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BPR Food Health and Physical Activity Strategy

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BPR Food Health and Physical Activity Strategy Powered By Docstoc
					     The Burnley, Pendle & Rossendale


Food and Physical Activity
  Framework for Action
                    2006 - 2009




       DIANNE GARDNER, SENIOR HEALTH PROMOTION SPECIALIST   1
       BURNLEY, PENDLE AND ROSSENDALE PRIMARY CARE TRUST
                    dianne.gardner@bprpct.nhs.uk
1. INTRODUCTION
This framework is about enabling Burnley, Pendle and Rossendale residents to be healthy by:
    Eating healthier diets
    Being more active
    Achieving a healthier weight for those who are overweight or obese

It outlines action to guide partnership working across all local organisations to achieve health improvement. It incorporates
relevant actions and targets specified in the 3 boroughs health, environment and culture action plans (from the Local
Strategic Partnerships and Community Plans) and takes into account the Government’s Public Health White Paper ‘Choosing
Health’ launched in October 2004.

The various elements of the framework will be driven and reviewed by the multi-agency BPR Food and Physical Activity
Forum and progressed in a number of ways. These will comprise:
    Integration into work plans of existing partnerships and individuals
    Specific groups for the weight management of adult and children which will produce additional local guidance for
      pathways of care and collation of data
    The establishment of stakeholder groups to explore the development of key actions, identify resources and form new
      ways of joint working
    The creation of a Food and Physical Activity Network to communicate to a wide range of individuals, organisations
      and groups

CONTENTS
       Why have a Local Framework for Action on Food and Physical Activity? p. 3

       The Local Framework for Action:
      Vision and Overall Approach p.8
      Targets and Implementation p.10

     The Action Plan:
    Big Win 1 Children and Young People: Healthy Schools p.13; Children’s Travel p.16; Early Years Interventions p.17
    Big Win 2 Tackling Obesity Prevention: Physical Activity p.20; Food / 5 A DAY p.25
    Big Win 3 Obesity Care Pathways and Support Services p. 30
                                      DIANNE GARDNER, SENIOR HEALTH PROMOTION SPECIALIST                                        2
                                      BURNLEY, PENDLE AND ROSSENDALE PRIMARY CARE TRUST
                                                   dianne.gardner@bprpct.nhs.uk
2. WHY HAVE A LOCAL FRAMEWORK FOR ACTION ON FOOD AND PHYSICAL ACTIVITY?


Figure 1: Trends in eating, physical activity and body weight


PHYSICAL ACTIVITY
   In England only 32% of adults meet the recommended level of 30 minutes of moderate intensity physical activity 5
     times per week. Participation in physical activity is less among people with lower incomes and falls with increasing
     age.
   Among children, one third of boys and two fifths of girls do not achieve the recommended weekly physical activity
     level.

HEALTHY EATING
   The recommended level of fruit and vegetables is 5 portions per day. Currently the average consumption by adults
     is 2.8 portions per day, with households with lower incomes eating less.
   The average consumption of fruit and vegetables for children is 2 portions per day. One in five children does not
     eat fruit.
   We consume more ‘empty calorie’ snacks and sugary drinks than ever before – soft drink and confectionery
     consumption is now respectively 30 and 25 times what it was in the 1950’s.

OVERWEIGHT & OBESITY
Trends indicate that numbers of people who are overweight and obese have been growing in England:
    22% of men and 23% of women are now obese, a trebling since the 1980’s.
    70% of men and 63% of women are either overweight or obese.
    Among children 16% of 2-15 year olds are obese.

If current trends continue, a conservative estimate is that at least one third of adults, one fifth of boys and one third of
girls will be obese by 2020. If the current accelerated trends of the past 10 years continue in the future, the predicted
prevalence of obesity in children will be in excess of 50%.
                                                                                           (Royal College of Physicians, 2004)


                                       DIANNE GARDNER, SENIOR HEALTH PROMOTION SPECIALIST                                        3
                                       BURNLEY, PENDLE AND ROSSENDALE PRIMARY CARE TRUST
                                                    dianne.gardner@bprpct.nhs.uk
With statistics like these it is no wonder that in the past few years national and international reports have focussed on the
progressive rise in overweight and obesity among children and adults in developed countries. The definition of ‘obesity’ is
usually based on an approximation of body fat, the Body Mass Index (BMI), which is calculated by dividing the individual’s
weight in kg by the square of their height in metres.

                                                 BODY MASS INDEX                           (SOURCE: WORLD HEALTH ORGANISATION)
                                                  weight in kilograms
                                                height in metres squared

                     CLASSIFICATION                                                  BODY MASS INDEX
                      Underweight                                                       < 18.5
                      Normal Weight                                                   18.5 – 24.9
                      Overweight                                                      25.0 – 29.9
                      Obese Class 1                                                   30.0 – 34.9
                      Obese Class 2                                                   35.0 – 39.9
                      Obese Class 3                                                     > 40


Where healthy weight ends and unhealthy weight begins is a matter of research and debate. However, the links between
obesity and a wide range of health conditions has been well established and the World Health Organisation estimates that
around 58% of type 2 diabetes (a person with a height / weight ratio or body mass index (BMI) of 35 has around 100 times
the risk of type 2 diabetes), 21% of heart disease and between 2% and 42% of certain cancers are attributable to excess
body fat. Obesity is also associated with increased risk of hypertension, respiratory disorders, reproductive disorders,
osteoarthritis, back pain and social and psychological problems. For those who are already obese, even a modest weight loss
can have substantial benefits (Jung, 1997). Increased child obesity may mean today’s children have a shorter life
expectancy than their parents. Childhood obesity increases the risk of early onset of preventable disease in adulthood,
including diabetes, stroke and CVD, and thereby increases the demands on NHS services.

Obese patients attend their GP significantly more often than patients who are of a normal weight and account for a greater
proportion of the prescribing budget (Allan, 2005). The National Audit Office (2001) estimated the costs of treatment for
obesity alone at £1.5 billion; the Health Select Committee (2004) suggested this to be an underestimate of at least 27% and
possibly as much as 40%.


                                      DIANNE GARDNER, SENIOR HEALTH PROMOTION SPECIALIST                                         4
                                      BURNLEY, PENDLE AND ROSSENDALE PRIMARY CARE TRUST
                                                   dianne.gardner@bprpct.nhs.uk
The rise in obesity is attributed to eating and physical activity patterns which have changed significantly over the past few
decades, due to environmental, behavioural and lifestyle changes. It appears to be clear that people are over eating. The
cheapness, availability and heavy marketing of energy-dense foods makes this very easy to do, coupled with an increasing
reliance on snacks and ready-prepared food (Health Committee Report, 2004). Many people in society are losing the skills to
cook fresh foods and this makes selecting healthy options more difficult. The average time spent preparing a meal in 1983
was an hour, but in 2004 it had shrunk to just 13 minutes (Health Committee Report, 2004). Sanders (2004) believes that,
more important than how much we eat, is what we eat and how we eat it. He feels that there are more temptations to
overeat and feast in today’s society, especially with more food being eaten outside the home with increased calories and
portion sizes. Social and emotional pressures may play a greater role in determining food intake than the physiological
regulators responding to hunger and satiety and many social eating and drinking patterns encourage over-consumption
(Royal College of Physicians, 1983). Making healthy, informed choices about nutrition is more complicated than ever and this
is not supported by the fact that healthy foods are often more expensive.

