Efforts to boost health professionals’ knowledge of nutrition and ensure they feel confident talking to patients about sensitive topics like weight are among steps designed to tackle the UK’s obesity crisis set out in the long-term plan for the NHS in England.
The plan outlines a series of measures designed to boost prevention work and reduce health inequalities, including previously announced schemes to boost support for problem drinkers, more support to help people stop smoking, and initiatives to target vulnerable groups at greatest risk of poor health.
“It is about making sure staff on the front line feel equipped to talk about nutrition”
NHS Long Term Plan
With nearly two thirds of adults in the UK classed as obese or overweight, the documents sets down various courses of action designed to tackle obesity, including enhanced training on nutrition and weight management for doctors and other frontline clinicians.
According to the NHS Long Term Plan, the amount of training health professionals receive on nutrition and weight management varies widely between medical schools and universities.
“Some courses have just eight hours, at most, over a five- or six-year degree,” said the document, which was launched on Monday by NHS England and the Department of Health and Social Care.
However, it stressed moves to increase the amount of training health professionals receive was not about them “becoming nutritionists or dieticians”.
“It is about making sure staff on the front line who are contact with thousands of patients a year feel equipped to talk to them about nutrition and achieving a healthy weight in an informed and sensitive way,” said the plan.
“They should feel able to refer patients appropriately in cases where nutrition support could help, if they are overweight and have type 2 diabetes or high blood pressure for example,” said the plan.
The government has said it will work with health professions and educators to adapt the content of training courses.
“Together with the professional bodies and universities, we will ensure nutrition has a greater place in professional education training,” said the new blueprint for the health service in England.
Under the plan, the NHS will continue efforts to ensure its own premises offer healthy food to both staff and patients. In 2016, NHS England introduced a financial incentive for hospitals to encourage them to limit the sale of items high in fat, salt and sugar.
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According to the plan, new standards for hospital food due to be published this year will strengthen requirements further and include substantial reductions in unhealthy food and drinks.
Other measures to tackle obesity set out in the plan include more targeted support for those most at risk of being overweight and associated health problems.
This includes offering people with type 2 diabetes, high blood pressure or a high body mass index access to weight management services via their GP.
In addition, the new plan commits the government to funding an expansion of the NHS Diabetes Prevention Programme, which will see it double in size over the next five years.
It will also test an NHS scheme to support people with type 2 diabetes to adopt very low calorie diets, which have been shown to reverse the condition.
As was trailed over the weekend ahead of the launch, the document also highlights future action on smoking in hospitals and problem drinking.
It pledges action on smoking, alcohol and air pollution, including ensuring NHS vehicles and heating systems are environmentally friendly with more “virtual appointments” to cut down on the need for staff and patients to travel.
By 2023-24, all people admitted to hospital who smoke will be offered NHS-funded help to quit, according to the plan.
New smoking cessation support will also be on offer as part of specialist mental health services and services for people with learning disabilities. This will include the option to switch to e-cigarettes for those in inpatient settings.
Meanwhile, expectant mothers and their partners will get focused stop-smoking sessions and treatment under a new “smoke-free pregnancy pathway”.
When plans to boost smoking cessation support were first announced, NHS England said areas with the highest levels of smoking during pregnancy would be prioritised with a goal of supporting 600,000 people to quit over the next five years.
The plan reveals the service’s approach to helping people quit smoking will be based on a successful model developed in Canada, which has helped improve the rate of people giving up smoking long-term by 11%.
The Ottawa Model for Smoking Cessation, which operates in 120 hospitals across Canada, sees healthcare professionals find out the smoking status of all patients admitted to hospital.
Smokers are then given advice, bedside counselling and nicotine replacement therapy or drugs to help them stop smoking, and are followed up after they are discharged. This model will now be adopted across the NHS, states the long-term plan.
It also confirms previously announced plans to establish specialist alcohol care teams in hospitals who treat the highest numbers of problem drinkers.
Hospitals in Bolton, Salford, Nottingham, Liverpool, London and Portsmouth have already seen a significant reduction in A&E attendances, ambulance call-outs and bed days after establishing such teams, which ensure on the spot care and counselling as well as working with community services to ensure the all-round needs of people with drinking problems are being met.
Over the next five years, hospitals with the highest rates of alcohol dependence-related admissions will be supported to set up alcohol care teams, stated the plan.
These will be backed by health inequalities funding from local clinical commissioning groups and developed with local authorities, which commission drug and alcohol services.
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Overall, the plan promises “stronger NHS action on health inequalities” in a bid to address the startling variations in health outcomes between the most affluent and people from deprived communities.
Measures to reduce the gap include boosting maternity support for the most vulnerable mothers and babies.
By 2024, three quarters of women from Black and ethnic minority communities – and a similar proportion from deprived communities – should benefit from continuity of care from their midwife, said the plan.
Other steps include increasing the number of people with severe mental illness who receive physical health checks, more work to ensure NHS services meet the needs of people with learning disabilities and autism, and better support for adult and young carers.
“We will ensure nutrition has a greater place in professional education training”
NHS Long Term Plan
Last summer, the government announced it was putting £30m into services to help homeless people sleeping rough, an investment flagged up in the plan, which highlights a lack of specialist services for this vulnerable group.
One example of a successful scheme highlighted in the plan is the Pathway Programme for homeless patients developed by University College London Hospitals NHS Foundation Trust.
This sees hospital-based GPs and dedicated nurses work with other professionals to deal with housing, financial and social issues leading to a reduction in A&E visits and time spent in hospital.
The scheme, which has since become a charity, has worked with other trusts to create hospital teams with 10 hospitals in London, Leeds, Bradford, Manchester and Brighton adopting the model.
The plan goes on to highlight the importance of the NHS working with local charities, social enterprises and community interest companies who are “often leading innovators in their field” and better able to reach some of the most vulnerable sections of society.
“Many provide a range of essential health, care and wellbeing services to groups that mainstream services struggle to reach,” said the plan.