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					Adult Obesity                                                                                                                                                                             Heart of Birmingham
                                                                                                                                                                                                   Teaching Primary Care Trust

Care Pathway

                                                                                              Level 3
                                                                                                                      Bariatric Surgery for certain cases and
                                                                                                                      preferably where patients have been
                                                                                                                      through all levels of the care pathway.

                                                                                               Secondary Care -        (Heartlands, Walsall Manor)
                                                                                             Morbid Obesity Service

                                                                                                                                      Specialist Obesity Service
                                                                                                                      Service to treat people with morbid obesity

                                                                                              Level 2
                                                                                                                      within a Primary Care setting. Run by
                                                                                                                      a multi – professional team including a
                                                                                                                      GP Specialist Dietician and Cognitive
                                                                                                                      Behavioural Psychologist, the service aims
                                                                                                                      to be able to provide a more intensive
                                                                                                                      approach than would generally be possible
                                                                                                  Specialist          in Primary Care. Suitable for patients with
                                                                                                Obesity Services      morbid obesity for whom interventions in
                                                                                                                      Primary Care have been unsuccessful.
                                                                                                                      This service will ensure that all options have
                                                                                                                      been tried before someone is considered
                                                                                                                      for bariatric surgery.

                            Size Down                        Exercise on Prescription                                         One to One Dietetic Appointments                                                     Counterweight

                                                                                              Level 1
A free weight loss group. 6 week self       GP referral programme for people with a                                   Opt-in by patient to a 45 minute                                     Counterweight is the only fully evaluated,
referral courses delivered by food health   range of risk factors who would benefit from                              assessment and up to 5-6 follow ups (can                             evidence based primary care weight
advisors and primary care nurses, in        increased levels of physical activity. Run                                be groups), 1-2 months apart. Consists of                            management programme within the
community settings.                         in local leisure centres Health and Fitness                               behavioural / lifestyle / complex issues and                         UK. Structured, interactive nurse led
                                            Advisors work with people to develop a                                    advice on undertaking physical activity.                             programme run in some GP practices, it
                                            10 week activity programme to help get                                                                                                         can be accessed through referral from the
                                            them started and keep working towards
                                            becoming more physically active.
                                                                                                   First Line                                                                              GP or practice nurse.

                                                                                              Weight Management
                                                                       Gym for Free                 Service            Doctors Referral Into Exercise & Wellness
                                            The gym for free scheme currently operates                                Exercise on referral pilot scheme for
                                            in the Heart of Birmingham Teaching PCT                                   people between 15 – 74 who have some
                                            area. This initiative is jointly funded by the                            of the risk factors that can lead to coronary
                                            HoBTPCT and Birmingham City Council.                                      heart disease. This consists of a 12 week
                                            It offers all HoB residents who are 15+                                   programme based at a local women only
                                            years the opportunity to attend the gym                                   health and exercise facility.
                                            and swimming for free at their local leisure

                                                                                              Level 0
                                            centres. Membership will continue to be
                                            renewed monthly if the individual attends
                                            the gym at least four times each month. To
                             Food Net       find out if your postcode is covered by the
                                            scheme, check online www.hobtpct.nhs.uk
                                                                                                                                      Get Active…get walking!                                               Healthy Options Award
                                            or visit your local leisure centre.
Run five week cook and taste courses                                                                                  HoBTPCT are working with the Health                                  Award scheme to reward catering establishments that provide healthier
for community groups to increase skills,                                                             Early            Exchange to provide the Get Active…Get                               eating choices. Working in partnership with Birmingham City Council to
knowledge and confidence on eating a
healthy diet.
                                                                                                 Interventions        Walking programme. The programme aims
                                                                                                                      to increase physical activity in the HoB area
                                                                                                                                                                                           encourage and provide support for catering establishments to promote
                                                                                                                                                                                           healthy eating. The award has four levels, Five-a-Day, Bronze, Silver and
                                                                                                and Prevention        and provide residents with the opportunity
                                                                                                                                                                                           Gold, giving all catering establishments the opportunity to achieve an
                                                                                                                      to access regular, supervised walks on                   Walk        award.
                                                                                                                                                                       . ..Get
                                                                                                                      a weekly basis from a wide range of
                                                                                                                      locations. There will be a total of 30 walks
                                                                                                                      set up including 2 or 3 in each HoBTPCT
                                                                                                                      ward. To find out about where and when
                                                                                                                      your local Get Active walk group meets call
                                                                                                                      the Health Exchange on 0800 158 3535
         Childhood Obesity                                                                                                                                                                                                                                                                               Heart of Birmingham
                                                                                                                                                                                                                                                                                                            Teaching Primary Care Trust

                                                                                                                                                                             Level 3
         Care Pathway
                                                                                                                                                                                                                                                             Level 3
                                                                                                                                                                                                                           A Level 3 service is currently being
                                                                                                                                                                                                                           devised with a Consultant Endocrinologist,
                                                                                                                                                                                                                           Children’s Hospital
                                                                                                                                                                            Secondary Care -
                                                                                                                                                                          Morbid Obesity Service

