Meeting documents

1 THE ISSUE

1.1 To raise awareness of the Primary Care Trust's Obesity Strategy and to ask Members to support the ongoing development and expansion of a partnership project between the PCT, the Council's Sport and Active Leisure team and Aquaterra Leisure entitled Passport to Health.

2 RECOMMENDATIONS

2.1 Welcome the development and expansion of the partnership with the PCT to implement the Passport to Health referral scheme.

2.2 Endorse the aims of the programme and note the financial implications.

3 FINANCIAL IMPLICATIONS

3.1 There is no core funding for Passport to Health at present. The scheme currently costs £25K per annum, funded for one year only until October 2006 through a contribution of £12.5K from the Primary Care Trust and £12.5K PSA 'pump priming' funding. The current scheme would cost £50,000 per annum (including staff costs) if it were expanded across the District.

3.2 It is intended to work up a bid for the continuation and expansion of the scheme through a Local Area Agreement from April 2007. Funding for the period October 2006 - March 2007 would be from existing resources, plus a contribution from the PCT.

3.3 Should integration with the PCT proceed, it would be for that body to determine whether this initiative was a priority for joint resources. Should resources be insufficent to finance this initiative, the scheme would be discontinued.

4 THE REPORT

4.1 The rise in obesity is a significant and worrying trend, both nationally and locally. Overweight and obesity impact negatively on wellbeing and health and can be precursors to disease, most notably diabetes and heart disease. It has been calculated that the cost of overweight and obesity to the local NHS is in the range of £8m per year and the cost to the local economy £30m per year.
The NHS has now set national targets for the reduction in obesity and has highlighted the need for change in the recent public health white paper 'Choosing Health'.

4.2 Two local partnership strategies, supported by the Local Strategic Partnership, have been published recently in an attempt to address this issue:-

B7 'Shaping Up' - an Obesity Strategy hosted and supported by the multi agency Public Health Service Development and Implementation Group and driven by the PCT (see Appendix B), and

B7 GET ACTIVE - A Vision for Sport and Active Leisure hosted and supported by the multi agency Sport and Active Leisure Partnership and driven by the Council's Sport and Active Leisure team.

4.3 Both strategies recognise the important role that physical activity can play in helping to reduce obesity and both strategies have adopted two of the targets from 'Choosing Health':-
- To halt the rise in obesity for children under 11 and
- To reduce the number of people between 15-75 years with a BMI (Body Mass Index) over 30

4.4 A practical example of partnership action being taken is the Passport to Health scheme which was launched in October 2005. The Primary Care Trust and the Council's Sport and Active Leisure Team have collaborated to create and develop an intervention for people who are sedentary and overweight and at risk of developing diabetes. Individuals are referred by their GP or other health professional to a supervised and monitored activity and education based programme designed to motivate and enable lifestyle changes. The programme is run by a qualified fitness/health professional and is being closely monitored to establish impacts on long term lifestyle change. Further details of the scheme are included at Appendix A.

4.5 GP referral schemes are commonplace in most local authorities. Passport to Health however represents a true partnership between the Council and the PCT with a pooling of budgets to run the scheme. In addition, the Lifestyle Motivational programme offered to all those referred is thought to be a unique element of the Passport to Health scheme.

4.6 At present this is a pilot project for adults, based at Bath Sports and Leisure Centre for GP practices who wish to refer individuals to this centre. The intention is to expand the scheme early in the New Year across the Bath and North East Somerset area following increased interest and demand. The scheme should also be flexible enough to accommodate other health issues that would benefit from a physical activity intervention e.g. mental health and drug rehabilitation as well as being able to accommodate children and young people.

4.7 Although it is early days for the scheme the initial reaction from Health Professionals, particularly GPs and Health Visitors have been very encouraging. From Bath practices, we currently have 27 people participating in the scheme and this number is growing all the time.

4.8 It is hoped to develop a second strand of Passport to Health in the spring with the appointment of a full time Health Walks Coordinator jointly funded by the Council and the Primary Care Trust who will develop the existing "Walking the Way to Health" programme and deliver a range of supervised walks within communities across Bath and North East Somerset.

4.9 Those involved in developing the Passport to Health scheme are aspirational for its future development and would like to see it become an umbrella for a range of associated public health work between the Council and the PCT. The future of Passport to Health could have 5 main interrelated strands:-
- GP referral
- Cardiac and Pulmonary rehabilitation (pilot projects already in place)
- Healthy workplace - developing policies for major employers including links to occupational health
- Children and young people - Intervention through GPs but also through schools and school nurses. Family educational programmes
- Community - whereby individuals can partake in a supervised and monitored programme within their own community (not necessary in the Leisure Centre). The scheme would be run by qualified local 'activators'

5 RISK MANAGEMENT

6 RATIONALE

6.1 Obesity is a preventable condition in the majority of cases (source : PCT) but addressing it is both complex and challenging. The national and local objective is to enable the population to undertake more physical activity and to adopt healthy diet habits. This involves individuals, families, education, domestic and workplace settings. Coordinating action requires a cross agency approach and a timetable which is patient yet persistent. Transport, leisure, food procurement and availability, health promotion, lifestyle and education all need to be addressed in order to reach targets.

7 OTHER OPTIONS CONSIDERED

7.1 Not applicable.

8 CONSULTATION

8.1 The Executive Councillor, Overview & Scrutiny Panel, other B&NES Services, service users, Local Service users, Stakeholders/Partners, Other public sector bodies, Section 151 Finance Officer, Chief Executive, Monitoring Officer have all been consulted and given the opportunity to comment on this report.

8.2 A presentation has been made to the O&S Panel for EYC&L. Discussion and formal agreement has taken place with our partners. Details of the scheme are available to the general public.