Warwickshire Food for Health Group

Activity 2010

This document describes the activities that were undertaken in partnership and by individual organisations to achieve national, regional and local food based targets. Targets highlighted in violet and in italics indicate a national or local target/ indicator for partners

Group priorities for 2010were:

  • Increasing the percentage of people in Warwickshire reporting that they consumefive or more portions of fruit and vegetables each day
  • Improving the food offered to vulnerable adults
  • Reduce food related inequalities

Obesity Prevention

No specific targets relating to obesity prevention were set by the Warwickshire Food for Health Group, as the Warwickshire Obesity Strategy Group was addressing this. The focus of the Obesity Strategy Group changed during 2010 to focus on treating Childhood obesity, and they requested that work relating to the prevention of obesity be reported by the food for health group. Reference to obesity prevention is made throughout this report.

Specific activities relating to the treatment of obesity are:

  • A comprehensive training programme for school nursing for The National Child Measuring Programme has taken place including Growth

Foundation Training, Nutrition, childhood obesity and talking about weight

  • Two contracts have been awarded to Rugby Borough Council and Nuneaton and Bedworth Leisure Trust to deliver 9 week family structured

weight management programmes in North Warks, Nuneaton and Bedworth and Rugby

  • Activity to reduce obesity in high prevalence primary schools continues via Public Health Development officers with partners – information

continues to be shared with the Healthy Schools team to ensure collaborative working on the Enhanced model.

  • “Brief intervention” training across the NHS includes how to advise on healthy eating and to prevent obesity
  • 20 of the 23 schools participating in the Enhanced Healthy Schools model have selected obesity reduction as a target. They are supported

to do this by the healthy schools team, whose funding ends in August 2011

  • Local dietitians are contributing to a regional multi agency project to produce an obesity charter for people with a learning disability and

training for support staff.

Partnership work

1. Strategic Development

Chair: Ruth Breese.

Target Area

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Action/Activities

1a. To increase the number of people reporting that they eat 5 or more portions of fruit and vegetables by 1% each year. (Local target) / -To raise awareness of portion sizes and the produce that counts towards 5 a day
-To organise 2 Five a day training sessions, each year, training a total of at least 24 people
-Each member organisation to develop at least 2 pieces of publicity for their 5 a day work / -Unfortunately the question about fruit and vegetable consumption in the County Council Annual survey has been omitted since 2008. The Council were asked to include the question in future, but have not. The group is considering other ways to collect data e.g. using the ECM school survey results.
-The dietitians have merged 5 a day training into other sessions during 2010 due to increased demand for nutrition risk assessment training.
-For organisational publicity, please see below. Highlights include a 5 a day focus at George Eliot Hospital AGM where all those attending were given a bag of fruit and vegetables containing enough fruit and vegetables for their family for 1 day and Wacky forum conference for adolescents with LD – joint 5 a day stall with public health & dietetics
1b. To improve local communication relating to food and health / -Develop internet site on which examples of work can be placed.
-Identify how it can be kept up to date
-Encourage workers from all settings to share their work via the database
-To develop a newsletter containing food and health information for workers / -The site is still under development as the hosting site run by Warwickshire Community health is being restructured.
-165 entries for work relating to food and health were submitted for to the database. This information has been shared widely.
-29 editions of “Food News” have been disseminated – one every 4 – 6 weeks. The newsletter is circulated to 196 individuals, many of whom send it on to their team
Other Activity / -Publicity / -The group was invited to provide a workshop at a County Council public consultation event addressing prevention of ill health, and at a well being event for head teachers.
-Members of the group attended the Coventry & Warwickshire quality conference in October 2010 where we won the best poster of the conference.
-As a result of work carried out by the regional food policy group, a measure in the Warwickshire Transport plan is access to fruit and vegetables as a marker for access to healthy food.

