Promoting healthy weight in children, young people and families

A resource to support local authorities, NHS commissioners and providers, voluntary and community sector organisations to take action to reduce obesity | Public Health England


This resource is made up of briefings and practice examples to promote healthy weight for children, young people and families as part of a whole systems approach.

It supports:

  • local authorities
  • Clinical Commissioning Groups
  • other NHS partners and non-government agencies

The briefing papers help to:

  • make the case for taking action to reduce childhood obesity
  • give examples of actions that can be taken
  • provide key documents that form the evidence base and other useful resources

Practice examples are also given to illustrate what local areas are doing.

The briefings have been developed so they can be used as standalone documents and downloaded separately, or as part of the wider resource.

Full documents:

Fair Funding For Mental Health

Fair Funding For Mental Health: Putting Parity Into Practice | Institute for Public Policy Research (IPPR)

The NHS is currently in the process of writing a long-term plan that will set out what it wants to achieve with additional funding and how this funding will be allocated. This report argues that it is crucial that this plan raises our ambitions on mental health, what parity of esteem looks like and how much it will cost to get there.

The report states the NHS must scale up access to – and improve the quality of care – across all areas of treatment. In consultation with the sector, the authors identify the following themes that the long-term plan must address:

  • more investment in early intervention for children and young people (CAMHS)
  • scale up access to treatment for common mental health conditions such as
    depression and anxiety including through Improving Access to Psychological
    Therapies (IAPT)
  • provide universal high-quality community care for people severely affected
    with conditions such as psychosis, bipolar disorder, personality disorder and
    eating disorders
  • provide universal high-quality liaison and 24/7 crisis care for people living with
    poor mental health
  • reduce inpatient admissions, with more people treated in the community and
    supported at an earlier stage of their condition
  • set up a Mental Health Innovation Fund (MHIF) to spread best practise across
    the system.


How does stress affect the brain?

This research looks at the impact stress has on the brain in physiological and cognitive terms. The results published in the medical journal of the American Academy of Neurology suggest stress negatively affects memory and thinking skills | via EurekAlert


A study published in the October 24, 2018 issue of Neurology has found that middle-aged people with high levels of a hormone called cortisol in their blood have impaired memory when compared to those with average levels of the hormone. People with high levels of the hormone also had lower brain volume than those with regular cortisol levels.

Cortisol, produced by the adrenal glands, helps the body respond to stress. It can also help reduce inflammation, control blood sugar and blood pressure, regulate metabolism and help with immune response. High cortisol levels can be caused by stress, medical conditions or medications.

In this study, researchers identified 2,231 people with an average age of 49 who were free of dementia. At the beginning of the study, each participant had a psychological exam and assessments for memory and thinking skills. Their memory and thinking skills were tested again an average of eight years later. Researchers also measured cortisol levels in the blood and then divided participants into low, middle and high groups. A total of 2,018 participants also had an MRI brain scan to measure brain volume.

After adjusting for age, sex, smoking, and body mass index, researchers found that people with high levels of cortisol had lower scores on tests of memory and thinking skills than those with normal levels of cortisol. High cortisol was also linked to lower total brain volume.

Full reference: Echouffo-Tcheugui , J. B. et al. | Circulating cortisol and cognitive and structural brain measures | Neurology | First published October 24, 2018



Proportion of babies breastfed at six to eight weeks lowest in England for four years

Data published by Public Health England reveals the proportion of babies who are still being breastfed six to eight weeks after birth in England has fallen to its lowest level in the past four years | via OnMedica

The data covers the period 1 April 2017 to 31 March 2018, and were submitted by local authorities on a voluntary basis through an interim reporting system set up to collect health visiting activity data at a local authority resident level. baby-21167_1920

Some 140 out of 150 local authorities provided sufficient data, and their returns show an aggregate prevalence of 42.7% for 2017-18. This compares with 44.1% in 2016-17; 43.1% in 2015-16; and 43.8% in 2014-15.