Low levels of physical activity also play a dominant role in the development of obesity by greatly reducing energy needs.
Our bodies are made to move and as a result burn calories. The 2004 Health Committee Report found the current
generation to be growing up in an obesogenic environment in which the forces behind sedentary behaviour are growing, not
declining. There is no escaping the fact that 30-35% of men and women have been found to undertake fewer than four 20
minute periods of any type of moderate activity a month (Allied Dunbar National Fitness Survey, 1992) The physical
environment has changed enormously over the past 50 years. The NAO report (2001) stated that the extra physical activity
involved in daily living 50 years ago, compared with today, was the equivalent to running a marathon a week. Prentice and
Jebb (2004) found affluence to be associated with a decline in energy expenditure as people adopt increasingly sedentary
lifestyles in which motorised transport, mechanised equipment, and energy saving domestic appliances displace physically
arduous tasks. Only 20% of men and 10% of women are now employed in active occupations (Allied Dunbar National
Fitness Survey, 1992). The average person in England now watches over 26 hours of television a week, compared with 13
hours in the 1960’s (Office of Population Censuses and Surveys, 1994) and video and computer games further contribute to
inactivity in children. Active transport, particularly to and from school, has reduced dramatically over recent decades.
Between 1986 and 1996 the proportion of under 17’s walking to school fell from 59% to 49% and only 1% now cycle to
school. Car journeys to school have doubled in the last 20 years with almost 30% of pupils now being ferried from door to
door (DETR, 1999). Parents are increasingly fearful of allowing their children to play outside or walk or cycle to school due
to personal safety issues (Narayan, 2001).

Foetal development and consequent birth weight are another important biological piece of the obesity jigsaw even though
they have been ignored in many key documents when identifying causes of obesity. Ong et al (2002) found that the
                                      DIANNE GARDNER, SENIOR HEALTH PROMOTION SPECIALIST                                    5
                                      BURNLEY, PENDLE AND ROSSENDALE PRIMARY CARE TRUST
                                                   dianne.gardner@bprpct.nhs.uk
sequence of foetal growth restraint (e.g. low birth weight due to mothers poor nutrition) and postnatal catch up growth may
predispose them to obesity risk in the contemporary population. Law, Barker, Osmond, Fall and Simmonds (1992) studied 2
groups of men to investigate reduced early growths association with abdominal fatness in later life and found the tendency
to store fat abdominally may be a persisting response to adverse conditions and growth failure in foetal life and infancy.
Kries et al (1999) studied the impact of breast-feeding on the prevalence of being overweight or obese in children born in
the early 1990’s. The most remarkable finding was a consistent, protective, and dose dependent effect of breast-feeding on
obesity and overweight.

 What is apparent is the complexity of the causes of obesity in society today and that ‘more of the same’
 as far as actions to tackle the problem, is not going to be enough. No single measure is likely to reverse
 the tide of obesity and so to tackle the condition locally in Burnley, Pendle and Rossendale we require an
 approach that is clear but includes a wide range of different partners, measures and settings.


Central Targets: The challenge of increasing health through improved nutrition and raised physical activity levels (with the
consequential impact on lowering obesity) has been recognised and has a significant place within the UK public health policy
targets. The Choosing Health White Paper (2004) includes physical activity and healthy eating as central themes supported
by two action plans ‘Choosing Activity?’ and ‘Choosing a Better Diet?’ Through these action plans and the Department of
Health document ‘Delivering Choosing Health’ (2005) a number of good practice developments at a national level have been
proposed as well as key practical actions that are seen as best practice and should be taken into account when setting and
delivering local targets and interventions. These have been recognised and are incorporated into the BPR Food and Physical
Activity Framework.

The focus of the Choosing Health policy is placed on adolescent health. Promoting healthy lifestyle choices and providing the
support to carry out these choices at this stage in the life will be an effective way of improving the health of future
generations and reducing the burden on health services. The new Department of Health / Department for Education and
Skills / Department for Culture, Media and Sport Public Service Agreement to tackle this is:

    ‘To halt the year-on-year rise in obesity among children under 11 by 2010, in the context of a broader
                             strategy to tackle obesity in the population as a whole’.
               (Obesity in children rose by an average of 0.8% per year between 1995 and 2002)

This new children’s obesity target demonstrates commitment and the White Paper recognised that the target would only be
achieved through joined-up action locally and nationally as a shared priority across government.
                                      DIANNE GARDNER, SENIOR HEALTH PROMOTION SPECIALIST                                    6
                                      BURNLEY, PENDLE AND ROSSENDALE PRIMARY CARE TRUST
                                                   dianne.gardner@bprpct.nhs.uk
The main government target for England specific to physical activity (set jointly with the Department for Education and Skills
and Department of Culture, Media and Sport) is to increase the proportion of individuals undertaking 30 minutes of physical
activity on 5 or more days a week to 70% by 2020 (interim target: 50% by 2011). This level of physical activity has been
recommended in the UK since 1996, but reaching it would require a doubling of activity levels in less than 20 years so more
realistic targets are being proposed regionally and locally.

There are many cross-government agreements and strategies that directly link to the obesity agenda e.g. regeneration,
transport, employment, environment, workplace health. There are also those specific to health headlined by the National
Service Frameworks: Diabetes (1999); Coronary Heart Disease (2000); Older People (2001); Children, Young People and
Maternity Services (2004); Cancer Plan (2000); and Mental Health (2000).

The key National Service Framework for Coronary Heart Disease objective is to reduce substantially the mortality rates from
the major killer diseases by 2010: from heart disease by at least 40% in people under 75; and from cancer by at least 20%
in people under 75.

The following Department of Health Public Service Agreements are directly relevant to obesity activity:
    To substantially reduce mortality rates by 2010
    To reduce health inequalities by 10% by 2010 as measured by infant mortality and life expectancy at birth
    To tackle the underlying determinants of ill health and health inequalities



3. THE LOCAL FRAMEWORK FOR ACTION IN BPR

The BPR Framework will assist in achieving the national targets by setting out a systematic local agenda for action. It will
link to a number of regional and local plans for example:
     Local Strategic Partnerships and Community Plans
     Neighbourhood Renewal Strategy
     The Lancashire Healthy Schools Programme
     Local Transport Plans
     North West Regional Delivery Plan: Sustainable Farming & Food Strategy, 2003
     ELWOOD Business Plan 2004 – 2007
     East Lancashire Strategic Framework for the Prevention of CHD / Type 2 Diabetes, 2005
                                      DIANNE GARDNER, SENIOR HEALTH PROMOTION SPECIALIST                                       7
                                      BURNLEY, PENDLE AND ROSSENDALE PRIMARY CARE TRUST
                                                   dianne.gardner@bprpct.nhs.uk
      Local Planning Development Frameworks

It is important to acknowledge that there are a number of action plans and initiatives in BPR supporting the promotion of
healthy eating and physical activity already in place. This framework aims to incorporate and unite together such action to
strengthen the momentum of the healthy eating and physical activity agenda, ensuring that joined up action is central and
that we are all working together to an agreed and shared vision.

3.1 Vision and overall approach

Vision:
   That everyone living in BPR, regardless of location, ethnicity or social grouping, will have access to
   affordable, local naturally nutrient rich food and physical activity opportunities. They will have the
   knowledge and skills to benefit, making the necessary changes to incorporate healthy eating and regular
   physical activity into their everyday lives, with the long-term benefit of improved health.

The Frameworks starting point is a population approach which aims to facilitate the uptake of healthy lifestyles for all
residents, within a context of informed choice. By ensuring a systematic approach is taken across a range of settings, we
hope to create a context which promotes health, reduces the factors that contribute to obesity and provides a supportive
environment for those who are seeking to reduce or maintain their weight.

