Food and Health Action Plan Easington

Food and Health Action Plan Easington 2007-2010

Foreword The Easington Food and Health Action Plan sets out a framework to improve the diet and health of the people in the District of Easington. The Plan covers a three-year period from 2007/2010 and aims to address key food and health issues in the District. The issues include access to a healthier diet, affordability of good nutritious food, awareness of healthy eating and targeted project work. The Plan will also make a direct contribution towards the Government s White Paper, Choosing Health; Making Healthier Choices Easier (2004). In addition, the development of an Action Plan was recommended in the Director of Public Health s Annual Report in 2005/2006. I commend the Food and Health Action Plan to you and hope you find it useful in making a difference in reducing health inequalities and improving health locally. Anna Lynch Acting Director of Public Health County Durham Primary Care Trust March 2007 page 3

Contributors This Food and Health Action Plan has been developed in consultation with a range of partners working in the district of Easington. Acknowledgement and thanks are due to the people listed opposite: Janet Griffiths School Nurse, County Durham PCT. Maureen Grieveson Nurse Lead for Health Visiting, County Durham PCT. Jane Lowther Looked After Children s Nurse, County Durham PCT. Sandra Laws Dental Health Educator County Durham PCT. Zu Goodwin Modern Matron, County Durham PCT. Monica Nieuwoudt Dietician, Hartlepool Hospital. Pam Thirlaway Locality Manager, Age Concern. Alison Young Children Services Authority Advisor, Children & Young People s Services. Cath McLoughlin Group Manager, Scolarest. Barbara Hind Outreach Development Officer, East Durham Trust. Gillian O Neill Programme Co-ordinator, County Durham PCT, development of the Food and Health Action Plan. Graeme Greig Head of Public Health Planning & Performance, County Durham PCT, for the Advice and Guidance on development of the Food and Health Action Plan. page 4

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Contents Foreword Contributors Introduction Health in Easington Purpose of the Food and Health Action Plan National Policy Drivers Local Objectives Review Process Summary 3 4 7 8 9 10 11 12 12 Appendix One Current Food and Health Initiatives in Easington 14 Appendix Two Food and Health Action Plan 20 Appendix Three References 42 page 6

Introduction The purpose of the Easington Food and Health Action Plan is to improve the health of people in the District of Easington by increasing opportunities to access healthier food and increase skills, knowledge and confidence within the community to eat a healthier diet. The multi agency Food and Health Action Group will take the lead for the co-ordination and implementation of the Action Plan. The Food and Health Action Group is directly accountable to the Health Improvement Group (HIG), a sub group of the East Durham Local Strategic Partnership (EDLSP). Why access to healthier food is important: Approximately one third of all cancers can be attributed to a poor diet. An increase of one portion of fruit or vegetable a day can lower the risk of Coronary Heart Disease by 4% and Stroke by 6%. Obesity levels in 6 15 year olds have trebled between 1990 and 2001. Type 2 diabetes is increasingly being found in younger people. As it is normally found in older people. One in five children do not eat any fruit in a week. Three in five children don t eat leafy green vegetables. Between 1990 and 2000 the purchasing of convenience foods rose by 24%. 75% of salt in the diet comes from processed foods. 37% of total added sugar intake comes from soft and alcoholic drinks. page 7

Health in Easington A number of reports and publications over recent years have described health in Easington as poor compared with the England average, with extreme poor health in some areas: Life expectancy for men in Easington is 74.2 years and for women is 78.4 years compared to the England average of 76.9 years and 81.1 years respectively. Death rates from Coronary Heart Disease (CHD) and most cancers are above the national average. Percentages of adults who are obese are significantly higher than for England. Levels of smoking are higher than the national average (37.3% compared with the national average of 26%). Easington has the highest number of admissions due to alcohol poisoning and the highest rate of alcohol mortality of the County Durham districts. The teenage pregnancy rate has fallen but it is still above the national average. Significantly fewer 15 year olds achieve at least five good GCSE passes than the England average. page 8