                                                                                                                Paediatric Dietitians                                                                                                                      Watch It
                                                                                          Children and young people up to the age                                                                                          Held across 4 venues within the HoBTPCT:

                                                                                                                                                                             Level 2
                                                                                          of 16 are referred by GP or other Health                                                                                         Handsworth, Ladywood, Small Heath and
                                                                                          Professionals, for weight management.                                                                                            Nechells. This is a weight management
                                                                                          Individual appointments are held at Health                                                                                       programme that works with obese children
                                                                                          Centres, where advice on healthier eating,                                                                                       (8-11) and their families. It assists families
                                                                                          changing behaviour and exercise can                                                                                              in eating more healthily and being more
                                                                                          be offered by Registered Dietitians and                                                                                          physically active. The programme is made
                                                                                          Assistant                                                                               Specialist                               up of individual and group appointments
                                                                                                                                                                                                                           and includes weekly physical activity
                                                                                                                                                                                Obesity Services                           sessions for children with the focus on fun.
                                                                                                                                                                                                                           The programme is run at local leisure &
                                                                                                                                                                                                                           community centres 3.30-6.45pm and lasts
                                                                                                                                                                                                                           for up to one year

                                                                                                       Children’s Activity on Referral                                                                                                                      HENRY

                                                                                                                                                                             Level 1
                                                                                          This is a 12 week programme where                                                                                                Health, Exercise and Nutrition for the Really
                                                                                          GPs, school nurses and dieticians can                                                                                            Young. An initiative working with parents to
                                                                                          refer children to a specific programme of                                                                                        enhance their ability to provide an optimal
                                                                                          supported exercise in a safe environment.                                                                                        healthy environment for their babies and
                                                                                          The aims of the programme are to increase                                                                                        young children.
                                                                                          medium term activity levels, increase
                                                                                          intention to exercise, provide a positive                                              First Line
                                                                                          experience of activity and increase physical
                                                                                          wellbeing. Due to start Spring 2009                                               Weight Management

                           Phunky Foods                                                                 Childrens Gym                                                                                                                                            Growing Gains                                                            Face Fruits

                                                                                                                                                                             Level 0
A unique and innovative primary school                                        Currently available in HoBTPCT at Aston                                                                                                                  Working through the organisation CSV                                  Local mums trained to deliver this
programme of healthy eating and physical                                      Villa and Hamstead Hall Community                                                                                                                        environment this scheme takes place                                   programme which is a 2.5hr interactive
activity lesson plans and teaching                                            Learning Centre, the children’s ICE Gyms                                                                                                                 in school settings, where schools are                                 session in schools aimed at increasing
resources. Providing teachers and                                             are specifically aimed at 8-16 years olds.                                                                                                               assisted in creating a vegetable plot and                             understanding of fruit and vegetables, their
teaching assistants with all the tools and                                    They are accessible to local children,                                                                                                                   18 sessions are delivered to Key Stage 2                              benefits, how to eat them, portion size and
                                                                                                                                                                                                                                                                                                             variety. Sessions explain why we should
training they need to deliver top quality, fun
healthy eating and physical activity lessons
                                                                              families, schools and as part of an exercise
                                                                              on referral scheme. Children can access
                                                                                                                                                                                      Early                                            children around healthy eating, growing
                                                                                                                                                                                                                                       vegetables and cooking what they have                                 try and eat 5 a day and children’s faces are
in school                                                                     the children’s gym after school, weekends                                                           Interventions                                        grown.                                                                painted with images of 3 fruits. Certificates
                                                                                                                                                                                                                                                                                                             are taken home with a picture of the
                                                                              and school holidays.
                                                                                                                                                                                 and Prevention                                                                                                              children and 3 key health messages.

