Agenda item

The Chairman welcomed Gillian Fiumicelli, LBB Head of Vascular Disease Prevention Programme and Jess Seal, Primary and Community Care Transformation Manager, South East London CCG (“Primary and Community Care Transformation Manager”) to the meeting to provide an update on adult weight management services in Bromley.

Members were advised that data from the Active Lives survey 2019/20, which was prior to the pandemic, indicated that around 57% of adults in the borough were classified as being overweight or obese. The complicated picture of obesity and the benefits of a whole systems approach were highlighted.

The LBB Head of Vascular Disease Prevention Programme informed Members that in regard to the Bromley adult weight management workstreams, there were a number of groups which had a focus on obesity:

-  One Bromley Obesity Working Group (Local Bromley commissioners, providers, Public Health);

-  SEL CCG Obesity Group (a new group of Public Health Obesity Leads);

-  SEL Diabetes and Obesity Commissioning Group (Commissioners from across SEL); and,

-  the Health and Wellbeing Board had itself identified obesity as a priority.

Tier 1 (universal prevention services) of the Bromley adult weight management programmes were open to everyone – the Better Health NHS Weight Loss Plan app was continually being developed and provided a wide range of useful information. During 2021/22, there had been new 12-week programmes implemented within Tier 2 (behavioural services) – NHS Digital Weight Management Programme and Slimming World. The Local Authority would fund 1,364 places on the programmes – GP practices currently referred patients, however they would be working with the social prescribing team to increase the number of referrals, and self-referrals would be accepted to fill the places before the end of March 2022. It was noted that in Tier 3 (specialist services), they were looking to recommission the healthy weight programme for patients who were more severely obese. Board Members were provided with an overview of both the general adult weight management pathway, and the pathway that focused on diabetes.

With regards to identifying individuals who would benefit from the Weight Management Programmes, there were opportunities for Community Champions and Community Pharmacies to assist, in addition to self-referrals for the universal programmes (Better Health campaigns). Primary care remained the main mechanism for individuals to be identified via NHS Health Checks; Weight Management Referral Optimisation Protocol; computer searches; National Incentive Scheme; social prescribing team; dietitians and Health Coaches. The Primary and Community Care Transformation Manager advised that developments in primary care included the national enhanced service which encouraged practices to develop a supportive environment for clinicians to engage with patients living with obesity about their weight. This enhanced service worked alongside a broader expansion of weight management services, including the launch of the NHS Digital Weight Management Service for those with hypertension and diabetes, and further investment into Local Authority Tier 2 services. The workforce that could refer into these pathways had been expanded and now included all healthcare professionals, including social prescribers and PCN dietitians.

In response to a question, the LBB Head of Vascular Disease Prevention Programme advised that rather than waiting for patients to attend face to face GP appointments for referrals, systems had been used to identify patients with weights in the target area. These patients had been sent text messages, asking them to reply ‘yes’ if they were interested in participating in the programme, and then further interaction would take place. It was acknowledged that GPs were extremely busy, and they were mindful of the March 2022 deadline, which was why the programme had now been opened up to self-referrals.

The LBB Head of Vascular Disease Prevention Programme informed Board Members that Slimming World were required to submit data to OHID and to the Local Authority according to minimum dataset. Slimming World was currently only funded until the end of March 2022, and the outcome of further funding for next financial year was awaited. It was noted that the outcomes for the other programmes were managed by the commissioning organisation. The Portfolio Holder for Adult Care and Health highlighted the issue of ‘yo-yo dieting’ and said it would be beneficial to see data provided on sustainability, and how long these interventions worked for.

The Chairman highlighted that it had been eighteen months since the launch of the Council’s ‘Don’t Wait to Lose Weight’ campaign and asked what could be done to reinforce this message and further encourage residents. The LBB Head of Vascular Disease Prevention Programme advised that there were lots of communications planned, and they had recently been notified that a GP registrar would be identified to help boost primary care referrals. With regards to the Slimming World programme, as there had been a limited number of places they had been cautious about opening up the offer too wide, too soon. It was acknowledged that this offer now needed to be opened up further and it was hoped that the methods stated would help to fill the spaces by March 2022. The Primary and Community Care Transformation Manager said that Members could continue to echo the messages from primary care, keeping these issues at the forefront of people’s minds and increasing awareness. The Director of Children’s Social Care noted that prevention was key and highlighted the need to “get in early” to ensure that young people had good habits in relation to exercise, diet and healthy eating. In response to a question, the LBB Head of Vascular Disease Prevention Programme advised that these programmes had being promoted at the pop-up vaccination clinic in Mottingham. Another Member highlighted the need to provide pre-diabetic advice and its implications.

A Member noted that the PHE mapping diagram on page 29 of the agenda pack did not make any reference to alcohol consumption, and that dramatic weigh loss could occur if someone stopped drinking. The LBB Head of Vascular Disease Prevention Programme advised that the PHE diagram was used to show the complexity of obesity, but that there were a number of other things that needed to be considered. It was recognised that alcohol was a factor in obesity, as it was high in calories and drove unhealthy eating, and this was something that could be taken forward with colleagues. The Chairman agreed that alcohol consumption was a significant problem and considered that this could be included as a priority focus for the Board during the coming year.

The Chairman proposed that, going forward, the Obesity Task and Finish Group be reconvened.

The Chairman thanked the LBB Head of Vascular Disease Prevention Programme and Primary and Community Care Transformation Manager, South East London CCG for their presentation to the Board.