Purpose of the Food and Health Action Plan The Food and Health Action Plan demonstrates the link to the public health evidence base. It is consistent with the National Institute for Health and Clinical Excellence (NICE) guidance on Obesity (Dec 2006). The NHS Improvement Plan and other key documents such as National Service Frameworks all highlight diet and nutrition as key areas for action. The Government s Public Health White Paper Choosing Health: Making Healthy Choices Easier (2004) and Choosing a Better Diet: A Food and Health Action Plan (2005) reinforce this. There are five key aims of the Food and Health Action Plan: 1. Encourage healthy eating in a consumer society 2. Encourage healthy eating behaviours in children and young people 3. Promote opportunities for healthy eating in local communities 4. Ensure that the NHS promotes healthy eating 5. Improving nutrition in the workplace These aims will be addressed by the Easington Food and Health Action Plan. Reducing food poverty is a key goal. Food poverty is defined as the inability to afford, or have access to food to make up a healthy diet. Those experiencing food poverty may have limited money for food after paying household bills, live in areas where food choice is restricted by local availability, lack transport or lack the knowledge, skills or cooking equipment necessary to prepare healthy meals (Choosing A Better Diet, 2005). This can be achieved by focusing on the overarching factors affecting food poverty: Affordability of healthier food quality produce at affordable prices. Accessibility of healthier food transport issues, out of town supermarkets. Availability of healthier food local shops stocking a range of quality healthier food. Awareness, attitude and acceptability towards healthier food Improving the skills, knowledge and understanding of what constitutes a healthy diet and how to prepare healthier food. page 9

National Policy Drivers The Food and Health Action Plan is underpinned by a strong policy context around reducing mortality and improving health. The NHS in England: The Operating Framework for 2006/2007, details challenging national standards and priority areas that include the following: 1. Halt the year on year rise in obesity among children under 11 by 2010 in the context of a broader strategy to tackle obesity in the population as a whole (Choosing Health). 2. Reduce Health inequalities by 2010 as measured by infant mortality and life expectancy at birth. 3. Substantially reduce mortality rates by 2010 from Heart Disease and Stroke related disease by at least 40% in people under 75, with at least 40% reduction in equalities gap between the fifth of areas with the worst health and deprivation indicators and the population as a whole (NSF CHD). 4. Substantially reduce mortality rates by 2010 from cancer by at least 20% in people under 75, with a reduction in the inequalities gap of at least 6% between the 5th of areas with the worst health and deprivation indicators and the population as a whole (NHS Cancer Plan). page 10

Local Objectives The Food and Health Action plan has six specific objectives that are consistent with the national policy framework described above (see appendix 2 for the detailed plan). These are: 1. To improve the diet and nutrition of pregnant women and children in the early years of life. 2. To improve knowledge, skills, access and uptake of a healthy diet for children and young people. 3. To promote and improve access and availability of healthy food within the local community. 4. To promote and improve healthy eating within the workplace and for catering/hospitality. 5. To improve access and availability of healthier food choices for older people. 6. To increase capacity to promote healthy eating through workforce development and training. page 11

Review Process The Food and Health Action Group will meet quarterly and review the plan annually in line with the national and local policy. Amendments will be made accordingly. Summary Work has already gathered momentum in Easington and solid foundations have been set in relation to improving diet and nutrition within the district. The Easington Food and Health Action Group will expand upon the work already being delivered and drive the objectives forward. Through robust performance management the Food and Health Action Plan will contribute towards the public health evidence base and influence future Local Delivery Plans. page 12

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Appendix 1: Current Food and Health Initiatives in Easington The following section gives an overview of the current initiatives operating in the district. Many of these have been evaluated for impact. The national 5 A DAY programme has demonstrated successful outcomes as highlighted in Choosing Health (2005). Choosing Health has identified that the most effective interventions are those focusing on the underlying principles of affordability, access, availability, attitude and awareness raising. Children and Young People Health Visitors Health Visitors provide advice on maternal nutrition in the antenatal period and encourage parents to consider breast-feeding. Information is given in line with county-wide breast-feeding guidelines. Health Visitors carry out weaning visits to all parents between 16-20 weeks postnatally and provide information in line with the Countywide 0-5 healthy eating guidelines. They provide families with the Tasty Treats booklet and the Department of Health Weaning leaflets to reinforce information and advise about weaning groups running in the area. Parents are provided with feeding cups and encouraged to use them from six months, the importance of a healthy balanced diet, family foods and the 5 A DAY message are reinforced. At the eight to nine month visit the Simply 5 recipe books are provided. page 14

