Blackpool Council – Written evidence (FPO0036)

1. Obesity is one of the most serious Public Health challenges in England and has been recognised as a complex problem by the UK Government’s Foresight Programme, with multiple causes and profound inequalities by gender, ethnicity, socio economic status, geography and disability.  Excess weight is driven by environmental, societal and individual factors.  The scale of the problem has been well documented and there is no one single solution to tackling such an ingrained problem.  Obesity is one of the leading causes of ill-health in England and is having an impact on people’s lives across the life course in relation to quality of life, the risk of developing chronic diseases such as Type-2 diabetes and links to mental health disorders.  Local authorities have a key role to play in promoting healthy lifestyles working with its partners and stakeholders to directly influence the health of the population.  Public Health England in partnership  with the Local Government Association and the Association of Directors of Public Health developed a tool kit to support local authorities to take action.  The document Promoting healthy weight in children, young people and families: A resource to support local authorities was published in 2018 and provides a range of opportunities and actions local authorities can take to tackle the issues of obesity. The document provides the latest evidence, resources and data to encourage a systematic approach to creating local environments that promote healthy weight in children, families and young people.  There are a range of practice examples that provides evidence of what local authorities have been trying to do to tackle obesity in local areas.

2. In Blackpool obesity is having a significant impact on the health of the population and is a key priority for Public Health team.  The Blackpool data for the 2017/18 National Child Measurement Programme  reported that 27% of reception and 37.8% of Year 6 children are overweight or obese.  The reception figure is the highest it has ever been and highlights the need to focus work on targeting the 0-4 year olds to reduce the number of children starting school overweight.  However, the Year 6 figure is higher than last year (34.3%) but has not increased to the previous high of 40%.  In 2016/17 it was reported that 66.4% of adults experience excess weight.   In January 2016 the Council made a commitment to promote healthy weight and improve the health and well-being of the local population and was the first council in the country to sign a Local Authority Declaration on Healthy Weight.  Since the signing of this declaration the Public Health Team have been working with partners to develop a range of interventions and actions to tackle the issue of obesity in the town. The aim of the declaration is for the council to demonstrate a commitment to reduce unhealthy weight in the community, protect the health and well-being of staff and the local population and to make an economic impact on health and social care on the local economy.  This has been achieved through the development of 12 commitments ranging from access to free drinking water, and protecting children from inappropriate marketing.  The declaration was developed in partnership with Food Active and other Directors of Public Health across the North West of England.  Since Blackpool signed the declaration a further 17 local authorities have adopted the declaration in the North West, with Yorkshire and Humber in the process of encouraging all local authorities to sign a similar declaration and the South West of the country developing a declaration for the NHS.

3. Since the signing of the Local Authority Declaration on Healthy Weight in January 2016 the Blackpool Public Health team have been working in partnership with a range of organisations to drive the health weight agenda forward.  Key partners involved in the work are the NHS, Better Start, Lancashire Police, Blackpool Transport, Blackpool Community Football Trust, Living Streets, Food Active and Love my Beach. Over the course of the last 3 years a range of actions have been undertaken to tackle obesity and are detailed in the following paragraphs.

4. Healthier Choices Award- Since 2017 Blackpool Council has been supporting local businesses to make small changes to their menu offer to improve the healthier options on offer to the local population.  To date 134 Awards have been presented and the scheme has received national recognition for the efforts in helping improve the food and drink offer in the out of home sector.  Businesses include Chinese takeaways, fish and chip shops, sandwich shops, schools, nurseries, play centres and children’s centres.  The scheme continues to run with new businesses coming on board and work is on-going to ensure existing award holders maintain the required standard.

5. Junior Healthier Choices Award – To build on the above award Public Health partnered up with Better Start to offer a Junior Healthier Choices Award scheme.  This part of the scheme has been designed to encourage businesses to support infant feeding, complimentary feeding and offering free water and milk to children.  The award includes making smaller portions of healthier menu items appropriate for infants, a quiet area for breastfeeding, bottle feeding or infant feeding and free tap water for mum to help prevent dehydration and the restriction of sales of energy drinks to children.  The scheme was launched in May 2019 and 20 organisations have already been presented with the award.

