Asked by: Mary Glindon (Labour - North Tyneside)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps her Department is taking to ensure that Tier 2 weight management services are sufficiently (a) resourced and (b) integrated with (i) primary care networks, (ii) community health hubs and (iii) other relevant providers to offer comprehensive support for people living with obesity.
Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Health Service and local government provide a range of free tier two weight management services (WMS), to help eligible people living with obesity to lose weight. These are multi-component programmes, including dietary approaches and physical activity, with behaviour change support. The length of support can vary, but guidance from the National Institute of Health and Care Excellence suggests these should last at least three months.
The NHS offers the NHS Digital Weight Management Programme, which is a tier two service aimed at adults living with obesity, who also have type 2 diabetes or hypertension, or both, as well as NHS staff living with obesity. The 12-week programme is directly commissioned and managed by NHS England nationally, and is available via direct referral from any general practice or Community Pharmacy
Local authorities are able to spend funding from the Public Health Grant on weight management services in line with local population need. They may be delivered as a standalone service or as part of an integrated service, for example with smoking cessation support. Where local authorities commission these services, they are responsible for determining the required resourcing and interaction with other services, along with weight management service providers
Local authorities are part of integrated care systems (ICSs), which are partnerships of organisations that come together to plan and deliver joined up health and care services, and to improve the lives of people who live and work in their area. ICS membership also includes the NHS, social care providers, charities, and other organisations. Being a member of the ICS will help local authorities to work more closely with partner organisations and offer integrated support for people living with obesity.
Asked by: Mary Glindon (Labour - North Tyneside)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps her Department is taking to ensure adequate oversight of how primary care settings deliver equitable access to weight management services in line with NICE Guidance.
Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)
Local authorities and the National Health Service provide a range of Weight Management Services (WMS) to support their communities to achieve and maintain a healthier weight. Generally, WMS delivered in the community are behavioural services provided by local authorities or the NHS Digital Weight Management Programme, rather than in primary care.
Local commissioners and WMS providers are expected to take National Institute for Health and Care Excellence (NICE) guidelines into account, alongside the individual needs, preferences, and values of their patients or service users. The NICE’s guidelines provide recommendations on best practice in terms of both the effectiveness and cost-effectiveness of interventions and services. It is not mandatory to apply the recommendations, although health and care commissioners are expected to take them fully into account.
Although primary care services are not a main provider of WMS, general practice (GP) is an important source of referrals to WMS. The Department funds the GP Weight Management Enhanced Service, which incentivises GPs to develop and implement a proactive approach to identifying and engaging with patients living with obesity, including the referral to WMS where appropriate. The service delivery specification for this enhanced service includes minimum standards such as undertaking training to have sensitive conversations about weight, and the review and restoration of the practice obesity register.
Asked by: Mary Glindon (Labour - North Tyneside)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps her Department is taking to improve access to weight management services in areas of socioeconomic deprivation.
Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)
Local authorities and the National Health Service provide weight management services to support their communities to achieve and maintain a healthier weight. These range from behavioural weight management programmes to specialist services for those living with obesity and associated co-morbidities.
Local authorities are able to spend funding from the Public Health Grant on behavioural weight management services in line with local population need, including in areas of socioeconomic deprivation. Integrated care boards are responsible for commissioning NHS specialist weight management services in line with local population need, as well as determining the criteria for access to these services in line with relevant guidance.
NHS England commissions the Digital Weight Management Programme nationally for people living with obesity and an existing comorbidity of either diabetes, or hypertension, or both. The 12-week programme is available via direct referral from any general practice or Community Pharmacy.
The programme provides three levels of intervention at varying intensities, and patients less likely to complete a behavioural programme of this nature, for instance those of a younger age, from ethnic minority backgrounds, from a more deprived area, or who are male, are offered a higher level of intervention and support to retain their engagement on the programme. Approximately 50% of total referrals are from the two most deprived socioeconomic quintiles.
Asked by: Tanmanjeet Singh Dhesi (Labour - Slough)
Question to the Department for Education:
To ask the Secretary of State for Education, whether she is taking steps to include information about the benefits of eating (a) wholemeal and (b) traditionally made bread in the school curriculum to promote healthier eating habits.
Answered by Damian Hinds - Minister of State (Education)
The government wants to support the health and well-being of everyone. The department recognises the importance of education in delivering this aim and is supporting schools in a number of ways to provide high-quality healthy eating education for their students.