The Framework incorporates three complimentary key approaches:
    Whole population-based promotion / prevention approaches which are settings / locality based, built within a multi-
      agency partnership infrastructure
    Targeted food and physical activity action to tackle inequalities
    Specific weight management approaches for adults and children who are overweight or obese

In order to meet the vision and devise this Framework a multi-agency BPR Food and Physical Activity Forum was established
in March 2005 with members representing Health (e.g. Public Health / Health Promotion, Dietetics, Healthcare
Professionals); the 3 Local Authorities (e.g. Policy and Planning, Healthy Lifestyle Leads; Parks); Leisure Trusts (Rossendale
and Pendle); Environment (e.g. Groundwork East Lancashire and Rossendale); Voluntary Sector (e.g. BPR Council for
Voluntary Services); Community (e.g. Sure Starts) and Education (e.g. Lancashire Healthy Schools Teacher Consultant). It
would have been impossible, and inappropriate, to invite every individual / agency with an interest in the food and physical
activity agenda and so to ensure ownership and contribution from the full range of groups 3 actions were taken:
                                      DIANNE GARDNER, SENIOR HEALTH PROMOTION SPECIALIST                                      8
                                      BURNLEY, PENDLE AND ROSSENDALE PRIMARY CARE TRUST
                                                   dianne.gardner@bprpct.nhs.uk
          1) Members were co-opted to attend the Forum meetings as appropriate e.g. a representative from the Building
             Schools for the Future Programme; a member of the Lancashire County Council School Travel Team.
          2) Consultation to inform the Framework was carried out with a range of groups e.g. Pendle Healthy Lifestyles
             Group, Burnley Children’s Obesity Group.
          3) The findings from previous consultations were fed into the Framework e.g. Choosing Health consultation focus
             groups.

A number of factors specific to the local position underneath the obesity umbrella became clear to the Forum:
    There are no up to date, reliable data to quantify obesity levels, physical activity patterns or dietary habits amongst
     residents in BPR. This poses a problem when it is essential to demonstrate change and identify need. The last East
     Lancashire Lifestyle Survey was undertaken in 1996.
    There are currently some excellent examples of good practice in BPR. Mapping during the compilation of the East
     Lancashire CHD Primary Prevention Framework (2004) highlighted the wide range of action currently taking place
     around food and activity e.g. Healthy Schools Programme, Activate Pendle, Sow and Grow Project, East Lancashire 5
     A DAY programme, Sure Starts, Good Food Project, Exercise Referral Schemes, Walking Projects, Healthy Living
     Centres (Chai Centre and Howard Street). Unfortunately though this mapping raised the inconsistency and lack of
     capacity resulting in vast inequality of delivery throughout the 3 boroughs. A large percentage of the action is
     delivered through short term funding opportunities under the assumption that proven good practice will be funded
     longer-term and expanded to other districts. Also there is a need to be prepared to meet the demands of future
     developments e.g. Children’s Centres.
    Action is taking place through the community and schools settings but there is a huge gap around action focused
     within the workplace, a missed opportunity to impact on many residents health.
    In the Choosing Health Delivery Plan one of the good practice areas was around developing a coherent approach to
     training appropriate to local needs. This involves improving public health awareness and skills across the local health
     and social care community, including local partnership organisations (e.g. housing, schools, community
     organisations); specialist training to address specific skills deficits (e.g. management of obesity); and promoting
     health through primary care. A training needs gap analysis has recently been completed in East Lancashire (Almond-
     Birtwistle, 2005) to ascertain the training available and accessed by PCT, Local Authority and Voluntary Sector staff
     under the 6 key priority themes in Choosing Health. The resulting qualitative data proved little evidence of training
     available, and that accessed was ad hoc and currently out of date. The survey concluded that without the provision of
     a comprehensive training programme, the choosing health priorities would not be met and the workforce would not
     be fit for purpose.


                                     DIANNE GARDNER, SENIOR HEALTH PROMOTION SPECIALIST                                    9
                                     BURNLEY, PENDLE AND ROSSENDALE PRIMARY CARE TRUST
                                                  dianne.gardner@bprpct.nhs.uk
      There has previously been no focused action to tackle obesity. This agenda has previously sat underneath the healthy
       lifestyle / prevention targets and has been very ad hoc.

These issues need to be prioritised and included in a long-term multi-agency approach to meet the health needs of
residents.

BPR Food and Physical Activity Forum Aim:
To develop in consultation a food and physical activity action plan for BPR, bringing together the wider concerns and targets
surrounding food and activity in order to establish a long-term vision with clear objectives and coherent forward planning.

Key objectives of the BPR Food and Physical Activity Forum:
   Develop and agree a food and physical activity overview and action plan incorporating local and national strategy and
     targets e.g. Community Plans, Choosing Health White Paper.
   Establish a multi-agency approach ensuring agreed shared targets and joint ownership of the action plan.
   Develop evidence-based action, targets and indicators where possible.
   Identify proven good practice within short-term funded projects and incorporate into the action plan.
   Identify prospective funding opportunities.
   To performance manage consultation during the action plan development to incorporate stakeholder and community
     views.
   Propose the course of action to incorporate the food and activity objectives in relevant organisations / partnerships
     future planning e.g. housing, environment, transport, health, local authority.
   Identify the process to review, monitor and evaluate the action plan.


3.2 Framework targets and implementation

In order to impact on the Central Targets (p.6/7), but to place these within a local food and physical activity context, each
section of the Action Plan has been identified an aim and overarching objectives / milestones. The aims are:

      All schools in BPR to be working towards National Healthy School Status by 2009
      By 2010 all schools should have active travel plans
      To increase the number of women breastfeeding up to 8 weeks by 2% per annum by 2009
      To improve healthy eating and play opportunities for pre-school children
                                      DIANNE GARDNER, SENIOR HEALTH PROMOTION SPECIALIST                                        10
                                      BURNLEY, PENDLE AND ROSSENDALE PRIMARY CARE TRUST
                                                   dianne.gardner@bprpct.nhs.uk
      Increase the proportion of individuals undertaking 30 minutes of physical activity on 5 or more days a week (50% by
       2020)
      To increase residents intake of naturally nutrient rich food through raising fruit and vegetable intake, reduce salt and
       sugar intake and reduce total and saturated fat intake
      To maximise local food production for local consumption
      To halt the year-on-year rise in obesity among children under 11 by 2010
      11 years plus to decrease the proportion classified as obese with time

Monitoring these aims, and the associated objectives / milestones, will enable us to ascertain the progress and impact of the
Framework and will be further supported by quantitative and qualitative evaluation of the actions listed in each section. Most
sections also have some identified linked targets / actions which are planned developments within BPR that, as they fall
under the food and physical activity agenda, the Forum need to keep up to date with progress but which the Forum will not
be actioning directly.

To ensure that the Framework is a delivery document (and does not spend its life sitting on a shelf) each action has been
identified a lead officer. They will feed back to the BPR Food and Physical Activity Forum with progress, developments and
evaluation. The Forum will meet quarterly to drive the Framework forward and annually progress will be reviewed, and the
Framework revised.

Many actions do overlap and touch all big win areas for example:
   Building Schools For the Future – infrastructure to ensure ability to deliver physical activity (extended schools) and
      healthy eating e.g. kitchens, facility for food tech / home economics, growing allotments etc.
   Training – of health professionals / teachers etc. to support people to make change and provide information.
   Workplace – corporate schemes, healthy catering / vending in large organisations e.g. leisure, local authority,
      encourage walking / cycling to work (bike racks).

These have been recognised and links have been made within the action plan. The action plan also demonstrates how
partners can work together to jointly deliver the identified targets.