6. Give Up Loving Pop (GULP) – since 2015 we have run a range of campaigns to reduce the amount of sugary drinks our children drink.  There have been 2 campaigns in secondary schools, 3 campaigns in primary schools and we are currently running an early years campaign which is focused on dental caries with diet and nutrition being a secondary outcome.  We have also worked with our Further Education establishments to run campaigns, and one of our colleges does not sell energy drinks on any of its campuses.  This year Fit2Go  ran the challenge for every Year 4, 5 and 6 pupils across 32 Primary schools encouraging the children to take the 21 day challenge to give up drinking fizzy drinks and switch to water or milk.  In total there were 10,564 fizzy and sugary drink free days for children involved in the challenge. In November 2018, in partnership with Better Start an Early Years GULP campaign was launched ‘Be Kind to Teeth’.  The primary focus of the campaign was to target dental caries with a secondary outcome on diet and nutrition.  As part the campaign we were encouraging parents to swap the baby bottle for a cup and encourage the children to drink only water and milk.  The campaign engaged with Children’s Centres, GP Practices, Dental Practices, Women’s Unit at the Hospital,  Nurseries, Child minders and children’s social care. 

7. Children and Families weight management – This programme is provided by Blackpool Council Leisure Services and targets Primary School age (4-11 years) who are above a healthy weight.  It is mandatory that a parent/carer of each child should attend each session of the programme.   The aim of the service it to improve knowledge and skills around healthy eating and physical activity, to enable them to use these skills to make and sustain healthy lifestyle choices.

8. Fit2Go project – This programme is being delivered to every year 4 primary school in Blackpool by the Blackpool Football Community Trust.  This healthy lifestyle project is operated over 6 weeks and looks at healthy eating, physical activity and how to live a well-balanced lifestyle.   This programme has been operating for eight years and over the past year 96% of participants increased their understanding of a healthy lifestyle and 83% now eat more fruit.  Family Fit2Go – This programme follows on from the School based Fit2Go programme which looks to work with the whole family over three weeks, to support parents to make healthier choices for the whole household and the benefits this brings to the family.    The project worked with 526 families during the course of 2017/18. Better Start Fit2Go – This programme focuses on working with families with children aged between new born and 4 years of age, to support parents to give their children the best start in life.  The project focuses on supporting the family to understand the what child’s diet should include and strategies to live a healthier lifestyle.  In 2017/18 the project has worked with 82 families.

9. Walk to Project – In Blackpool there are currently 28 primary schools involved in the Living Streets programme which encourages school children to walk to school.  In addition to this there are 5 secondary schools involved in the scheme and the co-ordinator is also working with the business community to engage active travel across the town.

10. Healthy lunch boxes -  Over the past 12 months the Public Health nutritionist has been working with our primary schools to develop healthy packed lunch guidance to support parents with making healthy packed lunches.   Following consultation and running a number of workshops to promote healthy packed lunches resources have now been developed to help support and guide parents.  Our partners from Fit2Go deliver sessions within the primary schools to promote the use of the resources.

11. Planning - Where we live has a key role to play in tackling obesity and as a local authority we have a clear challenge in balancing healthier environments and the demand for thriving and vibrant high streets.  In particular the food environment  plays an important role in promoting a healthy diet including an individual’s proximity to food retail outlets and the type food available.  The food environment is constantly evolving with a wide range of choice of what to eat and when to eat.  Whilst not all fast food is unhealthy, it is typically high in saturated fat, salt, sugar and calories.   Maintaining choice is important but we need to support our residents to easily identify healthy options. Public Health have been working with planning colleagues to look at how to tackle the ever growing fast food takeaways.  Blackpool has decided to include the restriction on fast food takeaways as part of the Planning Local Plan.  The evidence has been submitted and the councillors are supportive of including this within the plan.  The proposal is to prevent the development of A5 uses in or within 400m of Wards where this is more than 15% of the year 6 pupils or 10% of reception pupils classified as very overweight. 

