Obesity Market Development Event The Strategic Context for NHS Mid Essex Jane Richards Assistant Director of Public

1. Obesity Market Development Event � The Strategic Context for NHS Mid Essex Jane Richards Assistant Director of Public Health (Health Improvement & Health Inequalities)

2. The Vision �Our vision is of healthy communities where everyone is able to make healthy lifestyle choices and get the health and well being services they need� Delivering Healthy Communities NHS Mid Essex Strategic Plan 2009 -2014

3. Investing where we can achieve greatest improvement in your health and targeting marginalised groups Improve access to health and well being services for all Support people in living a healthy lifestyle Improve the health of the poorest in our communities and marginalised groups Strategic Context

4. Commissioning for Health and Well Being Commissioning programmes to support behaviour change Stop Smoking & Tobacco Control Obesity & Weight Management Community Well Being (Including Health Trainers)

5. Redesign and commissioning health improvement services To improve the quantity of choice To promote and inform the community of services available to them To provide people with information and access to services that will lead to a sustained behaviour change to enable them to make healthy lifestyle choices

6. The QIPP agenda Quality � seeking to procure high quality outcome based service delivery model which meets the needs of our population Innovation � commissioning for outcomes resulting in opportunity for providers to demonstrate how this can be achieved using innovative models with a demonstrable evidence base Productivity � pathway is designed to maximise productivity at each stage in order to achieve highest level of return on investment Prevention � critical part of the prevention agenda with strong links to other areas of service delivery e.g. vascular health checks

7. Service Descriptions NHS Mid-Essex Obesity Care Pathway Context: how we�ve come to this point Context: how we�ve come to this point

8. Aim It is the intention of NHS Mid Essex to create a sustainable healthy weight infrastructure Integrated and tiered model of care designed specifically to meet the needs of the local population The framework will adopt a comprehensive life-course approach, encompassing pre-conception and antenatal phases through to adulthood and later life

9. Where have we come from Healthy Weight: Social Marketing Insight Directions, 2008/09 Healthy Weight; Healthy Lives Strategy, 2008 Foresight Report, 2007 Local gap analysis, 2008/09 Regional Support Team NHS Mid Essex Strategic Plan & 10 Commitments LAA 2 County JSNA Vital Signs NCMP PSA 12 NI sets: - 53: Breastfeeding rates 55: Obesity Reception 56: Obesity Year 6 198: Travelling to School Context Context

10. What is the current status of local provision Contracts with commercial sector, Central Essex Community Services and Mid Essex Hospital Trust Range of community-based prevention and treatment weight management and weight loss services: Breastfeeding Peer Support Programme Early Years multi-component prevention programme 7 -13 multi-component treatment programme Group based adult weight management service Commercial self-help adult weight management Adult Health Trainer service Brief and Opportunistic training for key workers Dietetics and dietetic clinics (working out GP practices) Pharmacotherapy Bariatric surgery Remember this slide does not indicate the supporting workforce; merely commissioned programmes Remember this slide does not indicate the supporting workforce; merely commissioned programmes

11. What do we know Existing care pathway are disparate and uncoordinated The weight management and obesity domain encompass a range of interventions; direct and in-direct services, spanning multiple directorates Anti-Obesity prescription costs have double in the last year A steady increase in the number of patients referred into bariatric surgery over the past three years We are not doing enough for patients with the most complex needs One size does not fit all Conversion to service engagement to programme completion is low Maintenance and follow up is traditionally very low GP�s and other HCPs are confused as to what services they can/should safely refer patients into Draw similarities with county partners and the rest of the countryDraw similarities with county partners and the rest of the country

12. What works: The Evidence Obesity is the second most common preventable cause of death after smoking in Britain today and is responsible for more than 9,000 premature deaths per year in England. Costs to the NHS, currently �4.2bn a year, are predicted to more than double by 2050 �85.1m:Estimated cost to NHS Mid Essex for diseases related to overweight and obesity for 2010 Healthy Weight; Healthy Lives Choosing Health 2004: invest in prevention/intervention for long term savings NICE Guidance Department of Health C4L insights/market segmentation National Obesity Observatory SEF/ Treating adult obesity through lifestyle change interventions, 2009/ Treating childhood obesity through lifestyle change interventions, 2010 Rotherham Model Maryon-Davis Middlesbrough, Redcar & Cleveland Addenbrookes Hospital West Sussex QA Standards (Aspiration)QA Standards (Aspiration)

13. What do we want Create a patient-led, sustainable healthy weight infrastructure Target resources on community based interventions that encompass one, some or all of the following (depending on patient assessment and RTC): dietary advice/ physical activity/ behaviour change Improved patient choice, journey and experience Confident and supported workforce Improve Early Years nutrition Up skill and enable families from the most deprived communities to live healthier lifestyles Outcomes rather than activity Better identification and assessment* of �at risk� patients Better whole population access to facilitated behaviour change & lifestyle modification Reduce the population trend in growth from individuals moving from a healthy weight to overweight and overweight to obesity * Direct link to workforce development, training and SPE * Direct link to workforce development, training and SPE