                                      DIANNE GARDNER, SENIOR HEALTH PROMOTION SPECIALIST                                      11
                                      BURNLEY, PENDLE AND ROSSENDALE PRIMARY CARE TRUST
                                                   dianne.gardner@bprpct.nhs.uk
REFERENCES
    Allied Dunbar National Fitness Survey (1992) A Report on Activity Patterns and Fitness Levels. London: Sports
     Council and Health Education Authority.
    Almond-Birtwistle, M. (2005) Choosing Health: Training Needs Gap Analysis in East Lancashire. East
     Lancashire Public Health Network.
    Department of Health (2000) National Service Framework for Coronary Heart Disease. London: Stationary
     Office.
    Department of Health (2004) Choosing Health? Choosing a Better Diet. London: Stationary Office.
    Department of Health (2004) Choosing Health: Making Healthier Choices Easier. London: Stationary Office.
    Department of Health (2004) Choosing Health? Choosing Activity. London: Stationary Office.
    DETR (1999) Transport Statistics Bulletin, National Travel Survey 1996-1998 Update. London: DETR.
    House of Commons Health Committee (2004) Obesity: Third Report of Session 2003-04, Volume 1. London:
     The Stationary Office.
    Jebb, S. (2004) Obesity: causes and consequences. www.medicinepublishing.co.uk, 2005.
    Jung, R.T. (1997) Obesity as a disease. British Medical Bulletin, 53, 307-321.
    Kries, R., Koletzko, B., Sauerwald, T., Mutius, E., Barnert, D., Grunert, V. and Voss, H. (1999) Breast-feeding and
     obesity: cross sectional study. British Medical Journal, 319, 147-150.
    Law, C.M., Barker, D.J.P., Osmond, C., Fall, C.H.D. and Simmonds, S.J. (1992) Early growth and abdominal fatness in
     adult life. In Barker, D.J.P. (1992) (Ed.) Foetal and Infant Origins of Adult Disease. London: BMJ.
    Narayan (2001) NW Health Bulletin: Obesity, the Biggest Unrecognised Public Health Problem? Liverpool:
     North West Public Health Observatory.
    National Audit Office (2001) Tackling Obesity in England: Report by the Controller and Auditor General.
     London: HMSO.
    Office of Population Censuses and Surveys (1994). General Household Survey. London: HMSO.
    Ong, K.K.L., Preece, M.A., Emmett, P.M., Ahmed, M.L. and Dunger, D.B. (2002) Size at birth and early childhood
     growth in relation to maternal smoking, parity and infant breast-feeding: longitudinal birth cohort study and analysis.
     Paediatric Research, 52, 863-867.
    Royal College of Physicians (1983) Obesity: a report of the royal college of physicians. Journal of the Royal
     College of Physicians of London, Vol 17, No. 1.
    Royal College of Physicians, Royal College of Paediatrics and Child Health and Faculty of Public Health (2004) Storing
     Up Problems: the Medical Case for a Slimmer Nation. Report of a working party. London: RCP, RCPCH and
     Faculty of Public Health.
    Sanders, T. (2004) Can MP’s teach us to be healthy? Fat chance. The Mail on Sunday, June 13th.p.27.
                                    DIANNE GARDNER, SENIOR HEALTH PROMOTION SPECIALIST                                   12
                                    BURNLEY, PENDLE AND ROSSENDALE PRIMARY CARE TRUST
                                                 dianne.gardner@bprpct.nhs.uk
4. ACTION PLAN

BIG WIN 1 – CHILDREN AND YOUNG PEOPLE

A. HEALTHY SCHOOLS

AIM: All schools in BPR to be working towards National Healthy School Status by 2009

Objectives / Milestones:
   Half of all schools (80) achieving the physical activity and healthy eating aspects of National Healthy
     School Status by December 2006
   From 2007-2009 an increase of 25 schools per year achieving the healthy eating and physical activity
     aspects of National Healthy School Status.

                                                         LEAD             OUTCOME / PROGRESS                TIMELINE
                       ACTION                        PARTNERS /
                                                        LINKS
1. To identify funding and then recruit an officer PCT, Lancs             Secure funding for 2006-     December 2005
dedicated in BPR to support schools and drive the Healthy Schools         2009 (potentially from
healthy schools programme forward                  Team, LHS              Choosing Health Monies)
                                                   Healthy Eating
                                                   Development            Recruit post                 April 2006
                                                   Group, Education
                                                                          Post to review schools       September 2006
                                                                          current position in BPR to
lead officer = Dianne Gardner
                                                                          provide baseline
                                                    HA Plans, CH
2. Devise and implement in partnership a local      PCT, Lancs            Training programme           February ‘06
training programme e.g. growing in schools, to      Healthy Schools       devised and circulated
support schools to adopt the ‘food in schools’      Team,
toolkit and 2 local guidance documents on           Groundwork +          Programme delivery and       April ‘06+
healthy eating and physical activity (launched      range of partners     evaluation
                                     DIANNE GARDNER, SENIOR HEALTH PROMOTION SPECIALIST                                 13
                                     BURNLEY, PENDLE AND ROSSENDALE PRIMARY CARE TRUST
                                                  dianne.gardner@bprpct.nhs.uk
October 2005)

lead officer = Jenny Slaughter                             HA Plan, CH
3. To apply elements of the ‘Food in Schools’              PCT + all forum       Compile resources and
Toolkit into food policies / actions in other              partners              identify the process of      Mid 2006
settings e.g. Leisure, PCT, Workplace to ensure                                  implementation
standardisation of healthy eating messages
                                                                                 Implement and evaluate       October 2006
lead officer = Dianne Gardner / Margaret Horner            HA Plan, CH           impact
4. To implement a series of training opportunities         PCT, Lancs            Design a programme of        March 2006
for partners who deliver in schools in order to            Healthy Schools       training and begin
ensure that they utilise their opportunity to              Team + range of       implementation with full
support the school to work towards achieving               partners              evaluation
healthy school status (e.g. provide the school
with a good practice certificate)

lead officer = Julie Johnson                               HA Plan, CH
5. Extend and revise the capacity of the school            PCT, Education        Identify Choosing Health     February 2006
nurse team (to include full-time roles) to further                               Monies plus other
support school health needs and children at risk                                 resource opportunities
with a strong link into the obesity agenda
                                                                                 Implement team changes       April 2006+
lead officer = Davina Gittins                              CH
6. Support the implementation of the revised               SHA, PCT’s, H S,      Monitoring of standards      April 2006
school meal standards, ensuring there are                  Lancs County
training opportunities for cooks / welfare                 Developments,         Ensure training of cooks     April 2006
assistants and that schools adopt the ‘Food for            Lancs County          around nutrition takes
Life’ targets (Soil Association) in line with SSFF         Commercial            place
and BPR PCT Food Charter                                   Services, LSPs,
                                                           Nelson & Colne        Career development for       Jan – March 06
                                                           College, East         school cooks / welfare       (see p.24 action 3.)
                                                           Lancs Ed Business     assistants – production of
                                                           Partnership           ‘bespoke’ package and
                                                           ‘Young Chef           feed into adapted
                                            DIANNE GARDNER, SENIOR HEALTH PROMOTION SPECIALIST                                       14
                                            BURNLEY, PENDLE AND ROSSENDALE PRIMARY CARE TRUST
                                                         dianne.gardner@bprpct.nhs.uk
                                                           Awards’               Nutrition Skills level 1,2,3

                                                                                 Monitor schools                 Summer 2006
Lead officer = Jenny Slaughter                             CH                    achievement in adopting
                                                                                 local ‘Food for Life’ targets
7. Cooking/Nutrition Skills for Children and
Parents                                                                          b. develop the packs and
Development of cooking / nutrition skills and              LHS, Education,       nutrition information and       March 2006
awareness raising in the whole school community            PCT, BSF, LCC,        then devise a plan of
through a number of actions:                               BBC, Groundwork,      delivery so schools can
   a. linked to the food in schools toolkit –              Education +           lead in the
      curriculum / teacher training                                              implementation. Evaluate
   b. information / resources for schools to                                     impact.                         December 2006
      implement in curriculum time and for
      health events                                                              c. identify need and
   c. Cook and taste sessions /courses in                                        programme of delivery           Summer 2006
      schools for parents – links to extended
      school remit                                                               d. regular contact with the
   d. ensure kitchen development suitable and                                    BSF team and action as          Ongoing
      available for community use under                                          appropriate
      Building Schools for the Future
   e. After school nutrition / cooking                                           e. Assess the impact, good
      opportunities for children linked to                                       practice and sustainability Summer 2006
      BUFFALO project (Burnley Food and                                          of school based projects
      Fitness Aimed at Lowering Obesity), junior                                 and produce plan to best
      BEEP, Rossendale Healthy Lifestyle School                                  meet the after schools
      Project, Grow and Sow project and                                          remit
      extended schools
                                                           HA Plans, CH, EA      Roll out evidenced model        January 2007
Lead officer = Alison McLaughlin / Jenny Slaughter         Plans                 throughout BPR




