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Integrated whole systems approach for children’s healthy weight in Derby and Derbyshire

Derby and Derbyshire faced significant challenges due to persistent high obesity rates in children. The solution involved formulating a childhood obesity strategy with two main objectives.

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Derby and Derbyshire are collaboratively implementing a comprehensive strategy for managing children’s healthy weight. 

This strategy, called "A Time for Action," emerged in response to persistent obesity rates and a serious incident learning review linking obesity to an incidence of child mortality. It focuses on creating coordinated action across various sectors, emphasising a whole-system approach over individual blame. The strategy comprises four key areas: 

  1. Families and early years 
  2. Health and care professionals 
  3. Education and schools 
  4. The obesogenic environment. 

Innovative initiatives include implementing children’s weight management services in Derbyshire and expanding the offer in Derby City, improving referral pathways, and a strong focus on prevention.

The challenge

Derby and Derbyshire faced significant challenges due to persistent high obesity rates in children. This was compounded by a lack of comprehensive and coordinated weight management pathways and services. Additionally, the complexities of operating across city and county boundaries with varying political and service landscapes posed challenges in implementing a uniform strategy.

The solution

The solution involved formulating a childhood obesity strategy with two main objectives. The first was developing clear pathways and signposting to enable children who are already overweight or obese to access joined up and long-term support. 

The second objective was for Derby and Derbyshire to develop preventative approaches for current and future generations using a whole systems approach which coordinates existing efforts, reveals gaps in provision and supports the efficient use of limited resources. 

Key initiatives included expanding children's weight management services, improving referral pathways between school nurses, primary care, and secondary care, and adopting a whole-system approach using the Public Health England toolkit published back in 2019. 

The impact

By delivering children’s weight management services as an integrated care system, more children and families are now getting the support needed when identified as living with overweight or obesity. 

In the city, Derby County Community Trust (the charitable arm of Derby County Football Club) has built up capacity to support 300 children living with overweight or obesity through their children’s weight management service and Active Schools programme. 

Whilst in the county, Live Life Better Derbyshire have mobilised the Healthier Futures service to ensure eligible families in Derbyshire can access a free healthy families programme that offers a range of support for parents and carers of children aged 0 to 12 years old. The programme includes online and face to face sessions.

Early impacts of the programme are promising, with increased capacity in children's weight management services and a high engagement rate in the community. 

The strategic multi-agency approach and focus on system-wide engagement have been crucial in driving momentum. The approach is adaptive, seeking to continuously address gaps and evolve based on emerging needs and evidence.

How is the new approach being sustained?

The sustainability of the strategy lies in its ability to hook into strategic levers, including the ICS and Health and Wellbeing Boards, integrating with existing community and health services, focusing on a shared vision with a long-term commitment and continuous partnership development. 

The approach supports key stakeholders to recognise the role they can play to take action within their own systems. 

A strong partnership developed with Active Derbyshire plays a critical role in maintaining momentum with key stakeholders and driving continuous improvement. 

Lessons learned

Key lessons from this initiative include the importance of a system-wide approach that moves beyond metrics and performance measures to focus on long-term impact. 

The strategy underscores the need for adaptability, partnership, and engagement with stakeholders who are actively interested in contributing to the solution. The initiative has demonstrated that building a ‘coalition of the willing’ can create a sustainable movement towards system level changes to improve the health of children across Derby and Derbyshire in the long-term. 


Andrew White, Public Health Manager

[email protected]