Tackling Obesity in England - National Audit Office

TACKLING OBESITY IN ENGLANDRegional Offices of the NHS Executive andhealth authorities1.8 The Department of Health also assumes overallresponsibility for ensuring that appropriate treatmentsare identified and made available through the NationalHealth Service. The eight Regional Offices of the NHSExecutive work with health authorities to ensure thateach region has a set of Health ImprovementProgrammes which address local needs and areconsistent with the national priorities of the NHS.Health authorities have a strategic role to co-ordinatethe local health economy to deliver on the NHSpriorities, including by providing the standards andservice models set out in National Service Frameworks.In compiling its Health Improvement Programme, eachhealth authority is required to involve a wide range oflocal stakeholders including Primary Care Groups andTrusts, NHS Trusts, general practices, local authorities,and local agencies and communities.NHS providers1.9 As detailed in the National Service Framework forcoronary heart disease 6 , NHS Trusts and Primary CareGroups and Trusts are required to contribute to thedelivery of local programmes of effective policies forreducing overweight and obesity.1.10 General practices are where 95 per cent of patientcontacts with the NHS occur 8 . General practitioners arerequired to offer all newly registered patients aconsultation with a full physical examinationcomprising the measurement of height and weight.Thereafter, general practitioners are required to offerphysical examinations for the purpose of identifying andreducing the risk of disease. The National ServiceFramework for coronary heart disease sets out aprogramme of action to improve services for coronaryheart disease. The first priority is to identify and treatpeople with established cardiovascular disease. A laterstage will be to identify people at significant risk ofcardiovascular disease and to offer appropriate adviceand treatment to reduce their risks. This includes adviceon reduction in weight or referral to appropriatespecialists. General practices also provide a forum tooffer broad advice to patients on healthy living, such ason healthy eating and the benefits of physical activity.1.11 The NHS more widely finances and monitors specialisthelp for obese patients referred by general practitioners,involving dietetics, hospital-based clinics and, in somecases, surgery. Hospital admissions also provide anopportunity to assess health risks associated with excessweight and to refer patients for appropriate help.Other Government departments1.12 The Public Health Group of the Department of Healthliaises with the representatives of other Governmentdepartments in order to advise on policies and initiativesto improve health, in particular in relation to dietand nutrition, health education, transport andphysical recreation.1.13 Relevant Government departments and agenciesinclude the Department for Culture, Media and Sport,Sport England and the Sports Councils; the Departmentfor Education and Employment; the Department of theEnvironment, Transport and the Regions and theHighways Agency; the Food Standards Agency; and theMinistry of Agriculture, Fisheries and Food. They have ageneral duty to work with the Department of Health aspart of joining up government within the overallumbrella of the Modernising Government initiative 9 .They also have specific objectives that relate toprotecting the public health and promoting healthylifestyles, for example through improving diet, achievingwider participation in sport and physical activity, andencouraging healthy modes of transport.part one9