I recently attended the Westminster Health Forum keynote seminar, Next steps for children and young people's health in England - inequalities, funding and the NHS Long Term Plan, 5th February 2019, where leading experts in the field of child health discussed key issues faced by services in the UK, and future plans for tailoring services to best suit the needs of children and young people. This post is about highlighting some of the issues raised and should be of concern to strategic health and economic planners and families across the UK.

Dr Jacqueline Cornish, National Clinical Director, Children, Young People and Transition to Adulthood at NHS England highlighted that children and young people's health is determined by more than healthcare.  Household income, housing conditions, and a stable and nurturing family life are all factors that significantly influence young people's health and life changes.  In the UK, 1.4 million children have long-term speech, language and communication needs, 2.5 million children are overweight or obese, 141 children per day are admitted to hospital for the removal of decayed teeth (often under general anaesthetic). Cancer is the most common form of death for children aged 1 to 15 years.  Infant mortality rates are also rising.  Dr Cornish noted that social inequalities play a role in almost all leading causes of infant death.

Professor David Taylor-Robinson, Professor of Public Health and Policy, University of Liverpool and Honorary Consultant in Public Heath, Alder Hey Children's Hospital, referred to research that shows that the rise in infant mortality is solely confined to the most deprived groups.  For those living in the most affluent areas, infant mortality continues to remain low.  Dr Ronny Cheung, Consultant Paediatrician, Evelina London Children's Hospital and Visiting Fellow, Nuffield Trust, cited Public Health England's Obesity Prevalence Graph, which shows that childhood obesity is also an issue around health care inequality. 

"Rising infant mortality is very rare in high income countries. It is something that we should be very concerned about.”

Professor David Taylor-Robinson, Professor of Public Health  and Policy, University of Liverpool and Honorary Consultant in Public Health, Alder Hey Children’s Hospital

In the most deprived areas, the rates of obesity are rising exponentially, with no change in more affluent areas.  The evidence demonstrates that health care and socioeconomic inequalities have a significant impact on life expectancy.

Dr Cheung stated that infant mortality is a barometer of health in the UK and called for a renewed focus on poverty and inequality to tackle child health.   A report by the Joseph Rowntree Foundation UK Poverty 2018 (December 2018) found that 4.1 million children are now living in poverty, a rise of 500,000 in the last five years.  The vast majority of this rise has taken place in working families.  Read the full report here: https://bit.ly/2UNNNiW

Dr Jacqueline Cornish gave details of NHS England's Work Programme on Child Mortality.  The NHS have commissioned a National Child Mortality Database from the University of Bristol, National Perinatal Epidemiology Unit (NPEU) and UCL Partners.  Their aim is to gather data for the purpose of reducing preventable child mortality and improving the experience of bereaved families and practitioners in the period following the death of a child.  Currently around 4,000 children die in England each year.  The project will gather socioeconomic and health factors, and will facilitate active learning through the capture of modifiable factors. 

What Matters to Us: Healthcare Priorities for Young People in the UK

Over the Summer of 2018, the Association of Young People's Health spent time working with the Royal College of Paediatrics and Child Health to engage with young people across the UK to identify their top priorities for health. 

#1 Create Youth Friendly Services

When accessing health services, young people want to talk to someone who believes in them, understands them, and who is trained on how to communicate with them.

#2 Improve Mental Health Support

Young people expressed a need for improved access, quick referrals, recognition of needs, and for all staff to be trained and aware of their needs. 

#3 Give Us Skills for Health

Young people want services that will show them how to stay healthy, support learning about buying and cooking healthy food, and that will show them how to do self-care well to help prevent problems happening. 

#4 Listen to Our Voice

Young people said that services should understand, listen and include their voice and their rights in their healthcare.  They want to be included in shaping the services and for adults to respect that young people's needs are different to when they were their age. 

#5 Improve Transition

Young people would like a lead worker who keeps in touch through transition to adulthood, and for staff to be adequately trained to support them through this transition. 

Jenny George, Director, Health, Value for Money Audit, National Audit Office, gave an overview of the findings of their 2018 report Improving children and young people's mental health services.  Currently, only 25% of children with a diagnosis of a mental health condition are accessing services.  Part of the government plan focusses on increased mental health support in schools, which they aim to have rolled out to 20 to 25% of the country by 2023.  However, a 2017 education survey found that 50% of schools had cut back on mental health support in the previous year.  Ms George highlighted that workforce is emerging as a major risk to meeting children's mental health needs. 

Download the full report here: https://bit.ly/2Nv6svD

Professor Russell Viner, President, President, Royal College of Paediatrics and Child Health, stated that they are hugely welcoming of the NHS Long Term Plan. 

"I think that we stand at the turning of the tide for children and young people’s health.”

Professor Russell Viner, President, Royal College of Paediatrics and Child Health

Previously, children were encompassed in all-ages programmes within the NHS for services.  Although children make up a quarter of the population, when included in all-ages programmes they are in the minority and they become invisible.  He believes that the current problems, "Have their roots in social and economic change, in how we live our lives and how we behave, changes in the structure of power and wealth in our society." Even with the current challenges, Professor Viner believes that the move to distinguish children and young people as a group in their own right in the NHS Long Term Plan is a positive step forward. 

Post Contributor:

Caitriona Fitzsimons Digital Reporter