                              Villa Vitality                                                                Active Kids                                             Early Year’s Physical Activity                                                  Rowing Machines In Schools                                                    Row Before You Go
Developed by working in partnership with                                      Partnership between the HoBtPCT and                                            This is a new programme being                                             Working in partnership with and                                       Working with the Birmingham Schools
Aston Villa Football Club. The Villa Vitality                                 Hamstead Hall Community Learning                                               developed between Birmingham City                                         Birmingham City Council’s Education                                   Rowing Association, leisure services
programme aims to ensure that all year                                        Centre. Local year 4 and 5 school                                              Council and HoBTPCT. Physical                                             Department and Concept 2, the PCT have                                coaches are trained in delivering indoor
5 school children within Birmingham visit                                     children are invited along to the Active                                       education consultants will be delivering                                  given all primary and secondary schools                               rowing sessions. A 20 week course is
Aston Villa and receive 3 days of healthy                                     Kids day where they have the opportunity                                       training to Early Years settings staff                                    in HoB the opportunity to purchase up                                 offered to schools to kick start after school
lifestyle tuition spread over 6 weeks, in                                     to experience a range of activities from                                       around new Physical Literacy guidance                                     to 5 rowing machines. The driver is to                                rowing clubs in schools which received
an innovative and exciting environment.                                       orienteering, brush craft and green gym                                        and resources for active play. This is                                    encourage children to partake in physical                             machines as part of the HoBTPCT indoor
Including; physical activity with the Aston                                   activities, assault courses and team                                           helping settings to implement guidance                                    activity that does not have to be competitive                         rowing initiative. Enthusiastic and interested
Villa coaches, an interactive healthy eating                                  building games, archery and the children’s                                     around developing physical literacy in                                    or team based. 83 schools have so far                                 parents will also be offered training by
session, cooking in the community kitchen,                                    ICE Gym as well as prepare and enjoy                                           young children which will enable them                                     taken this opportunity and are developing                             Concept 2 and the Amateur Rowing
attending a children’s ICE Gym session and                                    a healthy lunch outdoors. The day is                                           to go on to become physically able and                                    initiatives to increase the levels of physical                        Association to facilitate rowing sessions
filming their healthy lifestyle project in Aston                              delivered by Community Sports Leaders                                          more likely to take part in sport and                                     activity within schools. Feedback from                                after the end of the 20 week programme.
Villa’s film studio.                                                          who are local teenagers that have been                                         exercise as they develop.                                                 children has been extremely encouraging
                                                                              trained to deliver the programme. The                                                                                                                    “I like rowing because it’s healthy and I
                                                                              overall aim of the project is to introduce                                                                                                               can keep fit. Other than Basketball, it’s the
                                                                                                                                                                                                                                                                                                                                  Schools Nutritionist
                            Street Games                                      children to alternative forms of activity other
                                                                              than traditional school PE sports, and to
                                                                                                                                                                                                                                       only thing I’m good at. I feel more confident
                                                                                                                                                                                                                                       because I can do it by myself.” Michael
                                                                              emphasize fun and enjoyment in activity.                                          Early Years Healthy Settings Award                                     Gardener, Year 9                                                      Heart of Birmingham schools Nutritionists
Street Games is a community activity                                                                                                                                                                                                                                                                         and Food Health Advisor work with primary
initiative that will increase the opportunity                                                                                                                The Early Years Healthy Settings award is an adaptation of the                                                                                  and secondary school children and their
for physical activity for young people in the                                                                                                                Healthy Schools Standard and supports early years’ settings                                                                                     parents offering interactive sessions and
community. Street Games will work with                                                           Early Years Nutritionist                                    in meeting their Ofsted self-evaluation criteria. The award is                                        Milk to Meals                             work shops i.e. classroom based sessions,
the 3rd sector to deliver over 700 sessions                                                                                                                  offered to a number of private and voluntary nurseries as well as                                                                               parent/children work shops/sessions,
of Multi-Sports and Street Dance on the                                       The Under 5’s Dietitian/ Nutritionist supports the Corporate Health Visiting   Children’s Centres in HoBTPCT, and city-wide. Healthy eating,             Development of recipe books, DVD, poster                   m...       healthy packed lunches workshops, cook
                                                                                                                                                                                                                                                                                             g fro
community doorstep through 6 projects                                         teams in HoBTPCT and is responsible for under 5’s childhood nutrition          physical activity, emotional health and well-being and personal,          and presenter to support families with                   Milk t o     and taste programmes etc. Also provided
across Hob. It will also engage over 70                                       issues, including obesity prevention and treatment and healthy weaning         social health education (P .S.H.E) are the four aspects looked at         weaning.                                                              are various training packages for school
young people as sports volunteers and                                         throughout the PCT area. This is achieved through providing training,
                                                                                                                                                                                                                                                                                                Me al s
                                                                                                                                                             as part of the award. Its purpose is to build staff capacity through                                                                            staff, to enable them to run healthy lifestyle
train over 50 young people as qualified                                       support and clinical supervision as well as developing appropriate and         a whole settings approach, as well as creating a supportive                                                                                     sessions with pupils. Additionally we advise
Community Sports Leaders.                                                     relevant resources to support the staff to deliver messages around infant      environment that promotes health and well-being. Settings are                                                                                   schools regarding school food policy
                                                                              nutrition. The post also works in partnership with the Under 5’s team                                                                                                                                                          development, the school food standards,
                                                                              to deliver the HENRY (Health Exercise Nutrition for the Really Young)
                                                                                                                                                             supported to achieve the award over a 12 to 18 month period
                                                                                                                                                             by the Health Education Service and Food Net (Birmingham
                                                                                                                                                                                                                                                          Healthy Schools Team                               healthy schools attainment or renewal,
                                Empower                                       programme in Children’s Centres, an exciting new initiative designed to
                                                                              tackle early childhood obesity.
                                                                                                                                                             Community Nutrition and Dietetic Service).
                                                                                                                                                                                                                                       Members of the team work to provide
                                                                                                                                                                                                                                                                                                             breakfast club establishment, menu
                                                                                                                                                                                                                                                                                                             planning etc.
                                                                                                                                                                                                                                       support for schools to achieve the
Empowering mothers to prevent obesity at weaning. Delivered by a
                                                                                                                                                                                                                                       healthy school status
specialist health visitor, intensively working with parents who have babies
who are at a particular risk of obesity.

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