School Nursing team The School Nursing team work in partnership with health professionals and colleagues in education to improve the knowledge, skills and access to a healthy diet for young people, including those with special needs. School Nurses ensure young people are aware of issues relating to a balanced diet and the importance of healthy eating. This is especially highlighted within personal health and social education in Year six but also within other sessions and health events in schools. School Nurses offer one to one support and advice in relation to healthy eating and weight issues both to young people and their carers. This is available within the school setting, clinics and young people s own homes as required. At present all parents of reception and Year six children are asked if their child can have their height and weight recorded as part of a new national surveillance programme. The Weight Management Service then collates all received data, and enters it into the National Childhood Obesity Database, in accordance with Department of Health guidelines Measuring Childhood Obesity. Within each comprehensive school, School Nurses run a drop-in service for young people to access health information and advice. Within the primary school and Children s Centre setting parental drop-ins are available in ten schools. In addition a School Nurse drop-in is available for young people or their carers in Peterlee Health Centre every Wednesday afternoon during term time. Healthy diet issues can be discussed at these sessions. 5 A DAY: 2003 2005 A successful 5 A DAY programme initially funded by the Big Lottery, has become a mainstream programme delivered by County Durham PCT. The main aim of the programme was to increase awareness and consumption of fruit and vegetables amongst 0-11 year olds and their families. The 5 A DAY team has now integrated with other food and health specialists to form the Food and Health Service. The Food and Health Service has been delivering the following areas of work. page 15

Weaning Programme Food and Health Facilitators deliver a three week course to expectant mothers and new parents. The course focuses on improving the skills, knowledge and confidence of how to prepare home made weaning foods. All participants receive a free weaning starter equipment pack and Tasty Treats recipe book. Recipes from this book have been used on the national Healthy Start web site. Pre and post course evaluations have highlighted behaviour change to be significant over the last four years. Nursery Nurses and Family Workers as well as Food and Health Facilitators are now delivering the weaning programme. The Food and Health Facilitators are mentoring Nursery Nurses to ensure there is a consistent message being given to parents. A weaning network forum has been established to share good practice and provide training updates. Cooking for the Family This is a five week course developed from community consultation. The course is offered to residents wanting to develop their skills, knowledge and confidence to prepare balanced healthy meals for the whole family at affordable prices using locally available ingredients. The courses have been popular, with behaviour change being very positive and maintained outside of the courses. As with the Weaning Programme, all participants receive a free cooking equipment resource pack and the Simply 5 recipe book. This course is offered in a variety of settings including Children s Centres, Community Centres and extended schools. page 16

Healthy Snacks in Nurseries All nurseries and parent and toddler groups have been offered healthy snacks training for staff. This has resulted in over 40 nurseries adhering to the guidelines and improving their snack provision for young children. Food in Schools Easington is well placed to support the introduction of the Department for Education and Skills new School Food Standards. Over the last three years schools in Easington have received training on the importance of a whole school food policy, how to improve food provision throughout the school day and curriculum links and guidance on how to incorporate healthy eating into core curriculum themes. This training has been delivered in close partnership with the School Nursing Team and Local Authority Advisory Teachers. This supports the Local Area Agreement stretch target for all schools to become Healthy Schools by 2009. To date 21 breakfast clubs have been supported to become Healthy Breakfast Clubs. Training and guidance is provided in the form of a breakfast club workers network forum and also school specific support. Evaluations have demonstrated that levels and attendance have improved following the implementation of the Healthy Breakfast Clubs. A variety of nutrition carousels have been delivered in partnership with the school nursing service and volunteers. Children s cooking courses with Year six pupils have also been popular. page 17

Community Access Food Co-ops Eight food co-ops are operating within the District of Easington in areas where access to fresh affordable produce is poor. The co-ops are staffed by volunteers from the community. The Food Chain Company North East co-ordinates deliveries of the fresh produce. Evaluations have highlighted an improvement in access to affordable fresh produce in the areas where food co-ops operate. Community Cafes Working with community organisations Community Cafes are being encouraged to provide much healthier menu options. To date, three Community Cafes are running in Easington. Luncheon Clubs To support the work on healthy eating for older residents, luncheon clubs have been established within community venues. To date there are 16 luncheon clubs across the district offering older people social time as well as an affordable nutritious meal. Luncheon clubs are a partnership venture between church groups, Age Concern, Public Health and other services. Weight Management Health professionals in Easington deliver a 12-week Weight Management Programme. The programme is structured, fully resourced, and delivered from the primary care setting. The method of delivery utilises the GP practices within the district and practice staff deliver Weight Management in Practice a fully supported programme to enable the delivery of a structured behaviour change, motivational course. To date, 15 of the 17 practices within the district deliver the service on behalf of the County Durham PCT. page 18

