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Action on childhood obesity in two tier areas

This learning note pulls together some findings on how to organise action on childhood obesity in two tier areas. It draws on the experience of the Nottinghamshire and Pennine Lancashire trailblazers and on the discussion on this topic at a workshop at the Trailblazer Assembly in September 2021.


In areas with “two tier” local government, action on childhood obesity requires the involvement of county, district and borough councils. County councils are mostly responsible for strategic, public facing services including public health, adult services, education and children’s services. Relevant district council services include planning, environmental health and leisure. District councils are mostly responsible for more place-related services like housing, planning and licensing.

Two of the trailblazers are in areas with two tier local government. The Nottinghamshire trailblazer involves the county council and seven district and borough councils. The position in Pennine Lancashire is more complex: a unitary council, a county and five districts are involved.

This learning note pulls together some findings on how to organise action on childhood obesity in two tier areas. It draws on the experience of the Nottinghamshire and Pennine Lancashire trailblazers and on the discussion on this topic at a workshop at the Trailblazer Assembly in September 2021.

Officers from both trailblazers are clear that the collaboration between different types of council has added real value to their work. Officers in Nottinghamshire cite the three Ps (passion, people and partnership) as being central to their work, with partnership between the county, district and borough councils being a key feature of the third P. Wider engagement between public health teams and district council services is seen as having provided a firm foundation for collaboration on the Trailblazer, as has joint working as part of the response to COVID.

Also important is the need to work with the different levels of energy, ambition and need of the councils in a county area. Seeking to pursue a “one-size-fits-all” approach will not work. This can often create a cascade effect as councils learn from each other and adopt and adapt new approaches. Indeed the “test and learn” culture which underpins the Trailblazers is seen as having been important in securing joint working across the tiers.

Action on childhood obesity is seen as an area in which there is a leadership role for county councils, but it must be leadership which reflects and respects the things that district councils bring to the table. In Nottinghamshire this was helped by the fact that two of the key people involved in the trailblazer have experience of working for both county and district councils. One participant in the workshop noted that in order to deploy this leadership role, public health teams must ensure that they are not (and are not perceived to be) overly “purist” or “academic” in their approach.

Formal engagement between county and district councils can take place through the relevant health and wellbeing board. In Pennine Lancashire, an informal members forum has also been useful in maintaining a joint approach. It provides a degree of structure but enables any councillor with an interest in the topic to get involved. An effective mechanism for keeping all partners regularly informed of the latest developments with the trailblazer is essential.

In some other areas, the geography will be as complex as it is in Pennine Lancashire where the trailblazer covers a unitary council and part of a two tier county. The challenge of working with this geography is balanced by two important factors: the area is the same as that for a parallel Sport England initiative on physical activity; and the geography is used in the governance arrangements for the emerging integrated care system and its health and care partnership. Both are powerful plus points.

Top tips for two tier working on childhood obesity

  • Involve all types of council from the start including the scoping and visioning stage which must reflect the strengths and assets that each type of council brings to the party;
  • Have a lead person in each council and be clear what the policy hook for each council is;
  • Recognise the capacity constraints faced by some councils, go for some quick wins and break the work down into manageable chunks;
  • Ensure good communication and feedback throughout.

Further advice on joint working between county and district councils can be found in The Drivers of Collaboration: Working in Partnership Across Local Governmenta report, published by the LGA and produced by Shared Intelligence.

Find out more about the Childhood Obesity Trailblazer programme and previous learning notes, case studies and blogs.