Notes of an informal meeting with the Centre for Research in Primary and Community Care (CRIPACC), University of Hertfordshire, Hatfield, Wednesday 11 February 2009

In attendance:Josefine Magnusson, Research Fellow Child and Adolescent Health, CRIPACC

Dr Wendy Wills, CRIPACC

Cllr Michael Downing, Chair of HCC Health Scrutiny Obesity Topic Group.

Mike Thomas, Scrutiny Officer, Watford Borough Council

Stephen Weaver, Scrutiny Officer, Stevenage Borough Council

The Chair of the Obesity Topic Group thanked Jo and Wendy for agreeing to meet with him to provide their insight into issues around Childhood Obesity.

Jo Magnusson was conducting a survey of GPs and practise nurses in Hertfordshire and Bedfordshire to explore the current procedures for dealing with young people who are obese.

Jo Magnusson stated that the findings of the review were at an early stage and were based on a return rate of approximately 20% of surgeries in Hertfordshire and Bedfordshire, which equates to approximately 300 surgeries. The Primary Care Trusts in the two counties where aware of the survey and had given their permission for it to be carried out, but had not exhorted surgeries to respond. All sizes of surgeries had been canvassed in this survey.

There were specific examples of individual GPs and practise nurses who had individual expertise in this area and demonstrated a commitment to advising and finding health solutions for obese young people who presented to them. However, overall awareness amongst those who responded was poor, with less than half of the practises demonstrating a good awareness.

Anecdotally a number of practise nurses had said that they would benefit from having BMI conversion tables for adolescent and obese children, Jo had to direct them to this information.

Overall the numbers of teenagers presenting at GP surgeries was low and GPs were unable to refer under 16s to take exercise by prescription to gym sessions.

Jo Magnusson suggested thatbased on her experience at a practise base,obesity amongst adolescents was not a high priority.

Dr Wendy Wills drew attention to a study with Practioners with the under fives in Peterborough and Oxford, this had revealed a lack of systematic weighing of children and a lack of opportunity to refer obese children on to clinical experts, in Dr Wills view this was likely to be mirrored in Hertfordshire.

Both Jo and Dr Wendy stated that communicating with parents, children and adolescents was problematic, as

Intervention at a pre-school age was required but there was currently no obligation for health visitors and practice nurses to weigh this age of child beyond newborn children.

Jo Magnussondidn’t think GPs and practise based nurses were best placed to tackle obesity, as they were dependent on self referrals and on the evidence of the survey werenot best equipped to tackle obesity. Potentially health visitors, children’s centres and schools offered more hope for engaging parents and children.A useful tool that was suggested to show body shapes to parents to get the messages across about childhood and adolescent obesity was the internet. However, there are barriers here around access to the internet for health visitors and children’s centres, DVDs could be used as a good alternative.

Dr Wendy Wills suggested that two initiatives that were offering good advice around childhood obesity were MEND (Mind, Exercise, Nutrition, Do it). MEND offers a 10 week, two-hour, twice weekly, after school fun programme for children aged 7 to 13 whose weight is above the healthy range for their age and height.

HENRY (Exercise and Nutrition for the really young).HENRY aims to influence not only how practitioners work with families but also the settings in which they work, their own and their family’s lifestyles. HENRY supports those who work with parents and carers of babies, toddlers and preschool children. The Programme is underpinned by the Family Partnership Model, which emphasises working in partnership rather than taking a traditional expert approach. This is augmented by training practitioners to offer solution-focused support that builds on parents’ strengths rather than focusing on their difficulties.

The next stage of the study would be to interview teenagers and the methodology for doing this had not yet been agreed.

The Chair thanked Jo and Wendy for their time and valuable input into the review and suggested that a copy of these notes would be sent to them to check for accuracy and a copy of the Topic Groups final report would be sent to them.

S:\HERTFORD01\CSERV\LAHERT\SHAREDIR\SHARE\Member & Committee\Committees\SCRUTINY\Health Scrutiny Committee\2009\Topic Groups\Public Health Topic Group\Minutes\03 18 February 2009\Notes of an informal meeting with CRIPACC UH.doc