Workplace Working for Health Award and Heartbeat Award Nine employers are currently involved in the Working for Health Award. This award includes the promotion of healthy eating to employees as part of its criteria. Five catering establishments are involved in the Heartbeat Award, two of which provide a service to workplaces. Men at Work Men at Work is a new initiative designed to improve the health of adult males working within the District of Easington. The Men at Work team offer health promotion interventions on a range of issues including healthy eating and weight management, with the aim of providing individuals with the knowledge and skills to make informed choices regarding their health. Individuals are provided with one to one or group support at their place of work in order to help them make and sustain any behaviour changes. Two local employers are currently involved with the initiative. page 19

Appendix 2: Food and Health Action Plan Objectives Actions Health/Information Objective 1 Pregnant Women & Early Years To improve the diet and nutrition of Pregnant Women and Early Years. Develop a programme to support the improvement of maternal nutrition. Deliver healthy eating session within the Bump to Baby groups. Develop a maternal nutrition recipe resource and information pack. Pilot and evaluate a maternal nutrition cooking group. To work towards the County Breast Feeding Strategy. Liaise with the County Fresh Group. Health visitors to promote breast feeding antenatally and to provide continued support in the postnatal period. Prioritise what can be achieved at locality level and implement. Scoping exercise on how NHS buildings, council owned buildings and private businesses treat women who wish to breast feed. page 20 Implement and evaluate three tiers of training to employers and employees based on results from scoping exercise. Support national breast feeding awareness week.

Responsibility Outcomes Timescales Health Visitors. Midwives. Children Centres. Pregnant women to have the skills, knowledge and confidence to prepare home made food that will enhance the health of both themselves and their unborn child. 2008-2009. Measurement: Session evaluations and pre/post questionnaires. Health Visitors. Midwives. Children Centres. An increase in women continuing to breast feed for longer. More venues are breast feeding friendly. 2006-2008. Increased awareness on the importance of breast feeding. page 21 1

Objectives Actions Adopt North Durham s Healthy Eating Policy for 0 5 year Prevention Information olds. Food and Health Action Group to review current policy and ensure it is fit for purpose. Continuation of the weaning programme: Deliver a minimum of 36 courses per year. Nursery Nurses to be fully trained to deliver the weaning programme. Food & Health Facilitators to mentor the nursery nurses and co-ordinate a weaning network forum for top-up training and sharing good practice. If Well Being bid successful appoint HDS to roll out weaning programme across the North East. Health visitors to provide weaning information one to one as part of their home visiting pathway. Co-ordinate and roll out a Healthy Teeth Award for Nurseries and Reception classes. A steering group to co-ordinate and validate the Healthy Teeth Award. Engage a minimum of ten organisations per year Promote the award as a best practice model. If Healthy Teeth Award successful build upon it to become a Nutrition Award for Early Years settings. page 22

Responsibility Outcomes Timescales Food and Health Action Group. A consistent message for all organisations and professionals who work with 0 5 year olds. 2008-2009. Nursery Nurses/Family Workers. Health Visitors. Children Centres. New parents to have the skills, knowledge and confidence to prepare home made weaning food. 2007 ongoing. Nursery Nurses to become fully autonomous delivering the weaning programme. Measurement: Numbers attending groups and pre/post questionnaires. Community Dental Health. School Nursing. Children Centres. Nurseries. To provide a consistent message in all nurseries and reception classes about good oral health and what constitutes healthy snacks. 2007 ongoing. Measurement: Achievement of the Award. page 23