Dr Max Davie, Royal College of Paediatrics and Child Health officer for health promotion said: “Breast milk gives babies the best possible start in life. These figures are therefore disappointing, but sadly not surprising.”

He said the significant drop-off at the six to eight-week mark was due to a range of factors, which included lack of local support services, social stigma around breastfeeding in public as well as “inconsistent messaging from health professionals.”

Full story at OnMedica

Full detail:

Breastfeeding at 6 to 8 weeks after birth: annual data | Public Health England:


Sundowning (changes in behaviour at dusk)

With the clocks going back at 2am this Sunday 28th October, Dementia UK shares some tips for preventing and managing sundowning

What is sundowning?

alarm-clock-2175342_1920Sundowning is a term used for the changes in behaviour that occur in the evening, around dusk. Some people who have been diagnosed with dementia experience a growing sense of agitation or anxiety at this time.

Sundowning symptoms might include a compelling sense that they are in the wrong place. The person with dementia might say they need to go home, even if they are home; or that they need to pick the children up, even if that is not the case. Other symptoms might include shouting or arguing, pacing, or becoming confused about who people are or what’s going on.

Tips for managing sundowning as it happens

  • Use distraction techniques: go into a different room, make a drink, have a snack, turn some music on, or go out for a walk
  • Ask the person what is the matter. Listen carefully to the response and if possible, see if you can deal with the source of their distress
  • Talk in a slow, soothing way
  • Hold the person’s hand or sit close to them and stroke their arm.

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Practical tips on preventing sundowning

  • Follow a routine during the day that contains activities the person enjoys
  • Going outside for a walk or visiting some shops is good exercise
  • Limit the person’s intake of caffeinated drinks. Consider stopping the person from drinking alcohol altogether. Caffeine-free tea, coffee and cola are available, as is alcohol-free beer and wine
  • Try and limit the person’s naps during the day to encourage them to sleep well at night instead
  • Close the curtains and turn the lights on before dusk begins, to ease the transition into nighttime
  • If possible, cover mirrors or glass doors. Reflections can be confusing for someone with dementia
  • Once you are in for the evening, speak in short sentences and give simple instructions to the person, to try and limit their confusion
  • Avoid large meals in the evening as this can disrupt sleep patterns
  • Introduce an evening routine with activities the person enjoys, such as: watching a favourite programme, listening to music, stroking a pet etc. However, try to keep television or radio stations set to something calming and relatively quiet—sudden loud noises or people shouting can be distressing for a person with dementia.

Full information leaflet: Sundowning (changes in behaviour at dusk). Understanding changes in behaviour in dementia | Dementia UK

Patients start testing the new NHS App

Patients at a number of practices across England have begun testing the new NHS App | NHS Digital

The NHS App provides simple and secure access to a range of healthcare services on a smartphone or tablet. Developed by NHS Digital and NHS England, the app will enable many patients to register without attending the practice, reducing administrative burden on reception staff.

Once registered, patients can:

  • check their symptoms using NHS 111 online and the symptom checker on the NHS website
  • book and manage appointments at their GP practice
  • order their repeat prescriptions
  • securely view their GP medical record
  • register as an organ donor
  • choose whether the NHS uses their data for research and planning

Feedback from patients and practice staff will be used to help improve the app before it is gradually rolled out to patients across England from December 2018.

Find out more on the NHS Digital Website


Stopping fraud against the NHS: new plans announced

The government has announced how it will take tougher action on fraud and save hundreds of millions of pounds for the NHS over the next 5 years, increasing the money available for improving patient care | Department of Health and Social Care

The new approach will start with a commitment to halve prescription fraud, which costs the NHS £256 million a year. Prescription exemptions will be digitised, allowing pharmacies to check whether the patient does not have to pay charge before their medication is dispensed. cure-1006811_1920 This will be piloted next year, before being rolled out across the NHS. The focus on prescriptions is one aspect of a wider crackdown on NHS fraud, which will prevent up to £300 million being lost to fraud by April 2020.