The department does not specify how schools should teach the curriculum. It is a framework setting out the content of what the department expects schools to cover in each subject and trusts that teachers will develop the right approach for pupils in their particular school.
Cooking and nutrition are a discrete strand of the national curriculum for design and technology and is compulsory for key stages 1 to 3. The curriculum aims to teach children how to cook and how to apply the principles of healthy eating and nutrition. Students should become competent in a range of cooking techniques, as well as understanding the characteristics of a broad range of ingredients. The curriculum does not specify bread, but teachers may choose to include it among the foods they study.
A food preparation and nutrition GCSE, introduced in September 2016, requires pupils to understand and apply the principles of food science, nutrition and healthy eating when preparing and cooking food. Pupils learn about bread when studying food groups, where they could learn about the nutritional benefits of wholemeal. Similarly, they develop dough making skills in the preparation section of the course, allowing them to learn about traditional bread making.
The importance of healthy eating is also included in the science curriculum for both primary and secondary schools. Healthy eating is covered through topics relating to nutrition and digestion, which cover the content of a healthy diet and the impact of diet on how the body functions.
The statutory guidance for Relationships, Sex and Health Education includes content on the importance of daily exercise, good nutrition and the risks associated with an inactive lifestyle, including obesity.
Oak National Academy will be providing a fully resourced curriculum for key stage 1 to key stage 3 for food and nutrition. This will align with the national curriculum and also Oak’s guiding principles, which focus on the knowledge and skills specific to food and nutrition.
In addition, the standards for school food are set out in the requirements for school food regulations 2014, which can be found here: https://www.gov.uk/government/publications/standards-for-school-food-in-england. These regulations are to ensure that schools provide children with healthy food and drink options, and to make sure that children get the energy and nutrition they need across the school day. The standards require bread, with no added fat or oil, to be available every day. The ‘School food standards practical guide’ encourages use of wholegrain varieties of starchy foods, as well as using at least half wholemeal or granary flour when making bread, puddings, cakes, biscuits, batters and sauces. The ‘School food standards practical guide’ can be found here: https://www.gov.uk/government/publications/school-food-standards-resources-for-schools/school-food-standards-practical-guide#the-standards-for-school-lunch.
Asked by: Mary Glindon (Labour - North Tyneside)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps her Department is taking to tackle childhood obesity; and if she will take steps to work with (a) other Departments and (b) community organisations to provide access to safe recreational spaces for children.
Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)
Addressing obesity remains a priority for the Government and we are taking strong action to support people, including children and their families, in achieving and maintaining a healthier weight. This action includes: the introduction of restrictions on the promotion by location of less healthy products in key selling locations in store and online; working with the food industry to make further progress on reformulation and making healthier choices easier; the introduction of out of home calorie labelling regulations for food sold in large businesses, including restaurants, cafes, and takeaways; and supporting three million children through the Healthy Food Schemes.
The Government has taken steps towards providing access to open spaces for communities including children, this includes putting policies in place to require local authorities to provide access to open spaces for sport and physical activity, which is important for the health and well-being of communities. This includes a duty for all local councils to produce a design code for their local area. Design codes will be prepared locally, reflect the local context, and be based on effective community involvement. Officials in the Department are engaging with stakeholders, including those across Government, on a wide range of issues, to promote healthier places.
Asked by: Mary Glindon (Labour - North Tyneside)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what progress NHS England has made on integrating Wegovy to existing weight management structures within primary care settings.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The National Institute for Health and Care Excellence’s guidance on semaglutide, the active ingredient in wegovy, for managing overweight and obesity was published in March 2023, and updated in September 2023. It recommends semaglutide as a treatment option for patients that meet specified eligibility criteria, and recommends that the treatment is provided within specialist weight management services. These services are typically provided in secondary rather than primary care settings. The Government is committed to the safe introduction of new weight loss drugs into the National Health Service, and is exploring ways to increase access to more people, who meet the relevant eligibility criteria.
Asked by: Rachael Maskell (Labour (Co-op) - York Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what recent assessment she has made of the implications for her policies of trends in the level of obesity; and what steps her Department is taking to help tackle obesity.
Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government is delivering a wide range of measures to reduce the numbers of both adults and children who are overweight, or living with obesity. To date this includes legislative measures to limit the advertising, and location and price promotion, of less healthy products, and to ensure calorie levels are provided on menus when eating out of the home. Impact assessments for the legislated measures suggest there will be substantial health benefits, as well as savings to the National Health Service, accrued.
