Improving the National Child Measurement Programme in Kent

The National Child Measurement Programme sees letters sent to parents, letting them know about the health of their child.

Kent Community Health NHS Foundation Trust spoke with parents to find out the best way of doing this.

Listen to project lead Lindsay Gilbert talk about the project.

Changes to looking after children’s weight make a big difference to families

Supporting healthy weight and growth during childhood is an important step to a healthy start and creating a healthy future – that’s why the Healthy Weight Team at Kent Community Health NHS Foundation Trust (KCHFT) has made changes to their approach.

The National Child Measurement Programme measures and weighs primary school children to identify any problems and offers parents support to tackle any underlying issues. It can be a challenging process for both parents and the school health team, as weight is a sensitive and complex issue to discuss, but it’s a vital tool to monitor children’s health and to provide the opportunity for families to have a conversation, as well as access to information and support which makes a real difference.

Lindsay Gilbert from the Healthy Weight Team said: “A healthy future is what we all want for our children, so it’s not easy to hear your child may need help with their weight, or may even be at risk of heart disease or diabetes as they get older.“

As part of the programme, parents are sent a letter with their child’s results but we know from feedback this can cause upset – and that’s really not what we want.

“We’ve been working hard with parents and staff to make changes to the letter and improving staff training on how we have those important conversations with families.

“We have also improved our service offer for parents and the changes we have put in place have made a real difference. One mum told us how life was so busy, it was difficult for her to find the time to make healthy food for the family. After a brief telephone conversation with a member of the school health team, she realised just a few small changes would make a huge difference.”

The project began as a quality improvement (QI) initiative last year (2021). Leading this work were members of our Healthy Weight Team, Lindsay Gilbert, Zoe Fish, Alison Watkins and Michele Ellis.

Their aim was to improve the parent experience of the programme, which is delivered by KCHFT's School Health Service and to increase uptake of the trust's Family Support Programme for Healthy Weight, which is offered if issues are identified.

They used QI methodology to approach the problem and QI tools, including a driver diagram, to set out how they planned to achieve their aim.

Working with parents, the team made changes to the letter to avoid using words such as overweight and obese. Instead parents were provided with their child’s height and weight in a neutral way and signposted to the NHS BMI calculator.

There was additional staff training, to help improve confidence around discussing weight with parents. Changes were made to improve communication by staff when speaking to parents on the phone and a three month follow up call was offered as an alternative. A sub group of practitioners received additional training around the use of the Family Health Wheel, to see whether this would add benefit to the calls.

Following the changes, all parents said they felt respected and listened to and had a positive view of the School Health Team.

One mum said “The phone call was really helpful. At first, I felt a bit defensive but this changed as the call went on. As a family, weight is an ongoing battle. Life is just so busy, food has to be quick and I’m not a very good cook and we don’t eat together much. I felt inspired after the call and it’s not that I needed to change everything, just a few small things.”

The increase in uptake of the Family Support Programme for Healthy Weight, mainly with reception year children, has gone from 18 pupils in 2019, to 76 in 2021. More than 200 families took up the offer of a three-month review phone call to check progress on their family health goals and for ongoing support. Also, colleagues said they felt more confident calling parents.

Lindsay said: “We are so pleased we did this work and would like to thank the parents who helped us. Talking about weight is a sensitive issue and we recognise this can be very difficult and upsetting for parents. We are delighted that changes we have made this year based on feedback from parents have reduced the number of complaints received by the service and increased the number of families who have taken up our School Health support offer for healthy weight.

“We recognise further work needs to be done, as there are still many parents declining our help. We are continuing to work with parents and schools, to better understand why this is. This year, 2022, we plan to set up a parent focus group and we are looking for parents who would like to get involved to help us to continue to improve the way we do things.”

The team has set up a parent focus group for anyone who would like to get involved in making further improvements to how we work with families. Anyone who is interested in getting involved can email the QI team at kentchft.qi@nhs.net