Further measures being introduced to stop fraud include:

  • a new partnership between the NHS Counter Fraud Authority (NHSCFA) and the fraud prevention service Cifas, allowing NHS counter-fraud professionals to access Cifas data
  • more collaboration and data sharing between the NHS Business Services Authority and NHSCFA to identify the small number of pharmacists and dentists claiming payments for services they have not carried out
  • the introduction of a new counter-fraud profession in central government, bringing together around 10,000 counter-fraud specialists, including 400 focused on fraud in the NHS

Full detail at Department of Health and Social Care

A&E visits by young people with mental health problems have almost doubled in five years

There has been a steep rise in the number of young people aged 18 or under arriving at A&E departments in England with psychiatric conditions, according to new figures released this week | via YoungMinds


The Department of Health and Social Care has revealed that, in 2017-18, there were 27,487 attendances in A&E by young people aged 18 or under with a recorded diagnosis of a psychiatric condition. This figure has almost doubled since 2012-13, when there were 13,800 equivalent attendances, and almost tripled since 2010.

The findings coincide with a survey by mental health charity YoungMinds, which revealed that 61 per cent of parents said the care their child received in crisis was “bad” or “unacceptable.” In the survey of 1,531 parents whose children have experienced a mental health crisis:

  • 75% agreed that “it would have been helpful for my child to have a safe place to go to while they were in crisis within our local community”.
  • 65% agreed that “It would have been helpful for me or my child to have access to a mental health crisis telephone hotline”.
  • 86% agreed that “it would have been helpful for my child to have access to support before they reached crisis point.”

Full detail: A&E attendances by young people with psychiatric conditions almost doubled in five years – new figures | YoungMinds

How should health policy respond to the growing challenge of multimorbidity?

Experts call for health system change to tackle the challenge of multimorbidity in the NHS. The report discusses the need for patient-centred care, with more emphasis on generalist rather than specialist care and better integration between general practice, hospitals and social care| University of Bristol

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People with multimorbidity – one or more long-term health conditions, such as diabetes, heart disease and dementia – are more likely to experience poor quality of life and poor physical and mental health. They use both general practice and hospital services far more often than the general population. However, healthcare systems around the world are largely designed to manage individual diseases or episodes of illness rather than patients with complex multiple health care needs.


This policy report makes a series of policy recommendations including:

  • Promoting patient-centred approaches to the management of multimorbidity in primary care, which requires training, support and changes in incentives.
  • Developing and evaluating new approaches to managing patients with multimorbidity within hospitals.
  • Exploring new models of integration of primary and community care, hospital care and social care which enable better co-ordination and support for people with multimorbidity, which is likely to require substantial changes in commissioning and funding mechanisms, and a rebalancing of resources.
  • Changes to professional education, training and regulation to prepare professionals to manage patients with multimorbidity in new and more integrated systems.
  • Engaging and enabling people to manage their own health and long-term conditions, requiring co-ordinated action across many aspects of government and public life.
  • More research to understand and improve care for multimorbidity.

Full report: How should health policy respond to the growing challenge of multimorbidity? | University of Bristol

Early deaths twice as common in most deprived parts of England

People in the most deprived parts of England are twice as likely to die prematurely as those in the wealthiest areas, according to research on UK inequality | The Lancet


A study published in The Lancet has looked at death and disability rates across the UK in the period 1990 to 2016. This data was then compared them to life expectancy data to establish how many years were lost to people dying young or living with life-limiting physical and mental health conditions.

This assessment of health across the country revealed a stark division between rich and poor areas, with poorer people dying earlier and getting sicker quicker. The report identifies that over half of premature deaths are linked to behavioural risk factors including tobacco use, obesity, alcohol and drug use.

Full reference: Steel, N. et al. | Changes in health in the countries of the UK and 150 English Local Authority areas 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016 | The Lancet | published October 24, 2018

See also: Early deaths twice as common in most deprived parts of England, study shows | The Independent