Guidance

Guidance: child and family weight management services grant

Updated 25 May 2021

This guidance was withdrawn on

Applications for grant funding closed on Friday 23 April 2021. See the child and family weight management services grant (No.31/5627) determination, including allocations.

Applies to England

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This publication is available at https://www.gov.uk/government/publications/child-and-family-weight-management-services-grant-apply-for-funding/guidance-child-and-family-weight-management-services-grant

1. Introduction

This guidance has been produced to help local authorities develop their applications for revenue funding from the child and family weight management services grant to expand support for children identified as overweight or living with obesity and their families and reduce the prevalence of obesity and persistent health inequalities.

Public Health England (PHE) is seeking applications from local authorities with a high prevalence of childhood obesity and deprivation. Successful applicants will be allocated funding to support their work over the period 2021 to 2022.

Funding will be allocated for the provision of an extended brief intervention and behavioural weight management service for children aged between 2 and 19 years old and their families. The extended brief intervention will require local authorities to test approaches for the proactive follow-up of children identified as being overweight or having obesity through the National Child Measurement Programme (NCMP), and offer motivational support, including onward referral to locally available behavioural weight management services for children and families. Behavioural weight management services for children and families should be based on current evidence and reach those at increased risk of obesity, such as children from Black or Asian ethnic groups and those living in areas of high deprivation[footnote 1]. An outline of these services and the evidence base associated with them can be found in Annex A.

Funding allocated to each local authority will need to be adjusted based on the:

  • number of local authorities applying to the programme
  • scale of ambition among those local authorities
  • prevalence of obesity (based on NCMP data) and deprivation among children (IDACI) in those local authorities

Applications for grant funding closed on Friday 23 April 2021.

Payments to successful applicants will be awarded to the local authority through a ringfenced section 31 grant, under the Local Government Act 2003. PHE will administer the grant to local authorities on DHSC’s behalf.

2. Amount available

PHE is expecting to fund approximately 5 to 10 local authorities that submit ambitious plans clearly demonstrating how they will identify and meet the needs of children who are overweight or living with obesity and their families.

Up to £4.4 million will be made available in 2021 to 2022 (single year funding) and will be distributed across successful applicants. Applications should show activity across this period and how this will be budgeted for. Local authorities should provide clear rationale for the funds requested and budgets should be proportional to the funding available nationally, local population size and need. Funding allocations will be considered against a guide cost of £15 per child for the extended brief intervention and £500 per child for behavioural weight management services, though it’s recognised that costs may vary dependant on the models proposed[footnote 2] [footnote 3].

Given the funding available and the estimated cost of services, it is expected that a local authority would contact approximately 80% of children identified via the NCMP as being overweight or having obesity through the extended brief intervention, and approximately 25% of primary school children living with obesity (or a similar proportion of a different age group) through a behavioural weight management service.

3. Background

When children begin primary school, 1 in 5 are already overweight or living with obesity, and by Year 6 when children leave primary school, that figure increases to 1 in 3. Moreover, obesity rates are highest for children from the most deprived areas, and this is getting worse[footnote 4].

Obesity in childhood can lead to health conditions such as bone and joint problems and type 2 diabetes, and can also be associated with low self-esteem, stigmatism and school absence[footnote 5] [footnote 6].  It also increases the risk of obesity in adulthood, which in turn is associated with a higher risk of developing life-threatening conditions such as some forms of cancer, type 2 diabetes, heart disease and liver disease[footnote 7].

The government’s Childhood obesity plan: a plan for action: chapter 2 has set a national ambition to halve childhood obesity and reduce the gap in obesity prevalence between children from the most and least deprived areas by 2030. In the recent obesity strategy, Tackling obesity: empowering adults and children to live healthier lives (2020), the government committed to expand weight management services so that more people get the support they need to lose weight.

Weight management services for children and families can help support a child to grow into a healthier weight as they grow older. By changing a child’s weight trajectory through weight management interventions, there is an opportunity to manage and prevent some of the health and psycho-social consequences of childhood obesity and reduce the risks and consequences associated with obesity tracking into adulthood. Further guidance on what makes up an evidence base extended brief intervention and weight management services for children and families is provided in Annex A.

4. Eligibility criteria

Applications are welcome from local authorities who are able to demonstrate robust and ambitious plans that can be anticipated to lead to:

  • increased access to support for children identified as being above a healthy weight, through both an extended brief intervention linked to the NCMP and behavioural weight management services for children and families

  • improvements in BMI z-scores for those children participating in behavioural weight management services

  •  increased uptake of behavioural weight management services among children and families participating in the extended brief intervention

Areas with a high prevalence of childhood obesity and deprivation are particularly encouraged to bid and all applications are encouraged to demonstrate how they work with local and wider NHS partners to encourage join up across the system, where appropriate.