                                            DIANNE GARDNER, SENIOR HEALTH PROMOTION SPECIALIST                                   15
                                            BURNLEY, PENDLE AND ROSSENDALE PRIMARY CARE TRUST
                                                         dianne.gardner@bprpct.nhs.uk
LINKED TARGETS / ACTIONS:                                                            All schools to be part of a
1. School Sport Co-ordinator Partnership - has 3    Education, Sports                school sport partnership
strands: curriculum PE (aiming for the minimum      Clubs +                          by 2006                       April 2006
of 2 hours of PE a week); extra curricular sport at
school sites; sports club links.                                                     Evaluate impact on pupil
                                                                                     sport / physical activity     April 2007
                                                                                     participation (number
                                                                                     schools meeting 2 hours
                                                                                     of activity per week
Lead officer = Annette McNeil / Julie Johnson                  HA Plans, CH          target)

2. All eligible schools and nurseries to be taking             Education, LHSP,      Assess numbers taking         April 2006
part in the school fruit and vegetable scheme                  PCT                   part and approach those
                                                                                     that are not
Lead officer = Alison McLaughlin

                                                                                     Evaluate impact               End 2007

3. Development of physical activity opportunities              Sports                Monitor development
out of school e.g. links to voluntary sector, youth            Development,          plans from the 3 borough      Ongoing from
clubs, private sector, Burnley Sport and Physical              Leisure and           alliances and regularly       February 2006
Activity Strategy, Rossendale Sports Alliance,                 Recreation, Sports    feedback to Forum
Sport Pendle                                                   Clubs etc.
Lead officer = Joe Cooney, Martin Kay and Linda Searle


B. - CHILDREN’S TRAVEL

AIM: By 2010 all schools should have active travel plans (compare from baseline 2005)

                                                    PARTNERS /                       OUTCOME / PROGRESS                 TIMELINE
                    ACTION                            LINKS
1. All partners + Healthy Schools Team who work Healthy Schools                      To raise awareness and        From March 2006
in schools to promote active travel plans and the Team, LCC,                         handout borough lead
                                                DIANNE GARDNER, SENIOR HEALTH PROMOTION SPECIALIST                                   16
                                                BURNLEY, PENDLE AND ROSSENDALE PRIMARY CARE TRUST
                                                             dianne.gardner@bprpct.nhs.uk
resource / support available from the Lancashire              Education,            contact list at both the
School Travel Team                                            Healthy Lifestyle     Lancashire Healthy
                                                              Teams, BBC            Schools Steering Group
                                                              (ELEVATE) +           meeting and the East
                                                              other partners        Lancs Partner Training
                                                                                    Event March / April
Lead officer = Dorothy Crane / Julie Johnson                  CH
2. Actions to promote cycling and walking to                  LCC, Sports           Link to schools working      From September
school e.g.                                                   Development           towards physical activity    2006
 - discounted bikes through schools                                                 standard – evaluate
 - award system to encourage further use                                            numbers with schemes
 - Cycle training – passport to safer cycling
                                                                                    Create multi-use, off road   Ongoing
                                                                                    routes to the new super
Lead officer = Alistair Simpson / Julie Johnson
                                                                                    schools
3. Support national campaigns promoting walking All Forum                                                        See P. 23 Action 7
/ cycling to school                             members,
                                                Education, LCC
Lead officer = Dianne Gardner




C. - EARLY YEARS INTERVENTIONS

AIMS:
   To increase the number of women breastfeeding up to 8 weeks by 2% per annum by 2009 (baseline
     2005)
   To improve healthy eating and play opportunities for pre-school children

Objectives / Milestones:
   To increase the number of women breastfeeding up to 6 months by 2008 (from baseline identified
     2006)
   To increase the number of women breastfeeding at initiation by 2% per annum (from baseline 2005)
   25% of pre-school care organisations to be working towards BPR guidelines for food and drink by 2008
                                               DIANNE GARDNER, SENIOR HEALTH PROMOTION SPECIALIST                                     17
                                               BURNLEY, PENDLE AND ROSSENDALE PRIMARY CARE TRUST
                                                            dianne.gardner@bprpct.nhs.uk
                                                           Lead Partners        OUTCOME / PROGRESS              TIMELINE
                    ACTIONS                                    and links
1. To increase population awareness of the                Sure Start, Health    Identify funding for the      Choosing Health
benefits of breastfeeding through:                        Visitors, School      package production             funding? Early ‘06
     Identifying opportunities / programme to            Nurses, PCT,
        disseminate information to groups e.g.            Groundwork,           Develop a package to          Summer 2006
        youth groups, men’s groups, colleges              Leisure + all         educate groups
     Develop a package to educate groups                 forum members
                                                                                Devise the dissemination      Autumn 2006
                                                                                programme

                                                                                Implement and evaluate        2007-2009
                                                                                the dissemination
Lead officer = Jane Fletcher
2. Delivery of healthy eating and physical activity       Sure Start /          Review best practice          Summer 2006
through Sure Start and Children’s Centres                 Children’s            around weaning and
                                                          Centres, Health       devise a programme of
                                                          Visitors, PCT,        appropriate action to
                                                          Groundwork,           ensure standardised
                                                          Leisure, Parks        practice

                                                                                Work with partners to
                                                                                develop growing / gardens     Summer 2006
                                                                                and play opportunities

 Lead officer = Jenny Slaughter / Dianne Gardner          HA Plans, CH          Evaluate developments         From 2007

3. Support the BPR Sure Start Group to influence All forum                      Identify how the forum        Early 2006
businesses and sign them up to be breast feeding members                        can support the group
friendly employers and venues (link to the
Chamber of Commerce)                                                            Compile and disseminate a     Find out from the
                                           DIANNE GARDNER, SENIOR HEALTH PROMOTION SPECIALIST                                       18
                                           BURNLEY, PENDLE AND ROSSENDALE PRIMARY CARE TRUST
                                                        dianne.gardner@bprpct.nhs.uk
                                                                                 directory                         group

                                                                                 Include in the Forum             From April 2006
                                                                                 developments around
Lead officer = Jane Fletcher / Dianne Gardner                                    workplace

4. To develop a toolkit (working with the healthy          Healthy Schools,      In partnership develop a         Autumn 2006
schools team) around nutritional guidelines for            PCT, Private          toolkit
child minders and nurseries (include Procurement           Sector, Sure Start
Policy for caterers following DEFRA / SSFF?)                                     Disseminate the toolkit          2006-2009
                                                                                 including a programme of
Educate families at these sessions around the                                    training (incorporate
benefits of being active / healthy eating etc.                                   education) and monitoring

Lead officer = Jenny Slaughter


LINKED TARGETS / ACTIONS
1. Roll out of training around the La Leche and            PCT, SURE             Identify extra funding for    From Choosing
Unicef Baby Friendly Packages to health                    STARTS                training and roll out with    Health Funding?
professionals                                                                    continued support             February ‘06

Lead officer = Jane Fletcher                               HA Plans, CH


2. Ensure standardised dietetic / healthy eating                                 Link through the              Attend meetings
input into the development of Children’s Centres           PCT, Children’s
                                                                                 Operational Health Groups     from Jan 2006
(including the ‘Healthy Start’ and ‘Smiling for Life’      Centres
                                                                                 for each borough
initiatives)

