NICE public health guidance
Issued: November 2012
PH42

Obesity: working with local communities

This is an extract from the guidance. The complete guidance is available at guidance.nice.org.uk/ph42

Introduction: scope and purpose of this guidance

What is this guidance about?

This guidance aims to support effective, sustainable and community-wide action to prevent overweight and obesity in adults and overweight and obesity in children. It sets out how local communities, with support from local organisations and networks, can achieve this. The recommendations cover:

  • developing a sustainable, community-wide approach to obesity

  • strategic leadership

  • supporting leadership at all levels

  • coordinating local action

  • communication

  • involving the community

  • integrated commissioning

  • involving businesses and social enterprises operating in the local area

  • local authorities and the NHS as exemplars of good practice

  • planning systems for monitoring and evaluation

  • implementing monitoring and evaluation functions

  • cost effectiveness

  • organisational development and training

  • scrutiny and accountability.

This guidance focuses on the prevention of overweight and obesity. The recommendations may also help people who are already overweight or obese to lose weight, or to prevent them from gaining further weight. It does not cover clinical management for people who are already overweight or obese. (Also see related NICE guidance).

A 'sustainable, community-wide approach' to prevent obesity involves a set of integrated services and actions delivered by the many organisations, community services and networks that make up the 'local system'.

For the purpose of this guidance, 'local community' refers to a group of people from the same geographic location that is not necessarily related to any official, administrative boundary. The community may be located in a ward, borough, region or city. This guidance does not cover interventions in a particular setting (such as a school or workplace) that do not involve the wider community.

The guidance has a strong focus on local partnership working. For the purpose of this guidance, a partner could be a local department, service, organisation, network, community group or individual that could help prevent obesity.

Who is this guidance for?

This guidance is for local policy makers, commissioners, managers, practitioners and other professionals working in local authorities, the NHS and the wider public, private, voluntary and community sectors. It is particularly aimed at:

  • local authority chief executive officers

  • executive directors of local authority services (such as directors of children's or adult's services and directors of planning or leisure services)

  • directors of public health, members of health and wellbeing boards

  • elected members (particularly council leaders, including cabinet leads for health)

  • community champions.

The recommendations will also be of interest to academic organisations involved in designing and evaluating community-wide interventions to prevent and manage obesity, as well as members of the public.

Why is this guidance being produced?

In 2009, the Department of Health (DH) asked the National Institute for Health and Clinical Excellence (NICE) to produce guidance to tackle obesity at a local level using a 'whole-system approach'.

The work was put on hold in November 2010 and reviewed as part of the government's obesity strategy work programme. The scope was subsequently revised and the work progressed with a stronger focus on local, community-wide best practice, addressing both process and outcomes.

This guidance focuses on an overarching approach to obesity in local communities and the importance of integrating action on obesity in other local agendas (such as initiatives to prevent type 2 diabetes, cardiovascular disease and cancers, or initiatives to improve the environment and promote sustainability).

The guidance will support the Government's Call for Action on Obesity and the public health outcomes framework. It provides an organisational framework for existing NICE guidance (community-based or individual interventions) that directly or indirectly impacts on obesity prevention or management. (For more details see implementation and related NICE guidance respectively.)

The ongoing structural changes to the public sector, particularly local authorities and the NHS, have influenced the direction and tone of the recommendations. This guidance is intended to support organisations that have a role in obesity prevention in the wider public health agenda, including Public Health England, the National Commissioning Board, local authorities, local Healthwatch, local health and wellbeing boards and clinical commissioning groups.

How was this guidance developed?

The recommendations are based on the best available evidence. They were developed by the Programme Development Group (PDG).

Members of the PDG are listed in appendix A.

The guidance was developed using the NICE public health programme process. See appendix B for details.

Supporting documents used to prepare this information are listed in appendix E.

What evidence is the guidance based on?

The evidence that the PDG considered included: three reviews of the evidence, economic modelling, the testimony of expert witnesses and a commissioned report. Further detail on the evidence is given in the considerations section and appendices B and C.

In some cases, the evidence was insufficient and the PDG has made recommendations for future research.

More details of the evidence on which this guidance is based, and NICE's processes for developing public health guidance, are on the NICE website.

Status of this guidance

The guidance complements, but does not replace, NICE guidance on obesity (for further details, see related NICE guidance).