Objectives Actions Roll out of the Healthy Start Programme. Prevention Information Promote the revised Healthy Start Vouchers within all groups who have 0 4 year olds and may be entitled. Co-ordinate local media campaign. Promote the Healthy Start vouchers being accepted within the local food co-ops. Work with local retailers to accept Healthy Start Vouchers. Health/Information Objective 2 Children & Young People To improve knowledge, skills and access to a healthy diet for Children and Young People. All 48 Schools working towards achieving Healthy Schools Status. Support all schools in relation to the Healthy Eating Core theme. Support all 48 schools in implementing the new school food standards DFES (2006). Deliver school staff and governor training. Deliver parent awareness sessions. Consult with pupils about being part of the changes. Where Children do not take a school meal promote healthy packed lunches. Guidance on healthy packed lunches to be promoted in school. page 24 Support individual schools in working with parents around healthy packed lunches. Provide materials to all schools on healthy packed lunches.

Responsibility Outcomes Timescales Health Visitors. Nursery Nurses. Children Centres. Nurseries. Community venues hosting food co-ops. Retailers. To increase the use of the vouchers to buy fresh fruit and vegetables. Measurement: Number of vouchers being used in food co-ops. Recruitment of retailers to accept vouchers. 2007 ongoing. School Nurses. LA. Schools. Scolarest. All schools to achieve the Healthy Eating Core theme and have: A food policy. 2009. A robust curriculum. Whole school approach. School Nurses. LA. Schools. Scolarest. Volunteers. Schools to feel comfortable adhering to the new legislation. Schools to have a consistent message. 2008 primaries. 2009 secondarys. School Nurses. LA. Volunteers. Schools to have access to materials promoting healthy packed lunches. Development of guidance document for schools re packed lunches. Measurement: Evidence of schools promoting healthier packed lunches. 2007 ongoing. page 25 School food policy development.

Objectives Actions Continue to support the 21 Healthy Breakfast Clubs Prevention Information across Easington. Co-ordinate Breakfast Club network forum once a term to offer guidance and support to all breakfast club workers. Develop and update the Healthy Breakfast Club How To pack. Performance monitor the breakfast clubs and actively support them to secure additional funding from other sources. Evaluate the breakfast clubs. Raise awareness of the importance of a balanced diet amongst mainstream and special needs school aged children. Deliver healthy eating information within PSHCE lessons within all primary schools. Offer 1 1 support to young people and their carers as requested. Refer to specialist agencies as and when required. Deliver a variety of cooking courses within the school and extended school setting: Deliver a minimum of 12 per academic year. Food & Health Facilitators to offer cooking courses to parents and pupils and community members. Plan and host a Healthy Eating Best Practice in schools conference. Co-ordinate through Food and Health Action Group. page 26 Support the Cook It programme and any other national initiatives within the school setting that promote healthy eating. Work with the Extended school leads to develop the Cook It programme and ensure the programmes become sustainable.

Responsibility Outcomes Timescales School Nurses. Schools. Scolarest. Increase the number of children having a nutritious breakfast on a school morning. Measurement: Questionnaires to staff, parents and pupils. 2007 ongoing. School Nurses. All mainstream young people within Easington school nurses caseload to be aware of healthy eating information by the end of year six. To give continuing individual support to young people with special needs. 2007 ongoing. Measurement: Participatory appraisal tools and for young people with special needs methods suitable for the individual. Family Learning Leaders. Extended Schools Leads. Schools. Cooking to be a regular part of the school/extended school day. Measurement: Attendance at groups and pre/post questionnaires. 2007 ongoing. Food and Health Action Group. LA. Schools. An opportunity to share good practice and learning. 2008. Extended school leads. LA. School Nursing. The Cook It programme to have been a benefit to the whole school community. Measurement: Utilise Cook It evaluation tools. 2007-2008. page 27

Objectives Actions Support the Healthy Eating element of the Healthy Youth Prevention Information Work Standard. Deliver training to Youth Workers to enable them to plan, deliver and evaluate healthy eating sessions. Provide support to youth initiatives to improve the meals & snacks that are currently available to Children & Young People. To Co-ordinate the training and cooking courses being offered to Foster Carers, Residential Workers and Looked After Children. Attend the M.A.L.A.P. training sub group. Map the current work taking place across the county and develop a best practice guide in line with the National Healthy Care Standard. Deliver practical cookery training to foster carers and residential staff. Deliver practical cooking courses to Young People leaving care. Raise awareness of issues relating to diet and nutrition in the post 16 age group. Work with NEET group as identified by Connexions. Train staff working in sixth Form colleges on School Food Legislation. Support learning through Health and Social Care NVQ courses. Develop a resource pack for Freshers at college on how to cook on a budget. page 28

