Public Health England and Registered Nutritionists. Alison Tedstone, PhD RNutr (Public Health) Director of Diet and Obesity Health and Wellbeing

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1 Public Health England and Registered Nutritionists Alison Tedstone, PhD RNutr (Public Health) Director of Diet and Obesity Health and Wellbeing

2 Overview Role of PHE PHE s nutrition work The my role / teams role as registrants Challenges within the system 2 Presentation title - edit in Header and Footer

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4 What we do Public Health England: works transparently, proactively providing government, local government, the NHS, MPs, industry, public health professionals and the public with evidencebased professional, scientific and delivery expertise and advice ensures there are effective arrangements in place nationally and locally for preparing, planning and responding to health protection concerns and emergencies, including the future impact of climate change supports local authorities, and through them clinical commissioning groups, by providing evidence and knowledge on local health needs, alongside practical and professional advice on what to do to improve health, and by taking action nationally where it makes sense to do so

5 Place-based approach to public health Nonstatutory providers* People and communities Health and wellbeing boards NHS providers PHE centre Local government CCGs NHSE area team Public health advice EPPR Screening and immunisation Offender public health programmes Specialised commissioning Primary care public health programmes and population healthcare *Including voluntary and community sector

6 6 PHE priorities for 2013/14 Sets out Public Health England s priorities and actions for the first year of our existence Five outcome-focused priorities what we want to achieve Two supporting priorities how we will achieve it 27 key actions to take now The start of the conversation a three-year corporate plan will follow

7 PHE priorities Helping people to live longer by reducing preventable deaths from conditions such as heart disease, stroke, cancer and liver disease Increasing healthy life expectancy by tackling conditions which place a burden on many lives, such as anxiety, depression and back pain Protecting the population from infectious diseases and environmental hazards, including emerging risks and the growing problem of antimicrobial resistance Supporting families to give children the best start in life, through working with health visitors, Family Nurse Partnerships and the Troubled Families Programme Helping employers to facilitate and encourage their staff to make healthy choices 7

8 Supporting priorities 6. Promoting the development of place-based public health systems 7. Developing our own capacity and capability to provide professional, scientific and delivery expertise to our partners 8

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11 Adult prevalence by BMI status Health Survey for England Underweight 1.6% Underweight 2.2% Obese 24.0% Men Healthy weight 32.2% Obese 25.3% Women Healthy weight 40.2% Overweight 42.2% Overweight 32.3% Adult (aged 16+) BMI thresholds: Underweight: <18.5kg/m 2 Overweight: 25 to <30kg/m 2 Healthy weight: 18.5 to <25kg/m 2 Obese: 30kg/m 2 11

12 Prevalence of overweight in children National Child Measurement Programme 2011/12 One in five children in Reception is overweight or obese (boys 23.5%, girls 21.6%) One in three children in Year 6 is overweight or obese (boys 35.4%, girls 32.4%) Child overweight (including obesity)/ excess weight: BMI 85 th centile of the UK90 growth reference

13 Obesity prevalence Obesity prevalence and deprivation National Child Measurement Programme 2011/12 Year 6 children Local authorities in England 30% 25% y = 0.003x R² = % 15% 10% 5% 0% Index of Multiple Deprivation 2010 score (High score = more deprived) Child obesity: BMI 95 th centile of the UK90 growth reference 13

14 Costs of diet /obesity related disease 70,000 premature deaths prevented in the UK if nutritional recommendations on salt, saturated fat and added sugar were matched* Economic burden of diet related ill health estimated at 5.8 billion to the NHS** Cost of overweight and obesity to the NHS about 5.1 billion** *Strategy Unit 2008 **Scarborough et al 2011

15 PHE s Diet and Obesity Team 4 work areas: Scientific advice on nutrition Scientific Advisory Committee on Nutrition and research advice Monitoring the diet of the nation National Diet and Nutrition Survey and food composition data bank Nutrition advice The eatwell plate, support to LA, national campaigns (C4L), consumer messaging (NHS Choices), procurement Obesity and healthy weight Coordinating and facilitating PHEs work programme on obesity, supporting LA, providing advice on weight management (Tiers 1 and 2) 15 Presentation title - edit in Header and Footer

16 Specific deliverables SACN advice Draft reports on CHO s, vitamin D and complementary feeding. Position statement on iodine and potassium based sodium replacers NDNS data Nutrition Advice Guidance on healthy and more sustainable catering C4L January campaign Support to School Food Plan (food based guidance) Food competency framework Local engagement events 16 Presentation title - edit in Header and Footer

17 Matrix approach Physical Activity* Specific deliverable to prevent and tackle poor diet and obesity: an emerging programme Maternity, Children & Young People Change4Life* including roll out of sports clubs Adults and Older people Develop briefings to support local government on physical activity Virtual network to support regional physical activity networks Support engagement with physical activity PH Responsibility deal Diet & Nutrition* Weight Management Start4Life* Food competence framework & related interventions School food activity Food procurement & healthier catering guidance Advice to S4L, C4L, NHS choices and local government Dietary surveillance through the National Diet and Nutrition Survey Joint work with PHE and NHS England to review of the obesity care pathway Support Local Authorities in the provision of weight management services Knowledge and Intelligence National Child Measurement Programme Disseminate briefing papers Obesity & Children & disability; Inequalities; Social Care; Diabetes Deliver Standard Evaluation Framework workshops Produce national and local obesity, physical activity and diet data Prepare briefing papers i) Regulating the growth of fast food outlets ii) Increasing physical activity and active travel Strategic Deliver regional workshops Develop PHE s Obesity Work Plan 17 Develop with the LGA a peer challenge protocol Development of national/local advocacy with Region/Centres E-learning modules for clinicians

18 As a registrant I: Ensure diet and nutrition advice is evidence based Be very clear about what being evidence based means Interpret and communicate the evidence base for different audiences Drive / profile the diet and nutrition agenda in PHE, across government and with stakeholders Support and promote delivery front line services and standards to improve diet, maintain a health weight and combat obesity Ensure recruitment and development of staff is in line with the values of the UKVRN; Maintain CPD for myself and support and encourage the wider the team 18 Presentation title - edit in Header and Footer

19 Challenges for registrants Perceived lack of conscious on nutrition Mixed messaging Over selling of nutrition Managing commercial vs public interest Political environment It s not my problems attitude Are we all leading by example? Limited money Capacity of the work force Bigger /different priorities 19 Presentation title - edit in Header and Footer

20 Thank you!