Lead Officer = Jenny Slaughter
                                                                                 Devise a plan of how the      From April 2006
                                                                                 input will be delivered and
                                                                                 put into action

3. To review current play opportunities
identifying prospects for expansion / awareness            Leisure, Sure
                                                                                 Review current play           From February 2006
                                                           Start, Private
                                            DIANNE GARDNER, SENIOR HEALTH PROMOTION SPECIALIST                                       19
                                            BURNLEY, PENDLE AND ROSSENDALE PRIMARY CARE TRUST
                                                         dianne.gardner@bprpct.nhs.uk
raising for preschool children e.g. tumble tots               Sector, Friends of   strategies / provision and
(BBC), Elwood nature programme, and                           the Parks, PCT,      Park strategies and
encourage families to go to the park / open space             Schools and          feedback to the Forum
to play                                                       Nurseries,
                                                              Groundwork,          Identify any cross linkages   September 2006
                                                              Parks, BSF,          and joint working
                                                              Elevate + all        opportunities
                                                              forum members

Lead Officers = Joe Cooney, Linda Searle and Liz Hinchliffe   CA Plans, CH




BIG WIN 2 – TACKLING OBESITY PREVENTION

A. PHYSICAL ACTIVITY

AIM:
   Increase the proportion of individuals undertaking 30 minutes of physical activity on 5 or more days a
     week to 50% by 2020

Objectives / Milestones:
   To increase the number of adults taking 30 minutes moderate intensity activity on at least 5 days a
     week by 1% a year (baseline to be determined from Sport England Survey mid 2006)

                              ACTIONS                                     PARTNERS /            OUTCOME /              TIMELINE
                                                                              LINKS             PROGRESS
1. Workplace - Bringing public, private and voluntary sector             All Forum          Identify funding for a   From Choosing
together to promote physical activity:                                   members            workplace health post    Health Monies?
    Education of educators – teachers as role models,                                                               Early ‘06
      now a target in Healthy Schools Standard                                              Monitor teacher
    Produce paper on evidence base / what’s in it for                                      education under          Ongoing
      them – first step large employers e.g. supermarkets                                   healthy schools
                                             DIANNE GARDNER, SENIOR HEALTH PROMOTION SPECIALIST                                       20
                                             BURNLEY, PENDLE AND ROSSENDALE PRIMARY CARE TRUST
                                                          dianne.gardner@bprpct.nhs.uk
      Pledges from agencies / companies with guidance
       and information provided                                                           Produce resources,        From Autumn ’06
      LCC Travel Plans for the workplace (George Davis)                                  identify partners,
       (www.lancashire.gov.uk/environment/twise/btw/btp.                                  recruit workplaces
       asp)
                                                                                          Evaluate impact           2007-2009
Lead officer = Dianne Gardner

                                                                     CH
2. Training of health professionals, partners and voluntary /        All Forum            Secure funding to         Autumn 2006
community leads (incorporating physical activity                     members + link       recruit a lead post to
questionnaire when published end ‘05, use of pedometers,             to other Forums      identify training
National Health Competency Framework published end ’05)              e.g. Burnley         programmes and pull
to provide appropriate advice to groups and individuals              Sport and            together partner
around physical activity                                             Physical Activity    agencies for delivery
                                                                     Strategy Group
                                                                                          Devise and implement End 2006+
                                                                                          suitable training
                                                                                          programmes through
                                                                                          community /
                                                                                          voluntary networks

Lead officer = Dianne Gardner / Terry Hephrun                                             Evaluate impact           2007+
3. Community level interventions to promote sustainable              District             Partners raise profile    Ongoing
transport and increase the number of people walking /                Councils,            in schools to
cycling linking into local and county plans e.g. Lancashire          ELEVATE,             encourage active
Walking Strategy, Lancashire Transport Plan, Local                   Sports Colleges,     travel (+ workplace
transport plans, Elevate (contacts Mike Wellock; Peter               LCC, BC, all         travel – see action 1.)
Shorrock or Louise Kirkup), Local Development Frameworks.            Forum
                                                                     members, East        Sustain walking           April 2006
                                                                     Lancs Regional       projects in 3
                                                                     Park, Ramblers,      boroughs – review
                                                                     Groundwork           delivery
                                                                                                                    Autumn 2006
                                           DIANNE GARDNER, SENIOR HEALTH PROMOTION SPECIALIST                                         21
                                           BURNLEY, PENDLE AND ROSSENDALE PRIMARY CARE TRUST
                                                        dianne.gardner@bprpct.nhs.uk
                                                                                       Sustainable Transport
                                                                                       post? Shared funding
                                                                                       between PCT and LA?

                                                                                       Devise plan of action    End 2006
                                                                                       locking into national
Lead Officer = Dianne Gardner / Physical Activity Planning Group
                                                                                       guidance and
                                                                                       implement in
                                                                   CH, CA plans, EA    partnership
                                                                   Plans & HA plans
4. NHS Health Trainers – recruit a workforce of health             PCT + all Forum     Secure funding           Early 2006
trainers to provide practical advice and support (mainly 1:1)      partners,           (Choosing Health /
on healthy lifestyles, including activity, weight and diet,        private, public     PCT) to finance
initially in areas of greatest need to target inequalities –       and voluntary       Health Trainers
recruit and train people to lead in their own setting e.g.         sector              underneath the
workplace, college, disabled groups.                                                   Activate umbrella
                                                                                                                Early 2006
                                                                                       Recruit Health
                                                                                       Trainers in areas of
                                                                                       Burnley                  During 2006 /
Lead officer = Anne Shirley                                        CH
                                                                                                                2007
                                                                                       Expand to target
                                                                                       areas in all 3
                                                                                       boroughs and
                                                                                       evaluate impact

5. Borough Healthy Lifestyle Teams – ensure a holistic             Healthy Lifestyle   Review current team      Summer 2006
approach is taken at all sessions / groups / contacts with         Teams, PCT,         delivery and potential
residents to promote all lifestyle opportunities available in      Groundwork,         opportunities e.g.
the borough e.g. link to weight management courses,                Age Concern +       cook and taste
cooking skill courses, walking, green gyms, inequalities                               sessions / courses
(over 50’s etc.), smoking cessation.
                                                                                       Improve partnership      End 2006
                                        DIANNE GARDNER, SENIOR HEALTH PROMOTION SPECIALIST                                      22
                                        BURNLEY, PENDLE AND ROSSENDALE PRIMARY CARE TRUST
                                                     dianne.gardner@bprpct.nhs.uk
                                                                                            working and co-
                                                                                            ordination of joint     See Action 7.
Lead officer = Linda Searle, Martin Kay and Carol Harvey
                                                                       HA Plans, CA Plans
                                                                                            activities              p.23

6. Exercise opportunities for older people:                            PCT, Healthy         Leads to compile an
                                                                       Communities          overview of current
Increase physical activity opportunities and accessibility for         Collaborative,       opportunities and
this target group (tackling rural health and social isolation)         Age Concern,         action linking into
                                                                       Physical Activity    falls, chair based,     By the end 2006
Increase the knowledge of key people to influence this                 Leads etc.           gardening, Health
groups awareness and motivation (e.g. people working in                                     Trainers, BPR Healthy
sheltered accommodation) recruiting older peoples physical                                  Communities
activity champions                                                                          Collaborative etc.
                                                                                                                    2007 - 2009
Lead officer = Dianne Gardner / Linda Searle / Carol Harvey / Martin                        Devise and implement
Kay                                                                    HA Plans             an older peoples plan
7. Marketing strategy / campaigns – identify national and              All Forum            Identify 1/2          From February
local campaigns, encouraging wide support (e.g.     ‘ East             members              campaigns for 2006    2006
Lancs on the move’ on all media) and recognition by all                                     and implement
Network members (utilising local good news stories and
promoting the key messages and opportunities)                                               Devise a strategy     End 2006 to
                                                                                            implementing through implement 2007
                                                                                            all food and physical
                                                                                            activity network
                                                                                            members