Responsibility Outcomes Timescales Education in the Community. Out of Hours. To offer consistent messages to Young People through the Healthy Youth Work Standard. 2007-2008. Measurement: Achievement of the HYWS. M.A.L.A.P. Named nurses for Looked After Children and Young people. Following best practice, as identified in the NSF for Children & Young People, provide consistent training on Healthy Eating. 2007-2010. Measurement: Previous evaluations and NHCS. Attendance at courses. Changes in cooking practice. Post 16. Teachers/Lecturers. College staff and catering staff. Post 16 young people to have access to information about diet and nutrition. Measurement: Collate database of where information has been sent. 2009-2010. page 29

Objectives Actions Health/Information Objective 3 Community Access & Availability To promote and improve access and availability within the local community. Sustainability of the eight Food Co-ops. Raise profile of existing co-ops and increase orders to reduce the subsidy. Co-ordinate the food co-op network forum. Pilot and evaluate a market place initiative within Wingate Family Centre. Through needs assessment consider whether more food co-ops are needed. Research into alternative providers of produce. Develop and support a variety of community cafes: three per year. Three each year to be developed and supported. Community cafes to be able to offer internet access for food shopping. Work with community venues to be breast feeding friendly. Through scoping exercise find out the current situation in all community venues promoting breast feeding. Raise the awareness of breast feeding through promotional displays. All community staff to receive training on the importance of promoting breast feeding within their venue. page 30 Develop four fruit on the front desk scheme in community venues per year. Deliver training to community staff on how to set up fruit on the front desk scheme. Recruit and support volunteers to set up the scheme. Establish four fruit bowls per year.

Responsibility Outcomes Timescale Food Chain Company. Volunteers. Community Venues. Increased availability of accessible/affordable fresh fruit and vegetables. Measurement: Number of orders taken at co-ops and the uptake of Healthy Start Vouchers. 2007 ongoing. Environmental Health. Volunteers. Community Groups. Cafes offering healthier alternatives. Measurement: Menus and uptake of food. Establishment of Cafes. 2007 ongoing. Health Visitors. Community venues. Breast feeding parents to feel comfortable breast feeding within community venues. 2008-2009. Measurement: Questionnaires and focus groups. Volunteers. Community Groups. Increased availability of fruit in local community venues. Measurement: Number of schemes established and their success. 2007 ongoing. page 31

Objectives Actions Develop a retailer project that promotes affordable fruit and Prevention Information vegetables. Work with 1 2 retailers per year to consider their profitability when increasing the healthy produce they sell. Promote a healthy recipe stand: All the ingredients can be bought from one shop and displayed in one place. Map mobile snack bars across Easington to consider food outlets. Mapping exercise. Needs assessment of work based on mapping. Engage staff who work with vulnerable groups and offer training on diet and nutrition: Residential accommodation. Sheltered accommodation. Day Centres. Map existing organisations that work with vulnerable groups: Mental Health Service users; People with problematic drug/alcohol use; learning disabilities; Homeless people. Plan, deliver and evaluate training to professionals who work with these vulnerable groups on the importance of diet and nutrition. Deliver cooking skills courses to service users to increase skills, knowledge and confidence. Health/Information Objective 4 Workplace & Catering/Hospitality Promote and improve Healthy Eating within the workplace and catering/hospitality. Support the Healthy Eating element of the Working for Health Award. Work will come from Workplace specialist and NRF Men s Health programme who are engaging the individual workplaces. page 32 Develop four fruit on the front desk scheme in workplaces per year. Develop How To pack. Roll out the scheme to organisations and evaluate. Establish four fruit bowls per year.