We have seen important successes through the Soft Drinks Industry Levy (SDIL), which between 2015 and 2020 has seen sugar levels reduced by 46% in, and over 46,000 tonnes of sugar removed from, products in scope of the levy. Data from the National Diet and Nutrition Survey from 2019 shows that sugar intakes have fallen for some age groups. In older children and adolescents, this appears to be partly driven by soft drinks contributing less to sugar intakes, likely as a result of the changes made to drinks included in the SDIL. Further information from the survey is available at the following link:
A paper on the association of obesity in primary school children and the SDIL suggests that the reduction in the sugar content of soft drinks delivered by the SDIL could have prevented up to 5,000 cases of obesity in girls in the last year of primary school. Reductions were greatest in girls who attended schools in the 40% of the most deprived areas. Further information from the paper is available at the following link:
https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004160
The voluntary reformulation programme requires businesses reduce levels of sugar, salt, and calories in everyday food and drink. Levels of sugar have reduced in breakfast cereals, yogurts, and pre-packed milk-based drinks by 15%, 13.5%, and 29.7% respectively, between 2015 and 2020. Levels of salt have reduced in some products by 20%.
Asked by: Christopher Chope (Conservative - Christchurch)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if she will (a) publish average weight to height ratios for children in England and (b) provide advice on any health implications for those who have a ratio significantly larger or smaller than the average.
Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Child Measurement Programme (NCMP) collects data on the height and weight status of children aged four to five years old, who are in Reception, and 10 to 11 years old, who are in Year six. The data collected and published by NHS England is expressed as a Body Mass Index (BMI) centile, to estimate child overweight and obesity. Data on average weight to height ratios for children in England is not available. The Department does not plan to publish data on average weight to height ratios, or average waist to height ratios for children in England. Waist measurements are not collected as part of the NCMP.
The clinical guidance from the National Institute of Health and Care Research recommends that a waist to height ratio measurement is considered alongside a child’s BMI centile in individual clinical assessments, to give a practical estimate of central adiposity. If a child falls into an unhealthy weight category, a waist to height ratio will give additional health information in clinical settings. This includes helping to assess and predict individual health risks such as type 2 diabetes, hypertension, or cardiovascular disease, as the location of where children carry weight on their bodies has an influence on their health.
Asked by: Rachael Maskell (Labour (Co-op) - York Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps she is taking to help support parents of children up to the age of five to tackle childhood obesity.
Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)
We are taking strong action to support children and their families in achieving and maintaining a healthier weight. The Government is investing approximately £300 million to improve support for families though the joint Department of Health and Social Care and Department for Education Family Hubs and Start for Life Programme. The programme will implement many elements of the Best Start for Life Vision and is delivering a step change in outcomes for babies, children, and their parents and carers in 75 local authorities in England, including those with high levels of deprivation.
The funding package includes £50 million to invest in infant feeding services, which will enable participating local authorities to design and deliver a blended offer of advice and support, in line with local needs.
We support more than three million children through the Healthy Foods Scheme. We also support parents with primary aged children in England to eat well, and move more, through Better Health Families. This includes healthy eating advice and easy recipes, a Food Scanner app to help families to swap less healthy foods and drinks to healthier alternatives, and the Healthy Steps email-programme to inspire and support parents to take easy steps to improve their families' health and wellbeing.
We work with the Department for Education to ensure that children are provided healthy food options in early years settings, and in school. For children aged zero to five years old, the Early Years Foundation Stage framework states that where children are provided with meals, snacks, and drinks, they must be healthy, balanced, and nutritious. The Eat Better, Start Better guidelines and example menus support parents, carers, and anyone working with children to provide healthy food options.
The School Food Standards are set in legislation and require that school caterers serve healthy and nutritious food and drinks, to ensure children get the energy and nutrition they need throughout the school day. Foods high in fat, salt, and sugar are restricted. We are also helping schools boost physical activity to help children maintain a healthy weight and good overall health through the Primary School PE and Sport Premium and the School Games Organiser Network.
In addition, primary school children are educated about healthy eating through the relationships, sex, and health education curriculum. By the end of primary school, pupils should know what constitutes a healthy diet, the principles of planning and preparing a range of healthy meals, the characteristics of a poor diet, and risks associated with unhealthy eating. We have programmes to identify children living with excess weight, and local authorities and the National Health Service in England provide weight management services.
The National Child Measurement Programme monitors the weight status of children at the start and end of primary school. The programme provides is a useful prompt to parents and schools to support healthy eating and physical activity. Data is used to help local authorities plan healthy weight, food and activity support and services for children and their families.