12. Healthy eating is important for everyone, especially children, to ensure they received all the nutrients they need to grow and develop.  Eating well improves children’s health and their ability to learn and achieve at school.  Encouraging children to eat healthily at an early age makes them more likely to continue a healthy lifestyle as they get older.  Research has shown that free school breakfast can reduce food insecurity and many improve cognition, particularly in children and in the longer term improve nutritional and educational outcomes for the most vulnerable.  The evidence base supporting school breakfast schemes includes research arising from large scale programme operating in the US, where the federally assisted school breakfast programme has been operating since 1975[1], and Wales where the Welsh Government introduced its Free breakfast initiative in primary schools in 2004.  Magic Breakfast has formed partnerships with schools, working with them to ensure the most vulnerable children have access to a healthy breakfast without stigma at the start of the school day and have recently produced evidence for making the case for free school breakfast[2].

13. Blackpool is the most deprived area in the country and 28% of children under 16 years are living in relative poverty.  Families with a low income may find it difficult to maintain a healthy diet and prior to the implementation on the universal free school breakfast  scheme, it was considered that many children in Blackpool were arriving at school after either consuming no or an inadequate breakfast.  This scheme therefore contributes to reducing educational and health inequality in children living in Blackpool.  Blackpool Council’s free breakfast programme offers a free breakfast to all primary school pupils attending state primary school in Blackpool local authority area.  The programme was rolled out in January 2013 and sees around 11,000 breakfasts served each day in 33 primary schools across the town.  The offer is universal and for all pupils from Reception to Year 6 inclusive.  The scheme is currently funded from the Public Health Grant, but is currently at risk of being reduced due to the demand on the budget.  Northhumbria University undertook a number of research studies to evaluate the impact of the breakfast provision in Blackpool[3] [4].  The evaluation showed that children eating free breakfasts consume significantly more healthy items for breakfast than non-attendees; that the scheme contributes to reducing nutritional inequalities; the universality of the scheme reduced stigma by ensuring no child is singled out for a free breakfast and children are happier more alert after attending the free school breakfast.

14. With many families reliant on the provision of two free meals during term-time, there is a growing concern about ‘holiday hunger’ affecting children, particularly those from families on a low-income[5]. Foodbanks report significant increases in demand during school holidays[6]. In addition, the summer holidays present an additional challenge by causing ‘learning loss’ for children, disproportionately affecting those children from more deprived backgrounds – thought to be caused by social isolation and boredom as well as inequity in opportunities and experiences to enhance learning, compared to their more affluent peers[7].  In Blackpool in 2018, 4,742 children were receiving free school meals which equates to 25.3% of all children on the school roll, compared to 13.5% of children in England, and as described above all primary aged children are entitled to a free school breakfast.  This summer the Public Health team worked with the Blackpool Opportunity Area to offer a programme of summer activities which included a food provision.  The scheme targeted six of the most deprived areas in Blackpool with the aim to ensure healthy food and activities were available to children in Blackpool over the summer holidays.  The same programme of activities was offered across all areas and the type of activities offered were sport sessions, family craft, cook and eat sessions, team around the school, trips to the beach and a high ropes experience. Work has commenced on evaluating the Summer Holiday Activity Programme, and the early findings indicate that the scheme was well received by both parents and children, it was well attended, and the food offer proved popular.    The early findings indicate that a total of 484 children attended at least one session, 34 children were not of school age, 57.6% of the children who were school age attending the programme were eligible for free school meals, the majority of children were aged 7-11 years and 52.1% of the participants were male, 46% were female and 1.9% no data was available.  Due to the amount of data collected, further analysis is still being undertaken to gain a full understanding about the programme and its success.  This information will feature in the final evaluation report, which is anticipated will be completed by the end of September 2019.  The link below takes you to a short video clip that provides an overview of the type of activities and fun the children families had over the summer holidays.

https://www.facebook.com/1021617421334189/videos/454433221818975/

15. The success of this work has been due to a strong political leadership for the obesity agenda through the Health and Wellbeing Board.  The work that has been undertaken in Blackpool has received national recognition through various conferences in particular at the LGA conference in 2018 on Childhood Obesity where Steven Brine, Parliamentary Under-Secretary of State for Public Health and Primary Care at that time, acknowledged the good work that was being undertaken in Blackpool.  Additionally, one of our Public Health Practitioners has been working on a secondment with Public Health England at a national level and has the opportunity to shape and influence policy around what is happening at a local level.

Nicola Dennison, Public Health Specialist, On behalf of Public Health, Blackpool Council

12 September 2019

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