North Yorkshire County Council

 

Health and Adult Services

 

Executive Members Meeting

 

Friday 16th September 2022

 

REPORT TO Director of Public Health for North Yorkshire in consultation with Executive Member for Health and Adult Services

 

Establishing a pilot/interim Family Weight Management Service in North Yorkshire

 

 

1.0          Purpose Of Report

 

The purpose of this paper is to obtain a key decision to establish and pilot an 18-month family weight management service for North Yorkshire.

 

2.0         Executive Summary

 

2.1         Since the decommissioning of the Healthy Choices child weight management service in autumn 2020, there has been no weight management service or support for children, young people and families in North Yorkshire.  There continues to be an ongoing rise of excess weight prevalence in children both nationally and locally; in North Yorkshire 29% of 4-5 year-olds and 38% of 10-11 year-olds are affected by excess weight.  This data demonstrates an annual rise much higher than in previous years. 

 

2.2         There is a real need for families across the county to receive compassionate support to manage weight, eat well and move more.

 

2.3         An initial proposal for a new child weight management service was taken to the Public Health Leadership Team (PHLT) in February this year and since then numerous discussions have taken place between public health consultants, managers and officers to develop ideas and scope out a proposal for an interim Family Weight Management service (FWMS).  The intention of an interim (or pilot) Family Weight Management Service is that will be very much aligned to the Adult Weight Management Service. The vision for the longer term is to have one combined weight management service for North Yorkshire - for children, young people, families and adults.

 

2.4         Public Health are therefore proposing that we commission (from the Public Health reserves) one service provider to deliver a tier two family weight management service (“the Family Weight Management Service”) remotely via telephone or video callsacross all seven locality areas of North Yorkshire.

 

2.5         The Family Weight Management Service will utilise the current Adult Weight Management Service modelling to support adults who have dependents that need a holistic support for the whole family.  The Service will also take referrals for children and young people through National Child Measurement Programme and other health professional referral routes such as Healthy Child Team, Early Help, and primary care.

 

2.6         The overarching aim of the Family Weight Management Service is to provide a free, evidence-based, remote 9-month weight management service to the eligible population to improve lifestyles and achieve a healthy weight for the long term.

 

2.7         In line with evidence-based practice, the Service will be delivered as:

 

·         a free multicomponent service that includes nutritional advice and physical activity, underpinned by behaviour change strategies to achieve improvements in healthy lifestyles and a reduction/maintenance in BMI-z-score.

·         a remote service (up to 12 telephone/video calls) over a 3-6-month period.

·         Followed by a free maintenance programme (monthly remote check-ins over another 3 months) to support families with embedding and maintaining changes for the long term.    

The full service specification is included in the appendix.

2.8 The Family Weight Management Service will sit within the local child and adult weight management services pathways, with clear referral pathways from tier 1 to tier 3 and 4 obesity services/activities.

 

2.9 In terms of differences from previously commissioned children’s weight management services, the pilot Family Weight Management Service will be aligned to the existing Adult Weight Management Service and will be part of a longer-term vision of developing one all-age weight management service for North Yorkshire.

 

2.10 The service will be virtual and won’t involve face-to-face appointments and travel (more cost effective at 71k per annum instead of the previous 300k budget for Healthy Choices).  It will be integrated into the wider system, and will have a broad focus on signposting and supporting families with the wider determinants (e.g. finances/food poverty, mental health), as well as healthy eating and physical activity in local community areas.

 

 

3.0         Issues for consideration

 

Nothing additional to add – see sections 4.0 onwards.

 

 

 

 

 

 

4.0         Performance Implications

 

4.1         The service modelling work has been completed for the pilot service.  Support from our public health analysts, has projected that 194 children and young people will take up the offer of the Family Weight Management Service, per annum.    

4.2         This is a conservative estimate based on experience of the AWMS; with it being a new service we anticipate that it will take time to build referral routes etc.  The intention will be to market the service in areas of greatest need and with professionals working with the most vulnerable families.  Please note that as well as reaching this number of children and young people, the benefit will be extended to the parents/carers and siblings of the children and young people. 

4.3         The modelling document embedded in the appendix provides the detailed modelling workings. 

4.4         Performance will be managed through specific KPIs.

 

 

 

5.0         Financial Implications

 

5.1         A cost per client/family for the delivery of the 12 session structured programme, including triage and health assessments has been applied.  Plus a cost per client/family for the delivery of the 3 month maintenance programme, including health assessment (65%^ of referrals completing a 12 session programme going on to the maintenance programme)

5.2         At Public Health Leadership Team (PHLT) on 20th July 2022 it was agreed that the pilot/interim contract period would be 18 months to bring the contract in line with the contract end date for the Adult Weight Management Service (30 June 2024). 

5.3         A budget of £106,000 will be available from the Public Health grant reserves to deliver the pilot Family Weight Management Service over an 18-month period.

 

 

6.0         Legal Implications and Governance compliance

 

6.1         A number of procurement options have been explored and discussed with procurement and legal colleagues.

6.2         Options include out to the market for full procurement, asking for expressions of interest from current Adult Weight Management Service providers and applying a waiver, or establishing a partnership agreement with district/borough council adult weight management service providers.

6.3         Following a meeting with Legal and Contracting on the 25th August 2022 to review all 3 optionsit was recommended that we progress with a direct award through applying a waiver. 

6.4         We have had informal conversations with local authority current Adult Weight Management Service providers and Brimhams Active (who are a wholly owned Teckal company of Harrogate BC) have come forward to indicate they would be in a position to provide the Family Weight Management pilot Service.

6.5         Subject to this being agreed at HASEX today on 16th September, and a waiver being approved, we will progress discussions with district councils/AWMS providers, Procurement, Legal with the intended outcome of a the direct award to Brimhams.  Support and guidance would be obtained from Procurement, Legal and Contracting throughout.

 

7.0         Equalities Implications

 

7.1         An equalities impact assessment will be conducted as a next step to key decision approval.

7.2         Inclusion criteria ensure children with special educational needs (SEND) are supported up to the age of 25. 

7.3         To support families at risk of digital exclusion sessions can be video call or phone calls. If families don’t have access to the digital technology required we would look at CVS support/resources to ensure there is no exclusion relating to technology.

7.4         The Service will cover the county of North Yorkshire but will be targeted at areas of greatest need i.e. schools and geographical areas that have the highest excess weight prevalence and deprivation.

7.5         Access to translation services and British Sigh Language will be available where needed.

 

 

8.0         Climate Change Impact

 

8.1         Supporting families with challenges in accessing food and healthier food options will contribute to the emerging North Yorkshire food strategy priorities, of which the food environment and food for our planet are contributors to addressing climate change.

8.2         Families will be supported to consider and take part in sustainable physical activity i.e. active travel, outdoor recreational activities, conservation etc. 

 

 

 

9.0       Recommendations

 

Public Health are recommending that we commission (from the Public Health reserves) one service provider to deliver an 18-month pilot tier 2 Family Weight Management Service across North Yorkshire.

 

To ensure the most efficient procurement is delivered, it is recommended that we progress with a direct award (through applying a waiver), to Brimhams Active.

 

 

 

 

 

 

Authors:  Ruth Everson, Helen Ingle, Katie Needham

 

Date: 6th September 2022

 

 

 

Appendix 1

Service specification

 

Appendix 2

Service modelling