Implementation and Monitoring Working Party meeting 7 July 2003

Phil Morgan welcomed members to this first meeting and thanked them for volunteering to participate in the work of this important new Working Party. Members were asked to briefly introduce themselves to the rest of the group.

Phil Morgan outlined the background to the Nutrition Strategy for Wales ‘Food and Well Being’. This was developed by the Food Standards Agency (FSA) Wales in conjunction with the Welsh Assembly Government at the request of Jane Hutt, the Minister for Health and Social Services, in response to concern over levels of diet-related chronic disease in Wales.

A Steering Group was established to consider the status of diet and health in Wales and the barriers to healthy eating and how these might be overcome. A programme of action was produced following extensive consultation with stakeholders, which culminated in the launch of ‘Food and Well Being’ in February 2003.

One of the key recommendations for action in Food and Well Being was that FSA Wales set up a group to advise on the information requirements to facilitate evaluation of the strategy impact on diet and health, and to use this information to inform the future direction of the strategy.

This is in essence the remit of the Implementation and Monitoring Working group which seeks to address these issues through the diverse range of experience and expertise embodied in the group.

Given the strategy targets extend to 2010, it was anticipated the Working Party would continue for a similar period of time.

Given the focus on monitoring for evaluation purposes, the group considered the current situation regarding surveys of diet and health in Wales. The following were identified as potential sources of information:

• FSA UK and FSA Wales Consumer surveys
• The NDNS surveys
• The proposed Low Income Diet and Nutrition Survey (LIDNS)
• The Health Behaviour of School Children (HBSC)- an international survey in which Wales is partaking due to report in Autumn 2003
• The new ‘Welsh Health Survey’ currently being piloted
• Research projects
• Qualitative work undertaken by the Welsh Consumer Council on factors affecting food choices
• Data held by the private sector on purchasing habits

It was noted that whilst the British Retail Consortium had previously declined to nominate a member, a representative from this organisation would aid progress by the group on many issues including particularly this latter point. It was agreed a further approach would be made to BRC to come forward with a nominee.

Action: Secretariat

Phil Morgan introduced the draft Terms of Reference (appended here with numbered bullets) giving the rationale behind and significance of each. Members were invited to comment on whether they were deliverable and sufficiently comprehensive. The following points were discussed in relation to the ToR and it was agreed amendments should be incorporated in a further draft set of Terms of Reference which would be circulated to members for formal adoption at the next meeting:

• The reporting arrangements for the group should be clarified- this is primarily to the FSA Wales and Welsh Assembly Government but ultimately Ministers and those stakeholders responsible for taking the action plan forward.
• Reference should be made to the LHB Health, Social Care and Well Being Strategies given the parallels with ‘Food and Well Being’.
• Whilst a commitment to openness was consistent with the ideals of both the FSA Wales and Assembly Government, within the context of the current group, public meetings might actually impede information acquirement, although there was a case for open meetings where broader public interest indicated this. Proceedings of the group will be placed on the FSA website. It was also agreed that the group should produce an annual progress report which could form the basis of the proposed annual stakeholder seminars. Reference to this could be made in the Terms of Reference.
• Bullet 7 should include evaluation of the effectiveness of regulations in addition to activities and interventions.
• Bullet 8 could be extended to include ‘…. and draw on experience from other countries’.

It was decided that prioritising the milestones would be a useful way of defining the forward plan for the group.

6.1 Milestones

Milestone 1: This prompted much discussion over the range of existing leaflets providing information on healthy eating and their intended target audience. Whilst the milestone was primarily intended to reflect the availability of non-paper based resources, it was concluded that the group could usefully consider what information was currently available to enable identification where these could be improved and where there were gaps in provision. This milestone would therefore be considered as a priority and would be included as an agenda item for the next meeting.

Milestone 2: As yet there had been no headway on providing guidance on weight management, Teresa Owen had however undertaken scoping work as part of her MPH dissertation and would be formulating this into a formal report shortly which could form the basis of discussion at a later date.

Milestone 3: This concerned the establishment of a monitoring group and was essentially realised by convening this meeting.

Milestone 4: The Wales Centre for Health had been commissioned to review the current nutrition training and learning resources for health professionals and related professions, and to develop proposals for how these might be improved. A report is anticipated this autumn.

Milestone 5: The FSA Wales had piloted a ‘Get Cooking’ course with youth groups in the Rhondda area. This has subsequently been evaluated and the Welsh Food Advisory Committee will be asked at its next meeting to consider its suitability for rolling out across Wales. The evaluation report will be circulated to members for discussion at a later meeting.
Action: Secretariat

There are also eight community cooking projects being funded under the Assembly’s Community Food Initiative. The new Community Food and Fitness grant scheme shortly to be launched will require mechanisms to be put into place to make initiatives sustainable.

Milestone 6: The earlier discussion centring on current surveys of diet and health was pertinent here (see item 4 above). This milestone was considered to be a priority for Working Party attention. Additional collection of height/weight data by GP’s as part of routine consultations and by school nurses of all pupils was suggested although there were concerns over staff resources and confidentiality. Final year nutrition undergraduates might also be co-opted as data collectors.

Consideration of birth weight data as a means of tracking dietary status of mothers was discussed and whilst there was a need for caution in interpretation this could potentially provide useful information and demanded further consideration by the group.

As these data sources are fundamental to tracking progress against targets and milestones, it was recognised that it was essential to establish good baseline data. Phil Morgan asked members to quickly consider what reliable baseline sources existed against which progress could be measured and feed back suggestions to the secretariat.
Action: All members

It was agreed the secretariat would produce a paper summarising the currently existing surveys in Wales for discussion at the next meeting.
Action: Secretariat

Milestone 7: This milestone which concerns reporting of strategy evaluation results links in with milestone 6.

Milestone 8: There was nothing as yet to report on the initiation of a national award scheme for nutrition in the community.

Milestone 9: FSA Wales had commissioned work on the impact of new legislation on school meals and a report would be circulated to the group for discussion at a future meeting.
Action: Secretariat

6.2 Targets
The targets which include reference to knowledge of recommended portions of fruit and veg, their consumption, barriers to healthy eating and the balance of the diet will be tracked through the FSA Wales consumer surveys and the new Welsh Health Survey.

It was agreed that the Working Party should meet 2-3 times per year and that there was potential to split into sub-groups to cover specific areas. Sue Perkins advised that the WLGA had a recently appointed head of health who may be a more appropriate member of the group. She would make contact to identify whether they would be interested in joining the group.
Action: Sue Perkins

It was suggested that the dietetic representatives for North and South Wales alternate meetings attended, but members felt this was not conducive to continuity.

The Working Party membership was considered to cover the necessary range of interest and expertise, and where additional expertise was required, outside speakers could be invited to contribute. It was proposed that Professors John Williams and Rhys Williams from Swansea University could be invited to talk at the next Working Party meeting about research protocol and evaluation methods, and the requirements for good quality research output as this would be highly relevant to the remit of the group.
Action: Secretariat

Members asked that email addresses be circulated. Phil Morgan advised that any necessary travel and subsistence incurred in relation to members attending meetings of this group could be reimbursed. The secretariat would provide information on this.
Action: Secretariat

The next meeting was provisionally scheduled for Monday 6th October (venue TBA).