Responsibility Outcomes Timescales Private Retailers. Volunteers. Increased availability of fruit and vegetables from small local retailers. 2007 ongoing. Measurement: Number of retailers on board stocking fresh produce and the sales of the produce. District of Easington. In depth understanding of availability within the local community. 2008-2009. Professionals working with vulnerable groups. Engagement of vulnerable groups to be able to develop life skills in relation to healthy eating. 2008-2010. Measurement: Number of professionals trained. Number of participants attending cooking courses and pre/post questionnaires. Workplace Cross Health Programmes Group. Consistent messages. Measurement: Number of workplaces working on Healthy Eating activities. 2008. Workplaces. NHS as a priority. Increasing availability of fresh fruit in workplaces. Measurement: Number of schemes established and success. 2007 ongoing. page 33

Objectives Actions Develop a Food in the workplace resource pack. Prevention Information Develop a focus group to develop a resource pack. Pilot the resource pack and evaluate. Plan, deliver and evaluate employer training on healthy eating and how to incorporate it into the ethos of the workplace. Plan, deliver and evaluate training to both employers and employees. Promote a whole workplace food policy. Encourage workplaces to be breast feeding friendly. Work with HR departments to include breast feeding friendly approaches to women returning to work after maternity leave. Deliver training to front line staff on the importance of breast feeding and encouraging a positive attitude. Offer practical cooking sessions to employees. Work with four workplaces per year. Either through extended school evening courses or directly within workplaces offer practical cooking sessions designed to meet the specific needs of the group: Cooking for men, cooking for one etc. Based on North West example of good practice promote and improve healthier catering and hospitality. Map existing catering and hospitality within the NHS and Council owned venues. Using existing North West resource develop policy and guidance document for County Durham. page 34

Responsibility Outcomes Timescales To provide information in an easily accessible format for both employers and employees. 2009-2010. Workplace Cross Health. Programmes Group. NHS as a priority. Corporate response to improving access to a healthier diet. Measurement: Number of employers attending the training and number of food policies written. 2008-2009. HR departments. NHS as a priority. An increase in women continuing to breast feed once they have returned to work. 2008-2009. Measurement: Percentage of women continuing to breast feed. Workplaces. To increase the skills, knowledge and confidence to be able to prepare balanced nutritious meals. 2007ongoing. Measurement: Attendance and pre/post questionnaires. Food and Health Action Group. To provide a corporate identity for healthier catering and hospitality. 2009-2010. Measurement: Development of resource and the implementation of the recommendations. page 35

Objectives Actions Develop a pre-retirement package healthy eating Prevention Information in older life. Map existing pre-retirement resources. Work in partnership with different topic teams to develop a healthy lifestyle package. Health/Information Objective 5 Older People To improve access and availability of healthier food to older people. Raise awareness of the risks of malnutrition in older people and how to overcome the issues. Co-ordinate focus groups to consider the issues. Plan, deliver and evaluate a conference for professionals working with older people. Deliver training to professionals working with older people on how to promote and provide a healthier diet. Based on needs assessment from conference design, implement and evaluate training. Develop an easy to read signposting directory on issues relating diet and nutrition for professionals working with older people. Following on from the workshops at the conference collate the information on services and develop a resource. Launch the resource and evaluate. page 36 Support the development and maintenance of luncheon clubs. Co-ordinate luncheon club network. Conduct needs assessment for additional luncheon clubs to be established.

Responsibility Outcomes Timescales Food & Health Action Group. Occupational Health Departments. Practice Nurses. To provide information to a population of people before they leave the workforce. Measurement: Development of the pack. 2009-2010. Delivery of training on how to use the pack and uptake from pre-retirement population. Age Concern. Warden Services. Dietetics. Practice Nurses. To have a fully informed professional workforce aware of the issues in relation to malnutrition and how to overcome the issues. 2007-2008. Dietetics. Age Concern. To provide a consistent message to older people about healthy eating. This will also be a stepping stone onto the Certificate in Nutrition Courses. 2007-2008. Measurement: Attendance at training. Food and Health Action Group. Older People Steering Group. All professionals working with older people are able to access information on healthy eating for the elderly and referral pathways for support. 2008-2010. Measurement: Use of the directory. Age Concern. Volunteers. Community Groups. Older people to have access to affordable healthy food in a social setting. Measurement: Attendance. 2007 ongoing. page 37

