Wigan commissions leisure services to provide an integrated health and wellbeing offering which makes full use of the community assets that families trust most - schools and Start Well Family Centres - as well as providing weight management services for children and young people.
The challenge
The prevalence of overweight (including obese) children in Reception in 2018/19 was 26.8 per cent and in Year 6 was 37.2 per cent, both higher than the England average.
Nearly 52 per cent of children and young people are not achieving the average of 60 active minutes per day, according to data from the 2018/19 Greater Sport Active Lives survey.
Concerns about obesity, inactive lifestyles and mental health and wellbeing have prompted the council’s Let’s get Movin’ campaign, strong promotion of the Daily Mile and the Daily Toddle, more targeted work with families and the use of the soft drinks levy for school initiatives.
The approach
Wigan Leisure and Culture Trust, under the name Inspiring Healthy Lifestyles (IHL), is commissioned by the council to provide a complete programme of education, prevention, early intervention and treatment for children and young people.
Professor Kate Ardern, Director of Public Health at Wigan, said the approach moves healthy weight services away from the more familiar medical model, with the aim of a wider reach and more joined-up action across the life course.
Vital “anchor institutions”, such as schools and Start Well Family Centres (children’s centres) are at the heart of the “whole society, whole systems” approach.
This enables targeted work at and within school that have a higher prevalence of overweight pupils and ensures that Lets get Movin’ and messages around diet, nutrition and mental wellbeing are delivered proactively and consistently from the early years through to the upper end of secondary school.
To bolster work in schools, the council is match funding allocations from the soft drinks levy. Schools bid for money to fund facilities to enhance physical activity, healthy eating and mental health and wellbeing.
Work in the Start Well Family Centres includes a new approach to early nutrition. Breastfeeding support will be integrated into the Start Well offer, but also more support with be provided to parents with other feeding choices and aspects of health and well-being.
The impact
The Tier 2 specialist service for two to 17-year-olds is part of the commissioned offer. It is tailored according to age and the goals that families wish to achieve.
In 2018/19, 324 children and young people were referred into the service. More than 75 per cent of reduced their BMI and made progress towards their stated aims.
Thirty settings have delivered targeted healthy lifestyles programmes, reaching 900 children. Sixty five per cent of settings are continuing the programmes.
One school, Britannia Bridge Primary, reported that the scheme had helped it to identify and support children who would benefit from the specialist end of the service. The headteacher said the work had a very positive impact on the awareness and health and fitness of children and their parents.
As part of the Lets Get Movin’ campaign, 64 schools in Wigan – educating over 12,000 children - are undertaking the Daily Mile, including SEND settings.
A successful Young Health Champions scheme has 200 young people involved across the borough, building up their own skills and acting as peer mentors to pupils in primary school.
Recent results from the Active Lives survey show progress is being made. In 2017/18, just over 60 per cent of children and young people were failing to achieve an average of 60 active minutes per day. The figure has dropped to just under just 52 per cent in 2018/19.
Lessons learned
Schools and Start Well Family Centres have a crucial role to play. They are key assets that parents trust and through them, the healthy weight message can be spread to all children in a welcoming and positive context.
Health messages can also be linked to the sporting culture of the borough, with its successful rugby league and football teams. Manchester United’s women’s team is now based at Leigh Sports Village, a potential boost to the healthy lifestyles agenda for girls and women.
How will the approach be sustained?
Commissioning integrated services is more likely to lead to a transformational, whole systems effect compared to a more piece meal contracting approach.
Putting schools at the heart of the approach strengthens sustainability, given the central position they occupy in family life.
Councillor Jim Moodie, lead member for leisure and public health at Wigan Council, said: “Our approach to tackling the issue involves working directly with our communities, schools and families early on to embed a healthy culture. We understand that there is always room for improvement, but as part of The Deal for Health and Wellness, we are committed to ensuring residents of all ages lead active and healthy lives in a way that is suited to them.”
Contact
Professor Kate Ardern, Director of Public Health at Wigan