2. Children and young people

Target Area

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Action/Activities

2a. To improve access to a balanced diet / -Support (as time and funding permits) initiatives to improve the food consumed by school children (fruit in schools scheme, healthy schools, regional initiatives) / -3 schools in partnership with WarwickshireCounty caterers participated in the Food for Life Scheme. Young people in these schools are growing, cooking and eating fresh, seasonal, local and organic food and visiting farms where their food is produced. For the CountyCaterers, this has resulted in them serving seasonal school meals, with 75% of dishes freshly prepared. The scheme expanded to involve 41 schools from April 2011.
-Trading Standards were involved in a national LACORSNursery school project and commissioned dietetics to contribute. As a result an information booklet has been produced for nurseries, and the heartbeat award for this age group revised.
-Trading Standards and Warwickshire County Caterers worked in partnership to assess the nutritional quality of school lunches. This identified that while meals were cooked according to standard recipes, portion sizes given varied. A school with higher than average obesity rates was found to give larger portions.
-“Lets Get Cooking” came to Warwickshire with 33 schools receiving training and funding to run cooking classes.
2b.To promote a whole school approach to food and health (Enhanced healthy schools) / -Support schools to share good practice in Healthy Eating
-Support schools to meet the ten elements of the whole school approach through National Healthy School Status (NHSS) and the new Annual Review
-Support schools to plan and deliver healthy eating outcomes for the obesity priority through the new Enhanced Healthy Schools / -98% (236) of schools have achieved National Healthy School Status (NHSS) in Warwickshire. This means the schools met 11 nationally agreed criteria linked to healthy eating, ensuring that the school has a ‘whole school approach’ to healthy eating.
-35% (84) of Warwickshire schools have reviewed their provision for healthy eating, three years after achieving NHSS, and been confirmed as meeting the 7 revised national criteria linked to healthy eating.
-10% (23) of schools in Warwickshire are participating in the first cohort of schools working on the new Healthy Schools enhancement model. 20 out of 23 schools have chosen obesity as one of their two health priority areas (4 infant schools, 13 primary schools and 3 secondary schools).
-It is not yet clear as to how this work will be monitored or schools assisted to reach their goals as funding for the healthy schools team stops in August.
2c. To increase the number of children eating a school meal. (National Indicator 52) / -For WarwickDC to be the home authority for food safety in schools to ensure consistent standards across Warwickshire / -10 Warwickshire schools with low school meals uptake were supported by taking part in the West Midlands“Charlie and the Kitchen Cook Project”. Each school received a theatre visit promoting school meals, staff training, Healthy Schools Advisor time and a support pack created by the team (spring 2010).
-Warwickshire County Caterers report that meal numbers for the current year in comparison to 2009-2010 have remained fairly consistent with a very small percentage rise over all education sectors'.
-WDC continue to be the home authority for food safety standards in schools. This means that consistent standards are applied across the county and CountyCaterers only have to liaise with one environmental health team rather than 5.
2d. Increase the uptake of vitamins and vitamin drops under the healthy start scheme. (Regional target) / -To set up a steering group to develop this project
-To develop an action plan with Key partners / -A steering group has been set up, chaired by Carolyn Forman from Department of Public Health. The action plan has led to the vitamins being available through Children’s Centres across the county.
-Health Visitors, Midwives, GPs and Children’s Centre Staff are encouraged to sign families up to the scheme and to remind them to use the vitamins.
-From 1st April this target will be moved to NHS Warwickshire Community Health’s Performance Dashboard.
Target / Baseline from Q 4 2009 / Q 1
2010 / Q 2010 / Q 3
2010 / Total by December 2010
Women’s vitamin tablets increase by 10% =111 / 2 / 6 / 20 / 41 / 67
Children’s vitamin drops increase by 10% = 401 / 33 / 51 / 54 / 92 / 197

Meetings have taken place to set up a Warwickshire wide children and food group. This work has been put on hold due to organisational change,

but it is hoped to address this issue from April 2011.
3. Breastfeeding (led by the PCT breastfeeding liaison group)