5. Additional criteria

Bids will also need to be able to demonstrate that:

  • the application is signed up to by all involved organisations. The proposal contains evidence to show that it has been jointly agreed and endorsed, and that it is part of the strategic commissioning approach of the local partnership

  • they provide value for money. The proposal provides evidence that the project is value for money and outcomes can be measured using SMART (specific, measurable, achievable, realistic and timely)

  • they are committed to monitoring the effectiveness of services and dissemination of learning, including working with the national data and analysis leads to provide baseline data and a monthly minimum dataset outlined (see  Annex B for further details)

  • they are informed by service users. The proposal provides evidence that where appropriate it has been or will be shaped by users

6. Process and timetable

Applications for grant funding closed on Friday 23 April 2021.

Payments to successful applicants will be made directly to the local authority as a ringfenced section 31 grant, under the Local Government Act 2003 and the grant agreement will exist between PHE and the successful local authority only.

To indicate the commitment of the partnership to the bids being submitted signatures are required from:

  • the responsible commissioning officers

  • the local authority director of public health

  • local authority director of finance

  • local authority chief executive

Timetable for applications

PHE and DHSC launch the child and family weight management services grant application process: Monday 22 March 2021.

Local authorities submit grant applications to PHE: 11.59pm on Friday 23 April 2021.

National panel meets to select successful applicants: late April 2021.

Local authorities notified of outcome: early May 2021.

Local authorities return grant agreement terms and conditions together with requested payment documentation to PHE: May 2021.

PHE, working with a national panel, will prioritise the applications against a scoring scheme, attached as Annex C.

Recommendations of successful applicants selected by the national panel will be made to the Parliamentary Under-Secretary of State for Public Health and Primary Care for final approval.

Successful applicants will be sent a grant agreement outlining the final funding allocation and grant conditions and will be asked to return a statement of grant usage to the PHE grants team, along with requested payment documentation prior to funding being released to the local authority.

7. Monitoring

The grant will be awarded under section 31 of the Local Government Act 2003 and will be monitored in accordance with the Cabinet Office minimum standards, as summarised at Annex D.

All or part of the funding may be repayable to PHE in the event that grant conditions, contained in the grant agreement, are not met.

Annex A: outline of services and key guidance

Outline of services funded through the grant

Behavioural (tier 2) weight management services for children and their families

‘Behavioural (tier 2) weight management services for children and their families’ means family-based multi-component programmes addressing dietary intake, physical activity, and behaviour change for children who are overweight or living with obesity, with the primary aim of weight maintenance and growing into a healthier weight, rather than weight loss, depending on the age of the child, stage of growth and degree of obesity.

Extended brief intervention

‘Extended brief intervention’ means one or more sessions where a practitioner discusses a child’s weight/growth with their parent/carer, uses behaviour change techniques to support acceptance and action, and offers tailored support and onward referral to services. This would take place once a child has been identified as overweight or living with obesity.

Key guidance

The guidance and tools included in this annex provide information and support for local authorities to develop a project proposal to meet the criteria outlined to demonstrate; the identified need, proposed plans to increase and/or enhance services, the population reach and tailored needs for the population, including consideration of data collection and monitoring.

Extended brief intervention (EBI)

Funding is available for the provision of an EBI. This will require local authorities to pilot and test approaches for an EBI based on the existing evidence-base and guidance. For this grant period local authorities are expected to use the NCMP to proactively follow-up a proportion of children identified as overweight or living with obesity to deliver an EBI with the aim to offer support, including onward referral to locally available weight management services for children and families, and participate in national-level evaluation of approaches used.

Supporting clinical and practice guidance includes:

Behavioural weight management services for children and families

Evidence demonstrates that intensive behavioural weight management interventions aimed at children and families are effective at supporting child weight management. Funding is available to increase the provision and access to services and focus on how to engage high risk/higher need populations.

Supporting clinical and practice guidance includes:

  • NICE guidance (clinical and public health guidance for tier 2 child weight management). Obesity care-pathways overview

    • CG189 (2014, reviewed 2018). This guideline covers identifying, assessing and managing obesity in children (aged 2 years and over), young people and adults

    • PH47 (2013, reviewed in 2017). This guideline covers lifestyle weight management services for children and young people aged under 18 who are overweight or obese. It advises how to deliver effective weight management programmes that support children and young people to change their lifestyle and manage their weight

    • QS94 (2015) Obesity in children and young people: prevention and lifestyle weight management programmes. This quality standard covers preventing children and young people (under 18) from becoming overweight or obese, including strategies to increase physical activity and promote a healthy diet in the local population. It also covers lifestyle weight management programmes for children and young people who are overweight or obese. It describes high-quality care in priority areas for improvement.