Local authorities can fund weight management services to support children and families, to achieve a healthier weight from their Public Health Grant. The NHS has commissioned a number of Complications from Excess Weight clinics across England for children and young people living with complications related to severe obesity. We are also delivering an ambitious programme of work to create a healthier environment to help people achieve and maintain a healthier weight.
Regulations on out of home calorie labelling for food sold in large businesses, including restaurants, cafes, and takeaways, came into force in April 2022. Restrictions on the placement of products high in fat, sugar, or salt in key selling locations, came into force on 1 October 2022. We will be implementing restrictions on the sale of less healthy products by volume price, for instance three for two offers, and will introduce restrictions on the advertising of less healthy products before 9:00pm on television. We will also be implementing restrictions on paid for online advertising for less healthy products, from 1 October 2025.
We are working with the food industry to ensure it is easier for the public to make healthier choices and make further progress on reformulation. In addition, the Food Data Transparency Partnership will help enable and encourage food companies to voluntarily demonstrate progress on the healthiness of their sales.
Asked by: Rachael Maskell (Labour (Co-op) - York Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps she taking to help support parents to tackle obesity in their children.
Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)
We are taking strong action to support children and their families in achieving and maintaining a healthier weight. The Government is investing approximately £300 million to improve support for families though the joint Department of Health and Social Care and Department for Education Family Hubs and Start for Life Programme. The programme will implement many elements of the Best Start for Life Vision and is delivering a step change in outcomes for babies, children, and their parents and carers in 75 local authorities in England, including those with high levels of deprivation.
The funding package includes £50 million to invest in infant feeding services, which will enable participating local authorities to design and deliver a blended offer of advice and support, in line with local needs.
We support more than three million children through the Healthy Foods Scheme. We also support parents with primary aged children in England to eat well, and move more, through Better Health Families. This includes healthy eating advice and easy recipes, a Food Scanner app to help families to swap less healthy foods and drinks to healthier alternatives, and the Healthy Steps email-programme to inspire and support parents to take easy steps to improve their families' health and wellbeing.
We work with the Department for Education to ensure that children are provided healthy food options in early years settings, and in school. For children aged zero to five years old, the Early Years Foundation Stage framework states that where children are provided with meals, snacks, and drinks, they must be healthy, balanced, and nutritious. The Eat Better, Start Better guidelines and example menus support parents, carers, and anyone working with children to provide healthy food options.
The School Food Standards are set in legislation and require that school caterers serve healthy and nutritious food and drinks, to ensure children get the energy and nutrition they need throughout the school day. Foods high in fat, salt, and sugar are restricted. We are also helping schools boost physical activity to help children maintain a healthy weight and good overall health through the Primary School PE and Sport Premium and the School Games Organiser Network.
In addition, primary school children are educated about healthy eating through the relationships, sex, and health education curriculum. By the end of primary school, pupils should know what constitutes a healthy diet, the principles of planning and preparing a range of healthy meals, the characteristics of a poor diet, and risks associated with unhealthy eating. We have programmes to identify children living with excess weight, and local authorities and the National Health Service in England provide weight management services.
The National Child Measurement Programme monitors the weight status of children at the start and end of primary school. The programme provides is a useful prompt to parents and schools to support healthy eating and physical activity. Data is used to help local authorities plan healthy weight, food and activity support and services for children and their families.
Local authorities can fund weight management services to support children and families, to achieve a healthier weight from their Public Health Grant. The NHS has commissioned a number of Complications from Excess Weight clinics across England for children and young people living with complications related to severe obesity. We are also delivering an ambitious programme of work to create a healthier environment to help people achieve and maintain a healthier weight.
Regulations on out of home calorie labelling for food sold in large businesses, including restaurants, cafes, and takeaways, came into force in April 2022. Restrictions on the placement of products high in fat, sugar, or salt in key selling locations, came into force on 1 October 2022. We will be implementing restrictions on the sale of less healthy products by volume price, for instance three for two offers, and will introduce restrictions on the advertising of less healthy products before 9:00pm on television. We will also be implementing restrictions on paid for online advertising for less healthy products, from 1 October 2025.
We are working with the food industry to ensure it is easier for the public to make healthier choices and make further progress on reformulation. In addition, the Food Data Transparency Partnership will help enable and encourage food companies to voluntarily demonstrate progress on the healthiness of their sales.