Lead: Fran Poole [

Target Area

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Action/Activities

4.a. To increase Breastfeeding rates by 2% per annum(national indicator 53) / -To encourage workplaces & public places to welcome Breastfeeding mothers
-Gain baby friendly status for appropriate NHS premises
-Develop a county wide training programme for NHS staff
-Support for Community based projects including breast feeding cafes, peer support programmes, parent craft sessions
-Commitment to incorporate breastfeeding into teaching in school / -UHCW, SWFT and NHS Warkwickshire Community have agreed to go ahead with their Stage 1 application for “baby friendly status”.
-GEH are not ready to do this yet, but are taking action to address this.
-Training of staff and peer support workers continues
-26 Community based projects around breastfeeding were put on to the database
Breastfeeding data for first 3 quarters of 2010.
Initiation / Target / 6-8 weeks
B/F Totally / B/F partially / Total / Target
South / 77.8 / 72 / 35.3 / 16 / 51.4 / 53.5
North / 61.1 / 59 / 24.7 / 8.28 / 33 / 32.5
East / 74.6 / 76 / 29.75 / 13.66 / 43.4 / 42.15
Warwickshire / 70.8 / 70 / 30.1 / 12.6 / 42.76 / 44.3
West Midlands / 66.7 / 66.5

National Indicators relevant to this section

NI 53 Prevalence of breastfeeding at 6 - 8 weeks from birth

NI 55 Obesity among primary school age children in Reception Year

NI 56 Obesity among primary school age children in Year 6
4. Vulnerable Adults sub-group

Chair: Richard Brookes. ''

Target Area

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Action/Activities

3a. To improve the food given to vulnerable adults in care

Care Quality Commission Standards and National Care home standards /

-Provide support for caterers who provide food for vulnerable adults e.g. in care homes, intermediate care

-To promote and encourage achievement of the YAH Heartbeat Award (where available) / -Warwickshire County Council Care Homes were involved in a “focus on meal time project” which has improved nutrition communication across care and catering teams. Work carried out in partnership with dietitians. The project has also identified a need to provide suitable food for overweight residents. This will be addressed in 2011. This work is now being disseminated to partners in the private care setting and NHS.
-The Medicines Management Dietitian has produced and is disseminating nutritional guidelines for care homes. Training will take place in 2011.
-Trading Standards are to carry out a survey of the nutritional content of meals in care homes to see if nutritional standards are achieved.
-54 care homes have the Heartbeat Award. Homes across Warwickshire can apply for the award as WDCcarry out administration for SDC and N&BBC homes. One organisation has only joined the scheme because all its homes across the county can apply, stressing the importance of the county wide approach.

3b. To develop information about safe and healthy food to enable vulnerable adults to continue to stay in their own homes

/

-To identify the people who support people to stay in their own homes and ensure that they have correct information about food and health

-Understand current activities around round routine nutritional screening in the community /

-Members of the group were involved in the Meals on Wheels tender process, and Trading Standards will be testing sample meals during 2011.

-Training on Nutrition screening (MUST), including resources for patients has been run for NHS and County Council staff by the Dietitians. The resources produced by the medicines management dietitian will be put onto the county council web site.
-Training has been run for the County Council contracting team
-The plan of action for the re-ablement team includes nutrition screening
-WCH falls team have produced an information pack for people at risk from falls. This includes a leaflet on bone health

3c. To undertake gap/needs analysis and monitor trends over time

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-Collate baseline data on Warwicksvulnerable adults

-Participate the BAPEN survey 2010 / -GEH, WCH hospitals, SWFT and WCC care homes all took part in the BAPEN nutrition screening survey of 2010. Results indicate that malnutrition rates rise in the winter. The survey will be repeated in 2011.

3d. To ensure workers have the skills to care for the nutritional needs of vulnerable adults

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-Provide training on screening and nutrition support if needed

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-Nutrition risk (MUST) screening was a CQINN target for Warwickshire Community Health. All nursing staff have received training on MUST and care planning.