  • PHE child weight management guidance. Translates NICE guidance for commissioners and providers (local authorities, service providers, clinical commissioning groups, NHS institutions, providers of weight management)

Annex B: key success factors and data collection requirements

Key success factors

Key success factors will be outlined in the grant agreement upon funding allocated and will include the following, measured over the funded period (2021 to 2022):

  1. CWM1: percentage of offers of extended brief intervention which are taken up

  2. CWM2: percentage of individuals who complete the extended brief intervention

  3. CWM3: percentage of individuals who are referred to weight management services from extended brief intervention

  4. CWM4: percentage of children who complete the active intervention (extended brief intervention and weight management service)

  5. CWM5: percentage of individuals enrolled in the service from high risk groups (extended brief intervention or weight management service)

  6. CWM6: percentage of children whose BMI centile is reduced from week zero, at completion of the active phase of intervention

  7. CWM7: percentage of children whose BMI centile is reduced from week zero, at 26 weeks

For each measure, inequalities will be presented (exact details of presentation will depend on the detail and number of children).

Data collection and monitoring

The reporting of a minimum dataset will be outlined as a condition of the grant and is outlined in Child behavioural (Tier 2) weight management services commissioned by local authorities: minimum dataset technical guidance for submitters and will inform the evaluation programmes against key success factors. Monthly and quarterly data reporting will be expected using the child weight management data collection spreadsheet.

Submission of baseline data will also be outlined as a condition of the grant. Baseline data requirements will include the following:

  • outline of commissioned weight management services, including delivery mode

  • value of commissioned services

  • reach of commissioned services, including initiation and completion rates

  • service provider(s)

In light of COVID-19, information may be required on services contracted in 2019 to 2020 and 2020 to 2021.

Annex C: scoring scheme

Applications that are deemed to be able to demonstrate value for money will then be judged against the following criteria.

Criteria Weighting
Identified level of need (considering population size, prevalence of obesity and deprivation) 25%
Plans to deliver an extended brief intervention and a weight management service for children and families 20%
Plans to reach high risk groups and seldom engaged groups 15%
Proposed reach of services 20%
Innovation 10%
Data collection and monitoring 5%
Collaborative working 5%

 Annex D: Grant Standards

The Grant Standards were implemented by the Cabinet Office in December 2016 and seek to promote effective grant applications across all government departments.

There are currently 10 standards:

  1. Standard 1: named responsible officer for each grant. All government grants require a named senior responsible officer with clearly defined responsibilities throughout the lifetime of a grant.

  2. Standard 2: grant approvals process. Departments will ensure they have a robust grants approval process to approve spend over £100k, and that details of all current grant schemes and awards are available on the Government Grants Information System (GGIS).

  3. Standard 3: new grants advice panel. New government grants, including those that are high risk, novel and contentious, as well as those undergoing a step change in scope or funding, should be considered for submission to the New Grants Advice Panel for scrutiny and advice from subject experts.

  4. Standard 4: business case. A robust business case, proportionate to the level of expenditure and risk, must be developed for all government grants. This will be scrutinised and approved in stages, as part of the grants approval process, and in line with the guidance in HM Treasury’s Managing Public Money.

  5. Standard 5: competition for grant funding. Government grants should be competed by default; exceptions may be approved where competition would not be appropriate. Detailed supporting evidence for any direct award decision must be provided in the approved business case.

  6. Standard 6: robust grant agreements. All government grants must be awarded through robust grant agreements, proportionate to the value of the grant and which reflect the minimum standards for government grants, in line with guidance in HM Treasury’s Managing Public Money. All government grant agreements will include terms of eligible expenditure.

  7. Standard 7: due diligence and fraud risk assessment. All government grants will be subject to timely and proportionate due diligence and fraud risk assessment.

  8. Standard 8: performance and monitoring. All government grants should have objectives agreed and longer-term outcomes defined, wherever possible, to enable active performance management, including regular reviews and adjustments where deemed necessary.

  9. Standard 9: annual reviews and reconciliation. All government grants will be reviewed annually at a minimum with a focus on financial reconciliation, taking into account delivery across the period, resulting in a decision to continue, discontinue or amend funding.

  10. Standard 10: training. All those involved in the development and administration of grants must undertake core training in grant management best practice.

  1. PHE (2019), Differences in child obesity by ethnic group. ↩

  2. Estimated costs for proactive follow up of parents of children identified as having obesity are based on research carried out by the London School of Hygiene and Tropical Medicine (LSHTM) as part of the PROMISE trial. ↩

  3. Based on economic modelling carried out by NICE (2013). ↩

  4. NHS Digital (2020). National Child Measurement Programme 2019/20. ↩

  5. Gatineau M, Dent M. (2011). Obesity and mental health. National Obesity Observatory: Oxford UK. ↩

  6. Abbasi A, Juszczyk, D, et al. (2017). Body mass index and incident type 1 and type 2 diabetes in children and young adults: a retrospective cohort study. Journal of the Endocrine Society, 1(5), 524 to 537. ↩

  7. Simmonds, M, Llewellyn et al. (2016). Predicting adult obesity from childhood obesity: a systematic review and meta analysis. Obesity reviews, 17(2), 95 to 107. ↩

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