January 25 2002 - Jurys Hotel, Cardiff

Monday 25 March 2002

Minutes of the Nutrition Strategy Steering Group. Friday January 25 2002

Present:
Joy Whinney, Chair
Professor Pickard
Dr Jeremy Corson
Dr Paul Walker
Jo Clarkson
Teresa Owen
Su Mably

Secretariat:
Phil Morgan
Jayne Griffiths
Claire Paisley
Lorna Thompson
Viv Stein

Observers:
David Seal
Chris Tudor Smith
Susan Court

1. Chair's introduction

Joy Whinney thanked everyone for attending the 6th meeting of the steering group. Apologies were received from Hilary Neathey, Allan Davies, Keith Davies and Jane Ludlow. Nia Collier has now left the Agency, and Chris Llewellyn has left the Welsh Consumer Council. Jo Clarkson has replaced Ginny Blakey from the Assembly.

Joy welcomed David Seal from the Wales Centre for Health and Chris Tudor Smith from the Assembly who were invited to make presentations to the meeting, and Susan Court from the Centre for Health Leadership would be taking care of conference organisation for the Agency.

2. Wales Centre for Health – David Seal

David Seal gave a presentation outlining the establishment and remit of the Wales Centre for Health. It would be working in the following areas initially: information gathering, establishing effective partnerships, education and training, workforce capacity building, identifying and disseminating best practice, besides having an international role. A paper summarising this would be available.

Discussion centred on how the Centre could support the strategy and play a role in nutrition. These included: setting up a national network for nutrition to link health professionals and projects working in the area throughout Wales, introducing a national rewards scheme and recognition for achievement in nutrition, ensuring a presence at locality level, and setting up data collection and monitoring to link in with strategic targets.

Joy requested some input to the business plan that was being formulated.

Action: Joy Whinney

3. Better Health Better Wales health gain targets and the Assembly’s health surveys – Chris Tudor-Smith

Chris Tudor-Smith gave a presentation and tabled a progress report from the Expert Group on health gain targets.

A consultation is scheduled for February/March from which the Expert Group would make recommendations to the Minister.

This will include: background to, and work of the Expert Group on health gain targets; framework for development of these with indicators; and a series of questions to ascertain the views of NHS, local authorities and others. The Agency would have opportunity to comment.

David Seal suggested that the Agency should be represented on the Expert Group.

Action: Secretariat

The Assembly’s health surveys were also outlined. A bi-annual survey on health behaviour in 11-16 year old school children was next due to take place in February 2002. This included some new questions on food frequency, dieting, body image and hunger. The Wales Health survey on adults was last carried out in 1998, and a feasibility study was being carried out this year to develop new methodologies and questions to collect data for monitoring against the new health gain targets, the NHS reallocation review and other purposes. The next survey is scheduled for 2003. It will attempt to integrate both the Health Promotion Wales and the Chief Medical Officer’s Health surveys with a common core questionnaire, plus supplementary questions where data is required nationally.

Joy Whinney asked that the nutrition strategy targets be considered in revising this survey. Claire Paisley requested that we might comment on the nutrition questions. Professor Pickard made a case to request blood and urine testing of a sub-sample of the survey as a marker for nutritional status. This was particularly important for the elderly, who have poor nutrient absorption, and to determine folate status for pregnant women. Chris Tudor-Smith asked that these matters be referred to Chris Roberts.

Action: Secretariat

3. Minutes of 28th November

The minutes of the last meeting were agreed.

3.1 Matters arising

Professor Pickard again presented a matrix to map the nutrition needs of the population by age and descriptive groups, highlighting critical areas to be targeted in the strategy. It was suggested that the matrix be completed and included in the draft report for consultation. It would be circulated round the steering group initially for comment.

Action: Professor Pickard/Secretariat

Phil Morgan is due to meet a local PR company to discuss working with the media in promoting public health messages.

He also reported that a successful workshop on children and young people was held in December, attracting a high turn out, including those from the education sector; proceedings had since been circulated.

Su Mably was due to contact Su Perkins from LACOTS regarding the retail group meeting in March.

Jo Clarkson gave an update on the physical activity strategy, that the Healthy and Active Lifestyles Taskforce has been sent to Ministers in draft form.

This would be circulated around the Assembly especially to those involved in Transport and the Environment, and further work is ongoing on the strategy.

4. Forward Planning

4.1 Workshop on Middle aged men and women of childbearing age

Details of the next workshop on February 13th had been circulated previously. Jeremy Corson gave an overview of his talk. Will Roberts, a GP from Holyhead would liase with him regarding facilitating or providing a poster at the workshop.

Professor Pickard reported that Sarah Stanner from the BNF would be presenting Welsh data for her talk on middle aged men.

Joy Whinney asked for the workshop speeches to be forwarded to Jo Clarkson in advance, to include reference to the Assembly’s Breastfeeding strategy.

Action: Secretariat

David Seal mentioned that Better Health Better Wales II is being drafted by September, allowing time for any input.

Action: Secretariat

Lorna Thompson reported that 25 delegates had applied to attend so far, and that these were mostly from North Wales. Susan Court will be taking on organisational duties, including audio-visual arrangements. Delegates would be split into groups, as indicated on the reply form, to discuss issues for men and women. Professor Pickard, Jo Clarkson, Teresa Owen and Claire Paisley agreed to facilitate.