-WarwickshireCounty council organised, and Dietitians attended, a study day for private care homes which included a section on nutrition risk and learning opportunities relating to food and health.

National Indicators relevant to this section: NI 141Percentage of vulnerable people achieving independent living

5. Change 4 life (C4L) and Start 4 Life (S4L)

Target Area

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Action/Activities

5a. To co-ordinate local work relating to C4Land S4L issues and to share examples of good practice
Including the National obesity targets NI 55 & 56 / -C4L themes will be built into other promotional work carried out by partners. For example energy balance, portion sizes / -Change4life and Start4life were built into initiatives carried out across Warwickshire for example baby, toddler, and family nosh, cook and taste, talks to community groups.
-The Healthy schools team encourages schools to use the C4L materials
-Warwickshire workers are contributing to the development of a regional training package for workers on Introducing solid food (S4L).
-Staff from the NHS and County Council were involved in a local launch of the Great Swapathon
-The information about “swap it, don’t stop it” for adults was circulated.

6. Catering/Food preparation issues

Lead: Robert Chapleo and team [

Target Area

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Action/Activities

7a. To support caterers to improve standards
Care Quality Commission Standards and National Care home standards / -Working together to ensure that standards such as “scores on doors”, standards for better health and healthy eating are consistent across the county.
-To encourage schools and member organisations premises to apply for the Heartbeat Award or obtain the highest food safety awards from their local authority where available / -The Scores on Doors pilot reported at the end of 2010 so this work has been on hold
-WarwickDC now does heartbeat assessments for Young at Heart, (especially Warwickshire Care Services) awards and Schools for StratfordDC(who withdrew from the general scheme in 2009) and RugbyBC.
WarwickDC52 Heartbeat Awards
21 Young at Heart Awards
10 Kinder heart Awards
North Warwickshire4 Heartbeat Awards
2 Young at Heart
The award scheme is on hold in Rugby due to staff sickness.
The Kinder Award was updated to address the nutritional issues identified in the LACORS nursery project (see 2a). The Young at Heart Award for vulnerable adults will be updated in 2011.
Partnership working between WDC and South Warwickshire Dietetic Service allows the Heartbeat Award to continue in Warwickshire. Expertise is shared - the dietetic department provides expertise and training on nutrition for CHD prevention, under 5’s and vulnerable adults, while the Environmental Health Department gives the dietitians a structure to work with caterers, so they are no longer contacted by individual organisations. After receiving training, the EH team in Warwick assess premises for the standard award, leaving the dietitians free to assess the special awards
NHS staff requested information on food labelling. A leaflet was produced for the group by Trading Standards, who also helped in the production of a questionnaire on labelling for Health Visiting Staff.
7b. To encourage organisations to offer healthy food choices / -To jointly implement the county council/NHS healthy food policies where possible
-Carry out audit of food offered in premises where group members work to ensure healthy choices are offered.
-Encourage organisations to adopt the healthy food policy template / After consultation the local food policy was adjusted to focus on food purchased for business at work. The policies have been ratified and baseline provision in organisational restaurants and coffee shops audited to develop a plan of action. Members of the group are assisting with or leading on development for the following organisations areas
GEH – will adopt as a policyNBBC – adopting the policy
SWFT – adopted it as guidelinesWCC – put out for adoption in their format
WCHS and NHS Warwickshire – the policy is out for consultation
SDC – have existing procurement policy based on original FFHG policy
WDC – heartbeat caterer used for in house catering. Discussion taking place on adoption
Rugby – position unknown
Partnership Trust – developing a policy across Coventry and Warwickshire

Future Targets

The Governments Public Health Responsibility Deal 2011 includes a Food Pledge and a Health at Work Pledge.

The Food Networkwill lead on the food pledge; its activity will be wide-ranging and embracing four main areas: