Paediatric Diabetes Nicola Trevelyan Consultant Paediatrician Nov 2007.
Lambeth Specialist Healthy Weight Project Vanessa Impey- Paediatrician Deborah Thompson- Specialist...
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Transcript of Lambeth Specialist Healthy Weight Project Vanessa Impey- Paediatrician Deborah Thompson- Specialist...
Lambeth Specialist Healthy Weight Project
Vanessa Impey- Paediatrician
Deborah Thompson- Specialist Dietitian
Prevalence of obesity by Local AuthorityYear 6 children (age 10-11 years) resident in London, NCMP 2009/10
Low prevalence
High prevalence
Child obesity: BMI ≥ 95th centile of the UK90 growth reference
© NOO 2011
http://www.noo.org.uk/visualisation/eatlas
Childrens Weight:Lambeth Context
NCMP data - Levels of obesity (2010/11) Reception - 11.6% Year 6 - 24% Consistently above average for London and
England for both age groups.
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Lambeth Specialist Healthy Weight Project
Aims for a change in how we deliver a healthy weight service
A whole system or integrated approach Systemic Family Therapy principles and
practice Families as resourceful
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Principles and practice - examples
working with the whole family in mind
non judgmental
wider contextual and social factors - communities and cultures
reaching out - bridging hospital and clinic
multi disciplinary and multi agency - joined up working between health, family, activity and diet
team learning - what are our beliefs and experiences relating to health and diet?
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The process of our work
Working as part of the Lambeth Healthy Weight Care Pathway
Initial referral Two initial home visits / appointments Full assessment including health checks Plan and set up goals Weekly sessions until three month review 3 month review includes height/weight checks along
with some re-evaluations Appointment frequency to be assessed at this point Until 6 month review
Physical Activities - aims
Encourage and support families to make changes to current activity levels.
Identify local community sessions activity sessions for families.
Promote the long term benefits of regular physical activity.
Assess children's cardiovascular responses to exercise over project time frame.
Dietetic Therapy
Aim of dietetic therapy: To assess nutritional status To identify the main dietary causes of weight-
gain To provide nutritional education To support family with making dietary
changes
Paediatric input
Full health and medical check Screening out underlying causes Looking at the impact of obesity on the child Blood tests taken
Family Therapy input
The team works under a systemic umbrella. Connecting medical, physical, dietetic and
emotional/psychological/, mental health issues
Family patterns and underlying issues can be worked with
Experiences of health and health care professionals
Seeing weight issues as having a ‘logic’ within a family.
Case Examples include:
Working with the impact of:
parental mental health issues parental experiences of violence learning difficulties bereavement significant child mental health issues
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Success and challenges
appointment attendance improved engaging with families where other services don’t higher referral of children with special needs referrals to other services including adult community services referrals of families which appear to fall between gaps success in dietetics, physical health and parenting strategies all
identified in quarterly reports families referred for medical investigations as necessary which
wouldn’t have been picked up elsewhere identified children with vitamin deficiencies Changes in personnel
Making connnections :
Social services were contacted and asked to cascade down Links were made with consultants at St Thomas’s Increased links with paediatricians at the Mary Sheridan Centre Links were made with dieticians in Lambeth (Community) and
at St Thomas Links have been made with GP surgeries at Clapham Common
, Mawby Clinic Gracefield Gardens and meetings arranged to discuss the project in more detail
Team members are taking in project posters to schools when they visit
The team gave out fliers at Gracefield Gardens Anniversary day and made some links with other health professionals
Referrals to the service: how you can work with us
Identify families where children are aged between 4-12 with a BMI of over 98.
Where there are psychosocial issues or other complexities
Where families may have tried a Tier 2 service. If not, would that be helpful now : Ready Steady Go instead?
Families must agree to a referral
Any Questions