Building new health system action
to reduce obesity:
Audit findings of Integrated Care
Board Forward Plans

National targets and ambitions for reducing obesity and its impact in recent years have been missed. As set out in the 2007 Foresight report, obesity is a complex public policy challenge involving multiple variables and requiring a sustained multiagency response to succeed.^xvii ICBs – which bring together different organisations across the health and care system – could be new platforms for such multi-agency work at the regional and local level. The APPG on Obesity argues that ICBs have a particular role in setting out a long term vision for obesity services and helping ensure partners are working together to deliver this.^xviii

However the findings from this audit of ICB Forward Plans show that whilst some ICBs are committing to reduce obesity rates, and highlighting the links between obesity and other major conditions, ambitions for success are unclear and obesity is not listed as a strategic priority. Some ICBs do not include any references to obesity in their Forwards Plans and 60% include no obesity related data.

Where ICBs are focusing on obesity, efforts are primarily on reducing rates of childhood obesity and wider efforts at obesity prevention. Where plans include obesity services, most attention is on tier 2 and tier 3 weight management services rather than surgery or pharmacological interventions – both of which have proven cost-effective for a certain subset of people living with obesity.^xixxx

With just under two thirds of the population living with obesity and overweight today, growing health system and economic costs, rising health inequalities and new treatment innovations entering the market, the opportunity exists for ICBs to take a lead in reducing obesity rates in their areas. As still relatively new organisations with multiple competing priorities the question for ICBs is how should this best be done and what good practice exists that can be built from? In particular, how can ICBs co-ordinate and work with partners across the health and care system to reduce obesity rates? How can such work support wider ICB objectives such as reducing health inequalities and improving health outcomes for the most disadvantaged? And what does success in the future look like?

A one-size fits all approach across the country will not work, but what principles and models should be considered that can help deliver a system-wide approach, covering both obesity prevention and treatment and across both childhood and adulthood obesity? How should the existing tier system of obesity services evolve to deliver this? Can the Government’s planned Major Conditions Strategy aimed at reducing the impact of conditions such as cancer and cardiovascular disease help?^xxi

This audit has provided a snapshot of how ICBs are approaching obesity as part of their forward planning processes. Future Health looks forward to feedback on the findings and discussing with ICBs and others across the health and care system about how best to take forward an NHS agenda that can help reduce obesity rates in England.