                                                                                            Establish a BPR Food    2007
                                                                                            and Physical Activity
Lead officer = Dianne Gardner / Alison McLaughlin
                                                                       CH, CA Plans         website to share
                                                                                            information
8. Increase the awareness and access of the natural                    Council, Friends
environment through:                                                   of Parks, PEN,       Lead Officers to        From February
 the local community through a series of info leaflets,               Countryside          feedback to Forum on    2006
                                             DIANNE GARDNER, SENIOR HEALTH PROMOTION SPECIALIST                                       23
                                             BURNLEY, PENDLE AND ROSSENDALE PRIMARY CARE TRUST
                                                          dianne.gardner@bprpct.nhs.uk
    media coverage and events promotion – promote                         Agency, LCC,         developments and
    pathways / bridleways                                                 Groundwork,          identify joint action
   signposting, boards, maps, leaflets – link to national                Wildlife Trust,      when required
    curriculum in schools to appreciate the local natural                 BTCV, District
    environment                                                           Councils (Rights
   encourage use of parks, canal, allotments etc. by                     of Way Officers,
    teachers, youth workers, health professionals working                 Walking the
    with vulnerable groups                                                Way to Health
   Engage with the countryside e.g. green gyms?                          Officers)
   Extend and promote cycle paths – Sustrans cycle routes
    (operational network of linkages – cycle ways,
    bridleways and footpaths and opportunities to use them
    e.g. organised walks)
                                                                          CH, CA Plans, EA
Lead Officer = Liz Hinchliffe and Sandra Silk                             Plans
LINKED TARGETS / ACTIONS

1. Leisure to lead in the review of current leisure card                  All Leisure          Short annual paper /    June 2006 +
schemes, their usage plus provision of classes that target ‘at            leads, PCT,          review to feed back     annually
risk’ groups e.g. women only, ethnic minority and disabled                partners             to Forum
users, baggy t-shirt, 50+ activities – ensuring equality of
                                                                          CA Plans
access
Lead officer = Martin Kay
                                                                                          Regular updates,             From April 2006
2. Deprived Communities – sustain, support and add value
                                                                          PCT + all Forum evaluation and
to the targeted physical activity projects in the community                               reviews – invite leads
                                                                          members
e.g. Activate Pendle, Howard Street Healthy Living Centre,                                to attend Forum
Chai Centre                                                                               meetings
                                                                          HA Plans
Lead Officer = Dianne Gardner

3. Commit to improve on an ongoing bases the quality of
parks infrastructure and cycle networks                                                        Leads to feedback on    From February
                                                                                               borough plans /         2006
Lead Officers = Joe Cooney, Liz Hinchliffe, Sandra Silk                                        strategies on renewal
                                                DIANNE GARDNER, SENIOR HEALTH PROMOTION SPECIALIST                                       24
                                                BURNLEY, PENDLE AND ROSSENDALE PRIMARY CARE TRUST
                                                             dianne.gardner@bprpct.nhs.uk
                                                                                              of parks infrastructure
                                                                                              and cycle path /
                                                                                              bridleway
                                                                                              developments
B. - FOOD / 5 A DAY

AIM:
   To increase the intake of naturally nutrient rich food raising fruit and vegetable intake, reduce salt and
     sugar intake and reduce total and saturated fat intake
   To maximise local food production for local consumption

                                               PARTNERS /                       OUTCOME / PROGRESS                       TIMELINE &
             ACTIONS                             LINKS                                                                      HOW
                                                                                                                          DELIVER /
                                                                                                                           FUND?
1. Food Charter - To develop              All Forum members          Devise the charter with the support of the         Summer 2006
and implement a BPR Food                  and partners               BPR Food Planning Group extending it to
Charter (vision / pledge?) that                                      include physical activity / obesity
local companies / organisations
sign up to with practical                                            Once agreed circulate around the Network,
guidance to support change. Use                                      encourage support and include media                End 2006
these networks to implement                                          coverage
national campaigns

Lead officer = Jenny Slaughter / Alison
McLaughlin
2. Primary Care – Training for            PCT, Teaching PCT,         Identify needs and appropriate delivery /          Summer 2006
health professionals around               Training / Education       partners / resources
supporting people to change and           Partners
to provide standardised healthy                                      Devise the training package                        Autumn 2006
eating messages to meet
individual needs                                                     Implement the training with follow up and          End 2007+
                                          CH                         evaluation
Lead officer = Margaret Horner /
                                               DIANNE GARDNER, SENIOR HEALTH PROMOTION SPECIALIST                                     25
                                               BURNLEY, PENDLE AND ROSSENDALE PRIMARY CARE TRUST
                                                            dianne.gardner@bprpct.nhs.uk
Dianne Gardner
3. Training / Awareness            PCT + Forum                Develop a range of training packages to cover Jan – March
Raising packages – around          members and                the broad participant needs from raising      2006
obesity / food and health for a    partners                   awareness through to training the trainers
full range of groups including
health trainers, statutory                                    Implement and evaluate training to meet
organisations, community                                      local needs
workers and the voluntary
sector, harmonising nutrition
skills delivery and targeting                                                                               June 2006 +
inequalities incorporating good
practice identified through 5 A
DAY
                                   CH
Lead officer = Alison McLaughlin
4. BPR Food Action Group –         PCT, LA, Activate,         Establish the action group, key contact for   Jan 2006
establish a workforce subgroup     Sure Start / Children      media issues and include PR Officers
to ensure joint working and to     Centre reps etc.
lead around areas such as policy                              Oversee implementation of all Framework
development and respond to                                    food related actions and respond to policy    March 2006
media issues.                                                 development / media as necessary

Lead officer = Margaret Horner /
Dianne Gardner

5. Sustaining Projects –           Support from all           Compile a directory of food activity in BPR   Summer 2006
compile a directory of BPR food    Forum members and          including details of funding and outcomes
and health projects (including     partners
funding, timescales, outcomes                                 Include on the Forum agenda projects
etc.). Work in partnership to                                 needing support / continuation
support projects and continue                                                                               Ongoing
evidenced good practice.

Lead officer = Alison McLaughlin

                                        DIANNE GARDNER, SENIOR HEALTH PROMOTION SPECIALIST                                26
                                        BURNLEY, PENDLE AND ROSSENDALE PRIMARY CARE TRUST
                                                     dianne.gardner@bprpct.nhs.uk
6. Cooking Skills - Developing      PCT and a range of       Identify / improve availability of community   Jan 2006 +
cooking skills amongst residents    partners e.g. Age        kitchens (BSF)
in a wide range of settings         Concern
incorporating best practice and 5                            Train local people to deliver the cooking      April 2006 +
A DAY, utilising a variety of                                sessions / courses
community / school venues and
facilities targeting inequalities                            Implement an ongoing programme of              Summer 2006
                                                             sessions / courses to meet local needs         +
Lead officer = Alison McLaughlin

7. Catering Establishments:         PCT, Environmental       Extend the Catering for Health Award
Catering for Health Award –         Health, catering         throughout Burnley, Pendle and Rossendale,     From Summer
complete the Burnley pilot and      establishments,          identifying partners and resources. Evaluate   2006+
then expand the award               planning                 impact.
throughout Burnley, Pendle and      departments etc.
Rossendale.

