Learning from practice

Led by
The PACE (Promoting Action on Clinical Effectiveness) team who provide project management, facilitation, development of local guidance, education and dissemination. For more information visit www.learnonline.nhs.uk/pace

Involving
Local dieticians, PH specialists, District Nurses, Health Visitors, School Nurses, secondary care consultants (diabetologist, paediatrician and surgeons etc) as well as GPs.

Identified issues

Public Health actively pursuing primary prevention through District partnerships with LA, LSP

Lots of activity and high quality work

Obesity escalates cost of co-morbidities to primary and secondary care

but

Need for a wide range of services to meet needs of culturally diverse population, especially in addressing psycho-social / motivational issues

Services disjointed – for example Versa* commissioned to run 6 week programmes of diet, exercise and support by in some parts of new PCT area but not others; secondary care dieticians running 4 week course

No clear referral criteria or pathways

Uneven knowledge about services – even within practices: undermines equity, access and patient choice

Lack of capacity - especially in paediatrics and secondary care dietetics

Established 6 working groups
1. Review group updating existing Adult Obesity guidelines developed in 2002

2. Primary care group aiming to develop a practitioners’ guide – assessment algorithm supported by available service info

3.Paediatric group developing family-based intervention models, guidance and referral pathways

4.Secondary care group mapping available services which could form a pathway, link to survey of secondary and tertiary services by WYPCO

5. Audit group collating the fit between current offer and requirements

6.Group looking at the development and possible piloting of a model for delivery of obesity support in the community

Also an inter-agency group developing with Council a database of providers of activity programmes; clarifying accreditation status causes delays

Opportunities, Possibilities

BMI added to QOF Prevalence Registers

Free up secondary care dieticians for higher level intervention and support by shifting lower level work to primary care

Practice based commissioning of third sector to provide more pro-active, targeted outreach / primary prevention

Better / more integrated follow up of School Nurse measurement of Yr 6 pupils – only screening not monitoring

Online resource / directory of services

Developing structure which will provide clarity and equity to the management of obesity in the Bradford district through the close working of local health communities and leisure services.

* "Originally a Women's Health Group formed by local women, we grew into Keighley Women's Centre and in 2003 into the Versa Organisation, a charity, a business limited by guarantee and a social enterprise." see www.versa.org.uk