Agenda item

Ms Kelly O'Neill, the Council's Interim Director of Public Health, advised that the whole system approach to obesity had identified Hayes as being an area of need.  Action had been undertaken to establish how best to engage with these communities and a pilot had been completed.  The core team had been set up to lay the structures that would be needed to then build a framework to understand the community better.  Initial work had been completed to target communities where obesity was prevalent and where these individuals were less likely to seek help.  This included targeting obese young people too with initiatives such as active travel, for which three bids had been submitted.  Minet School had been successful in its bid and the outcome of the other two bids was still awaited. 

The Board was advised that a workshop would be held at the end of March and consideration had been given to who would need to attend.  It would be important to develop sustainable long term engagement plans and mobilise those who had already been identified whilst also trying to identify others that were currently unknown.  Consideration would need to be given to questions such as: was there a limited ability to walk to school?; was there a perception of poor safety when walking?

A reference group would be built up over the next few months with the community.  This could then be developed so that it identified what the community saw as barriers and came up with solutions and options to tackle obesity.  Measures of success would need to be identified that meant something to residents and which they would think were important.  Although this might be the achievement of a healthier weight, it might be a feeling of being fitter or a greater sense of wellbeing. 

Concern was expressed that there had been a wave of messages being sent out to residents from local GP surgeries stating that they were overweight and that they could sign up to a programme to get help.  It was noted that GPs had been incentivised to identify overweight patients and refer them on to a specific programme that had been funded by the NHS.  Unfortunately, there had been limited spaces on this programme (which had quickly become overwhelmed with referrals) which meant that there was a 13 week wait before anything would happen.  It would be important to change behaviour with the integrated neighbourhood process and that some of this could be facilitated by non-clinicians.  A meeting had taken place on 6 March 2023 to set up networks of community champions to go into neighbourhoods and develop a programme of health improvements and integration. 

Ms O'Neill suggested that more sustainable ways of getting active were needed and less reliance on GPs as the impact on them had been huge.  Council officers had been working with communities to get them more physically active and local sports facilities had been reviewed to ensure that they were affordable.  Consideration now needed to be given to the wider assets available in the community and whether or not they could be used more effectively. 

It was noted that there would be greater links in a whole system approach to obesity and links to integrated neighbourhoods.  Neighbourhood working and the purpose of neighbourhoods went hand in hand, especially in relation to conditions such as hypertension.  Priorities and actions would need to be identified on the neighbourhood agenda. 

NHS Health Check was a mandated national screening programme, delivered in Hillingdon by GPs, which had been useful in identifying previously undiagnosed long term conditions.  However, it was queried what happened after diagnosis.  Interventions needed to be put in place and patients needed to take ownership of their own conditions.  Consideration also needed to be given to how to engage with GPs and how to reduce the GP variation.

Ms O'Neill advised that the NHS Health Check was supposed to be undertaken every five years.  It would be important to identify those communities that were not taking part in the initiative as they were the ones that were less likely to have registered with a GP but most likely to have undiagnosed conditions.  Although it varied across ethnic groups, uptake of the Health Checks was less than 50%. 

It was suggested that the situation with obesity felt like déjà vu from about ten years ago.  The Royal Borough of Kensington and Chelsea (RBKC) had taken an advertising approach to negotiate with residents: if the 'place' did something for them, what would they do in return.  Rather than medicalising the issue, initiatives such as lunch clubs for older people had been established.  Ms O'Neill would be interested in looking into the work undertaken by RBKC. 

Ms Wright queried whether digital interventions had been used to make a difference as there were some low cost options available.  NWL was part of the digital accelerator for London and lots of technology would be available to do Health Checks at community events.  Ms O'Neill confirmed that digital options, uptake and access were being investigated, especially for those who wanted to help themselves. 

Momentum needed to be generated around School Superzones using digital to reach large numbers at a relatively cheap cost.  It was deemed encouraging that schools were engaging and that they had signed up to the Superzones.  It was queried whether dental nurses would return to schools or whether dentists would visit schools to talk to children about oral health.  Ms O'Neill noted that poor oral health had so many interdependencies with other issues such as obesity so was deemed a key issue.  Preventative measures, such as the provision of water in schools, was thought to be the panacea. 

RESOLVED:  That the discussion be noted.