Pressure on Local Authority                                                                                 March 2006
Planning Departments to                                      Identify contacts and assess current
consider the health impact of                                procedures
expansion of fast food outlets                                                                              End 2006 +
and / or new businesses must be                              Devise and implement new processes in
of a standard to achieve the                                 partnership with planning
Catering for Health Award /
healthy eating training for chefs
(contact David Hortin)

Lead officer = Margaret Horner
8. Workplace – to develop a            PCT + all Forum       Develop the toolkit                            Summer 2006
workplace food toolkit (based on members +
the food in schools toolkit) and       workplaces            Devise an implementation programme and         Jan 2007
then roll this out, initially starting                       evaluate
with leisure services.
                                       DIANNE GARDNER, SENIOR HEALTH PROMOTION SPECIALIST                                  27
                                       BURNLEY, PENDLE AND ROSSENDALE PRIMARY CARE TRUST
                                                    dianne.gardner@bprpct.nhs.uk
Lead officer = Margaret Horner / Alison
McLaughlin

9. Training for cooks /chefs              Nelson and Colne          Identify stakeholders                              Early 2006
– currently many local chefs and          College, Accrington
cooks (in a wide range of                 and Rossendale            Set up working groups                              Summer 2006
settings) are not trained in basic        College, LCCS,
healthy eating and cooking. Link          Connexions, Career        Pilot project with young people                    End 2006
to Colleges / Education KPGs. To          Service in Schools,
include local food procurement            East Lancs Business       Identify potential in Cooking / Nutrition Skills
in training. Raising the profile of       partnership, Café         training                                           End 2006
catering as a career – current            Culture
skills gap. Link to ‘Catering for
Health’ and North West Food
and Health Taskforce Catering
Guidelines

Lead Officer = Jim Dwyer?
10. Food procurement –                    Chamber of                See Chief Medical Officer’s report ‘Realigning
sourcing locally to support               Commerce, Local           Public Sector Procurement’.
business, the environment and             Authorities –                                                                Check with
the local economy. DEFRA toolkit          Sustainability Officer,   Work with BGH to sign up to the charter            dieticians from
for sustainable procurement               Economic Dev. Lancs                                                          the acute side
(Public Sector Food Procurement           County                    Links to PCT Green Policy
Initiative). Implement a ‘buy             Developments Ltd                                                             Feb 2006
local, eat local’ campaign.               (LCDL), NFU, Soil         Burnley Food Links Feasibility Study into
Initially identify what is or could       Association, NW           Community Supported Agriculture
be farmed locally and whether             Food and Health                                                              Ongoing
an increased demand could be              Task Force, Burnley       Café Culture procurement policy
met. Link rural and urban                 Enterprise Trust,
regeneration. Support                     LCCS, LSPs, NW            Monitor achievements of schools in achieving       Summer 2006
development of food related               Food Alliance             local procurement targets of ‘Food for Life’
social enterprises.
                                            DIANNE GARDNER, SENIOR HEALTH PROMOTION SPECIALIST                                           28
                                            BURNLEY, PENDLE AND ROSSENDALE PRIMARY CARE TRUST
                                                         dianne.gardner@bprpct.nhs.uk
Lead Officer: Environment Planning
Group
11. Create a food and                 BPR PCT – Public        Collate mailing list of interested people /       March 2006
growing network which links           Health, Dieticians,     organisations
with N.W. Food and Health             Burnley Food Links,
Taskforce (to include all             NW Food and Health      Collaborate in funding applications to sustain    Summer 2006+
community led initiatives) –          Taskforce,              network and support grant scheme
could administer small grants         Groundwork, Pendle
scheme as start up help for           Environmental           Strengthen community / voluntary                  Early Summer
community projects.                   Network                 infrastructure – identify what is out there and   2006
Hold networking events /                                      what is needed through a feasibility study
conferences

Lead Officer = Environment Planning
Group
12. Development of growing            Burnley Food Links,     Many local projects such as Off Shoots,
projects: accessibility,              Groundwork Ross         Hodge Hut, Fresh Fields, Pendle Environment
sustainability and awareness          and East Lancs,         Network, Pendle Barker House Road,
raising. Need expert to lead and      Environment KPGs,       Rossendale Cronkshaw, school gardens, food
advise others e.g. Leisure, green     Education, PCT, LA,     co-ops, Farmers markets in Pendle and
gyms, school allotments. Schools      Leisure Trusts, BTCV,   Rossendale, local food festivals (e.g. Pendle
- link to extended schools,           Lancashire Wildlife     Food Fest), little eden (school children
outdoor classrooms, alternative       Trust, Pendle           access), Leisure Centre gardens / allotments,
curriculum for excluded pupils,       Environmental           Green Gyms, working with excluded groups,
opportunities for children to see     Network, Youth          micro farming, Burnley Community Farm.
where food comes from –               Offending Team,
animals and crops, alternative        GRIP, Schools,
technology. Diversionary              Federation of City      Strengthen community / voluntary
activities for potential offenders.   Farms and Gardens       infrastructure – identify what is out there and   Early Summer
Development of Community              etc.                    what is needed through a feasibility study        2006
Enterprise in Growing
                                                              Devise action plan and implementation             Autumn 2006
                                        DIANNE GARDNER, SENIOR HEALTH PROMOTION SPECIALIST                                     29
                                        BURNLEY, PENDLE AND ROSSENDALE PRIMARY CARE TRUST
                                                     dianne.gardner@bprpct.nhs.uk
Lead Officer = Environment Planning
Group



BIG WIN 3 - OBESITY CARE PATHWAY AND SUPPORT SERVICES

AIMS:
    To halt the year-on-year rise in obesity among children under 11 by 2010
    11 years plus to decrease the proportion classified as obese with time

Objectives:
   Monitor children and adults - The proportion of adult patients with their BMI recorded in the last 15
     months by a GP should increase in time / decrease the proportion of patients with a BMI of 30 or
     greater with time
    Implement and improve support pathways for young people and adults identified as being obese

                      ACTIONS                           PARTNERS /                OUTCOME /                TIMELINE
                                                            LINKS                  PROGRESS
1. Development and further integration of the        PCT, GP Teams +       Identify funding to       January 2006 (from
BPR Obesity Management Strategy for adults           all partners          resource further sessions Choosing Health
                                                     leading healthy       and a part time lead      funding?)
                                                     eating / physical     officer
                                                     activity projects
                                                     and activities        Develop the weight        April 2006 +
                                                                           management service and
                                                                           opportunities to clients
Lead Officer = Margaret Horner                       CH, HA Plans          to meet need
2. To establish Body Mass Index monitoring for       PCT, GP Teams,        Identify funding and      Choosing Health
both adults and children and feed this back into     School Nurse          potential structures e.g. funding? Jan 2006
the system to adjust delivery of support             Teams, ELPHRIC        School Nurse Team
pathways                                                                   record children’s weight

                                      DIANNE GARDNER, SENIOR HEALTH PROMOTION SPECIALIST                                  30
                                      BURNLEY, PENDLE AND ROSSENDALE PRIMARY CARE TRUST
                                                   dianne.gardner@bprpct.nhs.uk
Base on correct international charts to record                             Awaiting national         Autumn 2006
weight changes (discouraging ‘fat’ babies)                                 guidance

Lead Officer = Dianne Gardner                        CH
3. Provision of a service that has the capacity      PCT, Paediatrics,     Identify funding for a    From Choosing Health?
and expertise to treat children who are              Primary Care,         family based approach     Jan 2006
overweight / obese (children’s exercise referral     School Nurses,
guidelines from April ’05 – CH)                      Health Visitors,
                                                     Children’s            Pilot in partnership an   April 2006
                                                     Centres, LA           intervention in Burnley
                                                     Healthy Lifestyle
                                                     Teams                 Extend to cover BPR and   April 2007
                                                                           meet identified needs
Lead Officer = Dianne Gardner                        CH




                                      DIANNE GARDNER, SENIOR HEALTH PROMOTION SPECIALIST                                     31
                                      BURNLEY, PENDLE AND ROSSENDALE PRIMARY CARE TRUST
                                                   dianne.gardner@bprpct.nhs.uk

				
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