Table of contents

Current services in relation to need

Background papers: Lifestyle and wider determinants :: Healthy weight :: Diet and physical activity :: Current services in relation to need

The Healthy Weight Team offer the following services:

Infant Feeding Programme

Medway Breastfeeding Network is a peer support network made up of local mums who have breastfed their own babies and who have had additional training so that they can give information and support to other mums. Members of the Network are available at various locations including local baby clinics, children's centres, breastfeeding drop-ins and at Medway Maritime Hospital.

A cross-organisation Infant Feeding Strategy has been adopted by local stakeholders to work towards the achievement of UNICEF Baby Friendly Initiative Award in both maternity and community settings.

Early Years Support

The Healthy Weight team work together with key partners to develop a range of initiatives to support the adoption of healthy lifestyle practices from a young age. The Obesity in Pregnancy and Early Years network meets 4 times a year to share activities, receive updates and develop plans to expand the range of opportunities families can access in Medway.

Early Years programmes include Mend 2–4, a lifestyle programme for families with children aged between 2–4 years, Start4life activities, Play days and support and training for early years practitioners.

Healthy Start is a national scheme, which provides pregnant mothers or families with children under four years old with Healthy Start vouchers to help purchase foods, which could benefit their health (milk and fruit and vegetables). The scheme is means-tested and actively promoted across Medway by health professionals and children's centres. The Healthy Weight Team is involved in promotional activities to raise awareness of the scheme with particular regard to expanding access to vitamins for both mothers and children, and submission of uptake data to the Department of Health.

MEND Portfolio

Mend is a community based, family programme that delivers healthy lifestyle advice in a fun and informal way to encourage small changes to lifestyles. Programmes are age specific to ensure advice and delivery is appropriate for each age group.

Mend 2–4 is open to all 2–4 year olds regardless of BMI. Topics covered during the programme include general healthy eating, fussy eating, active play, mealtimes and label reading.

MEND 5–7 is a 10-week programme for families with children aged five to seven, whose weight is above the healthy range for their age. The course runs once a week after school.

Mend 7–13 is a 10-week programme for families with children aged seven to thirteen, whose weight is above the healthy range for their age. The course runs twice a week and includes regular activity sessions.

Mend Graduates is a local scheme that provides weekly groups and holiday activities to encourage Mend graduates (families who have completed Mend courses) to sustain their new lifestyle habits.

Community Food Programme

Medway's Community Food Programme aims to promote and sustain healthier food choices in communities, to increase the opportunity to enjoy a healthier diet. The programme provides healthy eating training, nutrition resources, guidance for existing food related projects and develops new initiatives to increase access to healthy eating. The Programme also has access to a community food allotment site where local community groups can learn how to grow and cook their own food.

Medway Dines

Medway Dines is Medway's healthy eating award for food businesses in partnership with Medway Environmental Health. It rewards businesses that promote healthy eating and who make it easier for consumers to find healthier food choices when eating out or taking away. The award is open to all types of establishments that cater for the general public including takeaways, caf├ęs, sandwich shops and restaurants. Premises are usually considered for an award at the time of a satisfactory routine food hygiene or food standards inspection, partial inspection or audit. In addition, premises may also be assessed if requested by a proprietor.

It is not intended to apply to premises that cater for individuals with specific dietary requirements. These include care homes for older people, state schools and nurseries where there are already guidelines or measures in place to improve healthy eating.

The Award uses the Eat Well plate food groups to review food options and preparation methods offered by businesses. Successful businesses will receive bronze, silver or gold award.

Medway Healthy Workplaces

This is a free scheme open to businesses in Medway to help them implement health improvement initiatives in the workplace. Interested employers are encouraged to complete a staff needs assessment and to develop a local implementation plan with support from the Health Improvement Workplace Health Coordinator.

Tipping the Balance

Tipping the Balance is a community-based clinic designed to help people lead a healthier lifestyle. The main aims of the service are;
• To help patients work towards a healthy weight
• To encourage healthy eating and physical activity
• To boost the patient's self esteem and confidence Patients are referred by their GP and have regular appointments with a Specialist Health Improvement Practitioner.

Medway Health Walks

Medway Health Walks is a volunteer lead programme that encourages people to use their natural environment, to achieve some regular physical activity. The walks take place across a range of urban, semi-rural and green spaces in Medway, and are free for residents to take part in. The schedule includes slower paced walks for families with young children to faster paced, longer duration walks for adults, so are an excellent opportunity for people to get some fitness gains and social interaction.

Active Medway Cycling Groups

Active Medway Cycling Groups aim is to provide cycling groups for adults, who have not been on their bikes for a number of years, and would like to rebuild their confidence in a safe and supportive group environment. These regular groups are facilitated by Ride Leaders (trained by British Cycling), with low traffic and less physically challenging routes chosen to cater for beginners.

Medway Exercise Referral Programme

Medway Exercise Referral programme is a 12-week programme for people diagnosed with a medical condition that would benefit from becoming more active. Patients are referred from a whole range of health professionals, who are then offered a choice of class or gym based opportunities. The scheme is hosted in the local authority leisure centres, where the exercise referral instructors assess, induct and provide supervised exercise sessions to people wanting to become more active.

Bariatric Referrals

NICE (2006) recommends surgery as a treatment option for patients that have a BMI of >= 40kg/m2 or 35–40kg/m2 with other significant diseases such as type II diabetes and hypertension. NICE states that surgery should only be offered when all appropriate non-surgical methods have been tried but failed to achieve or maintain adequate clinically beneficial weight loss for at least 6 months. Individuals with a BMI>50 kg/m2 should be considered for surgery as a first-line option if surgery is considered appropriate.

In Medway, patients can be referred to the Specialist Commissioning Panel by the community weight management service, Tipping the Balance or by their GP. Each individual is considered by the panel on a case-by case basis.

Other Interventions

Other interventions and services promoting the healthy weight agenda are offered across Medway and include:
• Change4Life Change4Life has traditionally offered advice to families on achieving a healthy weight. The Government has now shifted towards a new life course approach to health improvement. Change4Life will expand to cover all nutrition-related messaging (including a new focus on the key area of calorie reduction) and to other topics that have relevance to target audiences, such as the harmful effects of drinking alcohol above the recommended daily limits. The Change4Life programme will continue its expansion into early years (via its sister brand, start4Life) and into advice for middle-aged adults.
• Free swimming for adults aged 60+ in possession of a Medway City Card
• Children's Centres offer support with diet and exercise to families with children aged 5 years and under. All Children's Centres have adopted a food policy, in partnership with the Healthy Weight team to improve the standard of food provision in that setting.
• The Health Trainer programme provided by Sunlight Development Trust programme can offer signposting and basic health improvement advice to those wanting to effect lifestyle change.
• Medway Community Learning Service provides courses to help people develop cooking skills and physical activity classes.
• The Physical Activity Network, facilitated by the Healthy Weight Team, is a collection of partners from across Medway who meet quarterly to identify opportunities to increase physical activity in the groups they work with.