guidelines Network (SIGN) (2010). Management of Obesity: A National Clinical Guideline. NHS QIS: Edinburgh. www.sign.ac.uk/guidelines/fulltext/115/index.html www.sign.ac.uk/guidelines/fulltext/115/index.html 7 National Institute for Health and Clinical Excellence (NICE) (2006). Obesity guidance on the prevention, identification, assessment and management of overweight and obesity in adults and children. Available: www.nice.org.uk/nicemedia/live/11000/30365/30365.pdf www.nice.org.uk/nicemedia/live/11000/30365/30365.pdf

28. 8 NHS Health Scotland H3 evaluation (2010). www.healthscotland.com/documents/4836.aspx www.healthscotland.com/documents/4836.aspx 9 NHS Health Scotland. Healthy Weight National occupational Standards (2011) http://www.healthscotland.com/uploads/documents/15725- National%20OccupationStandards.pdf 10 Health Scotland http://www.healthscotland.com/topics/child_healthy_weight.aspx