Objectives Actions Establish four fruit bowl scheme per year within Prevention Information older people s settings. Using the How To set up an honesty fruit bowl pack work with professionals and older people to set up the fruit bowl scheme. Establish four per year. Write a recipe resource for older people: Cooking for one on a budget. Collate recipes and pilot with older people. Confirm recipes and print resource. Evaluate. Deliver practical cooking courses within sheltered and warden controlled accommodation and older people s groups. Deliver and evaluate practical cooking course to older people. Deliver four per year. Provide cooking aid kits to participants. Deliver general awareness sessions to older people on the importance of eating a healthy diet. Deliver one hour sessions to informal groups of older people to increase the awareness and understanding of what constitutes a healthy diet. Deliver to six organisations /groups per year. Provide Cooking Aid kits to participants. Health/Information Objective 6 Workforce Development & Training page 38 To increase capacity to promote healthy eating through workforce development and training. Co-ordinate a Food and Health Conference to share good practice and learning. Plan, deliver and evaluate a conference and invite delegates from across the North East region.

Responsibility Outcomes Timescales Residential/sheltered accommodation. Older Person s Groups. Fresh fruit available to both staff and clients within the accommodation and/or groups. Measurement: Number of schemes established and uptake of fruit. 2007ongoing. Dietetics. Community. Practice Nurses. Age Concern. An easy to read recipe book with affordable and locally available ingredients. Measurement: Questionnaire feedback on resource. 2009-2010. Age Concern. Community Groups. Older people to develop the skills, knowledge and confidence to prepare nutritious affordable meals. 2007-2008. Measurement: Attendance and pre/post questionnaires. Age Concern. Community Groups. Older people to increase their awareness of the importance of eating a healthy diet. 2007-2008. Measurement: Attendance and follow up focus groups/ questionnaires on use of cooking aid equipment. Food and Health Action Group. Food and Health Operational Group. Sharing of good practice and learning. 2007. Measurement: Attendance and feedback from the day. page 39

Objectives Actions Develop an effective training programme to provide a Prevention Information consistent message across all 1. Roll out Royal Institute of Public Health (RIPH) Certificate in Nutrition agencies and communities with course and deliver three a remit in diet and nutrition. courses per year. 2. Deliver the OCN Healthy Eating Level three course. 3. Co-ordinate the delivery of the Foundation Stage Basic Food Hygiene course when required. 4. Research into delivering the RIPH Diploma in Nutrition course following evaluation of the certificate. Update and promote the website and new literature produced following Social Marketing approaches. Ensure regular updates are made to the Food and Health element of the health promotion website. Review all current literature and consider a new marketing strategy engaging with the local community. page 40

Responsibility Outcomes Timescales Dietetics. Beyond Learning. Community Groups. A robust training programme for all professionals and community groups with an interest/remit in diet and nutrition. 2007-2010. Measurement: Number of professionals completing qualification and how they are using it within their workplace. Food and Health Action Group. Communications Team. Community Groups. Relevant and up to date literature that is appropriate to the client group intended. 2007 ongoing. page 41

Appendix 3: References Department of Health. Choosing Health: Making Healthy Choices Easier. November 2004 Department of Health: Choosing a Better Diet: A Food and Health Action Plan. March 2005 Department of Health. Health Profiles. http://www.communityhealthprofiles.info Department of Health. National Service Framework for Children, Young People and Maternity Services. 2005 Department of Health. National Service Framework for Coronary Heart Disease. 2000 Department of Health. National Service Framework for Diabetes. 2001 Department of Health. National Service Framework for Older People. 2001 Department of Health. Tackling Health Inequalities: A programme for Action. 2003 Department of Health. The NHS Cancer Plan: A plan for investment, a plan for reform. 2000 Department of Health. National Standards, Local Action: Health and Social Care Standards 2006/6 2007/8, DH 2004 Department of Health. Our Health, Our Care, Our Say. January 2006 Department for Education and Skills. Every Child Matters: Next Steps. 2004 National Institute for Health and Clinical Excellence. Obesity Quick Reference Guide 1 for local authorities, schools and early years providers, workplaces and the public. December 2006 page 42 North East Public Health Observatory. Towards a Healthier North East: A profile of health and its determinants in the North East of England 2004 www.nepho.org.uk Wanless, D. (2004) Securing Good Health for the Whole Population, HMSO

0191 569 2816 www.health-promotion.cdd.nhs.uk Printed on 80% recycled fibre with the remaining 20% virgin pulp which is T.C.F (totally chlorine free). District of Easington 270307