Lorna Thompson had prepared a background paper with questions for discussion as before.

4.2 Steering group meeting 12th March

Viv Stein outlined a list of list of delegates to be invited to a session dedicated to issues for the retail and food production sector planned for the next meeting. These included Nutritionists from the major retailers, representatives from the British Retail Consortium and other retail groups, some food producers, Joe Harvey from the Health Education Trust, and Charlie Powell from Sustain who works on food promotion and marketing, particularly for children. Suggestions of other organisations to invite included Association of Farmers’ Markets, Sodexho, the WDA Taste of Wales, Meat & Livestock Commission, Vending Machines Association and Local Authority Caterers.

The aim of the meeting would be to feedback issues from the strategy pertinent to industry, hear what initiatives they have in operation, and discuss how we might work together, e.g. use of premises for publicity, provision of retail sales data.

Claire Paisley reported that the Health Development Agency had done some work with retailers and has produced a report of this.

Action: Secretariat

The need to work locally with retailers as well as nationally was highlighted by Su Mably.

It was proposed that the Agency come up with some suggestions for collaborative working with retailers and put together a paper summarising the issues raised by the strategy to be sent in advance of the meeting. This might include partnerships with schools and providing healthier options for vending machines. The need for Government and the planning processes to work with retailers, for example, having food outlets in deprived areas providing fresh fruit and vegetables which would merit lower rates etc. Joy Whinney pointed out that some of these issues should be raised with the Assembly.

Viv Stein reported that issues of transport, access and portion size in relation to low income and healthy eating were raised at a recent conference on Obesity by the National Audit Office.
It was also noted that Tesco and Iceland have done some promotion and research on fruit and vegetables.

Teresa Owen suggested that we should also liase with the Society for Health Promotion Specialists.

It was proposed that Lynne Kennedy, one of the speakers at the Socially Disadvantaged Groups workshop would be presenting her experiences of work developing the North West Food and Health strategy, and the role of community nutrition assistants at the start of the day. Retail delegates could also attend this if they so wish.

4.3 Nutrition strategy report and consultation timetable

It was agreed that a final workshop would be held on April 17th in Cardiff as part of the consultation for the strategy draft report. Joy Whinney commented that the group has effectively been holding a consultation since October through the series of workshops. She also pointed out the need to agree the strategy with Ministers in order to submit funding bids by June.

Phil Morgan reminded everyone that we should give a clear list of priorities for the actions recommended, and that a number of different organisations would be involved in implementing these. It was also advisable to forewarn the Assembly of relevant funding proposals in March.
Jeremy Corson mentioned that Local Health Boards will be coming into being in April 2003, and that the strategy should take this into account.

It was agreed that an initial draft report of the strategy would be prepared for March 12th as a ‘green paper’. The Steering Group would have an opportunity to comment on this before it was redrafted for wider consultation and presentation at the 17th April conference. A final document would then be produced by June, incorporating comments from the consultation.

Viv Stein tabled a paper summarising recommendations from the workshops to date. This would be circulated by email for the group to prioritise the recommendations made.

Action: Secretariat

It was proposed that a speaker from Sweden, Northern Ireland or Scotland, who had been involved in implementing a nutrition strategy, would provide welcome inspiration for the April conference. It was envisaged that members of the steering group would otherwise make presentations on the strategy, and that plenary sessions would suffice rather that group work for this event.

It was suggested that Anne Hemmingway would chair the conference, and the matrix is used as a focus for presentations.

A flyer could be prepared to advertise the date, with programme details to follow.

Action: Jo Clarkson/Secretariat

In order to oversee the strategy implementation, it was proposed that a ‘Welsh Nutrition Forum’ would carry this out, with a wider Nutrition Network meeting annually. Phil Morgan reminded the group that the strategy would have long term targets, that a progress-monitoring group should be set up, and that this could be discussed at the closing conference.

4.4 Commissioning further research

Phil Morgan asked the group to consider the gaps in our knowledge in view of baseline data, so as to begin commissioning research.

Joy Whinney cited an audit of the situation in schools as regards access to milk, water, vending machines etc. Sue Bowker could help establish information already collected.

Jo Clarkson commented that the Welsh Health Survey and others contain only a small amount of information on nutrition, and that until recently food surveys haven’t taken account of food eaten outside the home - an increasingly large proportion of overall consumption, with higher fat, processed foods. She proposed that we first need to agree targets and indicators within the strategy, look at the gaps around these, and then examine research questions and effectiveness of interventions.

Professor Pickard highlighted the need for an epidemiologist or statistician to review existing data and identify the gaps; he would discuss this with Claire Paisley. Phil Morgan stated that we still need more Welsh data and larger sample sizes for information to be applicable for the priority groups.

Action: Secretariat

4. A.O.B.

Professor Pickard mentioned that the BNF had produced a guide to smart foods.

Jane Hutt had asked her colleagues to support the strategy and asked for ideas on this. One of the Cabinet members set an example of this by suggesting an initiative on healthy lifestyles.

Viv Stein 7/2/02