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December 2018

What the National Child Measurement Programme Missed

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The National Child Measurement Programme (NCMP) is a boring name for what is actually a huge and extremely useful annual survey. It contains measurements taken in schools for Reception and Year 6 children and is published by NHS Digital annually. This year is the first time they’ve identified children with severe obesity (>99.6 centile) and there are some shocking figures for Sheffield.

  • 21.2% of Reception year schoolchildren are now obese. That’s 0.5% higher than the previous year, and above the national average of 20%.
  • 35.6% of Year 6 pupils in the city are either overweight or obese and 4.97% of these children are severely obese – compared with a national average of 4.07 per cent.
  • At the time of the survey there were 40,724 children in Sheffield aged 6-11, which means that 2,023 children on this ratio are severely obese.
  • And there were 36,472 children in Sheffield aged 12-17 so 1,812 of children in this age bracket could be severely obese. What’s even more worrying is that these children are not included in NCMP measures.

Many of these young people would benefit from specialist Tier 3 services like ours but we can only see 200 families a year! Providing services for these children would have a major impact on the health budget, which is perhaps one of the reasons why these services are not currently funded. But that’s a lot of children and young people who are being left behind.

This survey proves there’s a substantial proportion of children who fit the criteria for interventions for ‘severe’ level of obesity. In fact the children we’re seeing at SHINE are above +3 and +4, which is even higher.

But what services will be available for children like those in this report whose weight poses significant health risks?

Alongside services provision, the main thing we’d like to see here is more information. There are no measures as yet for young people once they enter secondary school. NCMP measures stop at Year 6 so after that children are not measured at any other stage of their childhood life. We know obesity increases with age so measuring children again after this age is crucial. We agree with Tam Fry at the National Obesity Forum who is pushing for children to be measured every school year as they used to be in the past – early intervention is paramount to prevent children needing Tier 3 services.

What will the Government’s Obesity Strategy do for children?

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So, have the government finally realised the obesity epidemic is at crisis point after publishing their very first statistics relating to ‘severe’ levels of obesity in children and young people?

Let’s start with the good news. It was hugely heartening, following SHINE’s visit to London to give evidence to Diana Johnson (member of the Health Select Committee) and Sharon Hodgson (Shadow Health Minister) to get a promise that provision for Tier 3 services for severely obese children would be included in chapter two of the Government’s obesity plan.This is important because it’s a pathway to funding treatment. Clinical Commissioning Groups (CCGs) fund at a local level based on money allocated from central government. There is currently no ring- fenced money for Tier 3 services for children. We desperately need the government to set clear performance indicators and targets for multidisciplinary services so that CCGs have to fund these services. SHINE’s track record of delivery means we’re perfectly placed to deliver these services.

Anyway, just before the report came was published last summer, we found out it wouldn’t actually include provision for Tier 3 services. It did include the following passage –

“Signposting to appropriate advice, and where necessary, timely referrals for treatment was inconsistent for children living with childhood obesity. The Government must ensure there are robust systems in place not only to identify children who are overweight or obese, but to ensure that these children are offered effective help through a multidisciplinary, family-centric approach….’”

But there were no further details of how this would be managed.

The release of the report coincided with reports of the tragic death of an obese 13-year old boy from a blood clot whose weight was identified in post mortem as a “significant associated condition” – link.

The need for Tier 3 services is self-evident. We don’t just see it in the news, we see it every day at SHINE. When we started in 2003 we provided 12-week courses for 30 young people a year with ‘mild to moderate’ levels of obesity (BMI lower than 98th centile). We had rapid results and helped young people achieve their goal weight within six months. Today, we’re seeing around 200 families every year and children and young people weighing over 20 stone (BMI’s > 99.6 & 3.5 SDS known as clinical or morbid obesity) with extremely complex needs requiring intense interventions and long term support for up to two years.

So, going back to the question we started with – have the government finally realised the obesity epidemic is at crisis point for ‘severe’ levels of obesity in children and young people? Unfortunately it would appear not. How many more children need to die needlessly before we address this problem?