Children and young people are our future. Making sure our children get the best start is an investment in both each person’s health and wellbeing and in our society. PHE has a real opportunity to make a difference by supporting a healthy start for all children and addressing the inequalities that disadvantage some from the very beginning of their lives. In all of our work at PHE we need to understand the impact on children and young people and seek to maximise the benefits for them.
The PHE priorities document makes clear the importance that we place on ‘getting it right for children’ and sets out our specific corporate priority for this year to:
‘support families to “give children and young people the best start in life, through working with health visiting and school nursing, family nurse partnerships and with strategic partners”
I am delighted to be the national director leading this priority area, working alongside Dr Ann Hoskins, PHE Director for children, young people and families.
The four work programmes in this priority area are to:
- accelerate improvements in child health outcomes
- promote healthy weight and tackle childhood obesity
- partner the Early Intervention Foundation
- partner the Troubled Families programme.
As recognised by Marmot, Kennedy and the Children and Young People’s Health Outcomes Forum, variation is a major concern. Across children and young people’s health outcomes variation often is about where they live and the socio-economic groups of their family.
Some examples of this variation which related to the PHE priorities work show:
- preventable infant mortality - best 2.2; average 4.4; worst 8 per 1000 live births
- smoking in pregnancy – England best 2.9%; average 13.2%; and worst 29.7%
- obese children in England aged 4-5 years - best 5.8%; average 9.5%; and worst 14.5%. Child obesity rates roughly double in the most deprived areas compared with the least deprived.
And we know some of the health challenges that face our young people. For example:
- 9.6% of children aged 5-16 years had a clinically recognisable mental disorder
- 11% of boys and 8% of girls reported current asthma symptoms
- data, compiled from the 2011 census, shows nearly a quarter of a million people aged 19 and under in England and Wales were caring for parents, siblings and others
- over 27% of 5 year olds have tooth decay
- 4% of boys and girls attending school described themselves as regular smokers.
So what can PHE do? We have evidence from neuroscience and life course studies about the importance of positive parenting in the first three years of life on life chances, of the impact of early years on adult health and thus the importance of prevention and early intervention. Public health has a critical role to play to promote the evidence base and influence commissioning and delivery. In PHE, we can make a difference in a number of ways:
- Use knowledge about risk and what builds resilience
- Promote evidence and learning from practice about what works
- Combine universal interventions with targeted help for those most at risk
- Take a life course and place-based approach –schools, families, and communities
- Work in partnership, taking a coordinated and collaborative approach, recognising strengths of different partners and using resources effectively
The priorities programme board will be making sure that we do this through both our specific action plan and supporting the work of PHE more broadly. We are commissioning a review of the evidence for the Healthy Child Programme to make sure our local services and the practitioners we support (for example health visitors and school nurses) have the best evidence for universal interventions and will be working with our partners in the Early Intervention Foundation and the Troubled Families Programme to develop effective targeted approaches. Most importantly we will continue to listen to the voices of children and young people and act on what they tell us.
Health visitors and school nurses are a really important part of the public health workforce in touch with many families and young people every day, providing services which make a difference to health and wellbeing. PHE is supporting these practitioners by working in strategic partnerships with the Department of Health, NHS England and Health Education England on national programmes to increase the number of health visitors and to support both professional groups to provide the most effective care. In the early years we have a focus on improving access experience and outcomes at key points, like transition to parenthood: pregnancy and the early weeks and at two years. For school aged children and young people we are doing work in supporting choices for good physical and mental health and working with those young people with specific needs like the recent work with young carers. A range of products to support this work can be found here.
We need to see sustained investment in services that improve and protect the health of our children and young people and to support commissioners. We are doing a range of work on measuring outcomes and on the economic case for prevention.
And finally, news of important events about good health in the school years. We are holding four regional events for Local Authority lead officers, elected members, public health teams, school nursing leaders, head teachers and commissioners of children’s services, called “Delivering excellence: maximising the health and wellbeing of school-aged children.”
These regional events give you the opportunity to:
- hear from policy leads, listen to latest updates and share new resources
- consider the opportunities and challenges in the new public health system
- be signposted to data and evidence to support commissioning and delivery
- listen to the views and experiences of children and young people.
Please share locally and join us and contribute and share your experiences and help to shape new developments.
For details on the events in your region and to book a place please go to:
- London PHE Event 30 Oct
- Leeds PHE Event 11 Nov
- Kettering PHE Event 12 Nov
- Bristol PHE Event 4 Dec
11 comments
Comment by Dr Cheryll Adams posted on
Excellent, keep up this good work - we will look forward to working with PHE in taking it forward. The iHV
Comment by @davidamunday posted on
Viv, you're absolutely right that we "need to see sustained investment in services that improve and protect the health of our children and young people". The HV plan has been a great opportunity to contribute to this. We still however need the same commitment for school nursing on top of the SN vision! It's been interesting meeting with HV plan 'boards' across the new NHS England and see all the prep their doing for the transfer to LA commissioning. They say 2 years is tight but school nursing was launched across without any of this prep work. We still need delivery on #121campaign!
Comment by Natalie Sumner posted on
I would love to see a school nurse implementation plan rolled out like the HV plan I have just qualified from-integrated services to protect all children can only be successful if there are enough professionals to work with.
Comment by Pippa posted on
This couldn't come at a better time for me, I am planning on presenting the unique worth and value of school nurses to the public health team on Monday... Thanks for the blog!
Comment by Ros Connolly posted on
School nursing does require parallel development and investment. LA commissioning and NHS cost improvement programmes re already starting to impact upon capacity and sustainability. We need to review the model of delivery so that school nurses as public health practitioners can target limited resources effectively underpinned by the principles of public health and proprtionate unniverslism,
Comment by Glenda Bestford posted on
Absolutely motivating reading 'behind the scenes' investments into developing school nursing services Early intervention is key however many families are missed School health play a vital role in helping CYP develop resilience in the face of adversity Food for thought in a new climate of integrated services Restores faith in the coal face workforce that Government are supporting us to achieve the 6 C's! Thank you!
Comment by John Rouse posted on
One way to give them the best start in life would be to educate them in the signs of skin cancer. This is affecting more and more young people, and is now one of the biggest killers of young people in their thirties. Yet "a healthy tan" is still seen that way by many youngsters.
Comment by Sharon White posted on
Excellent blog Viv and, as you know from our work together, whole heartedly support. All at the School and Public Health Nurses Association ( SAPHNA) look forward to continuing our partnership work on this essential agenda
Comment by Lynne Watson posted on
I would so agree that children and young people are our future but they are also our present too. I believe that each practitioner has the ability to transform not only the future for them but to make a difference to their present,l the 'here and now'. I strongly believe that children and young people want reality and action not just rhetoric and that means as practitioners we need to take up the mantle of the 6 C's and have the courage to challenge practice. We may only have the ability to effect a small change today but these will build together to create a more positive future for our children and young people. Creating resilient and respected children and young people is the key to ensuring lasting change as they become themselves the 'movers and shapers' of the future.
Comment by Sue Jones posted on
Thanks Viv, used your blog to help me prepare a presentation to Bristol's Health visitors. Resiliance and sustainbility and maximising opportunities, lifting the workforce out of years of making do.
Comment by Viv Bennett posted on
Thank you all for your comments and I am very pleased that you found the context/information for PHE work on children and young people useful. Your helpful and positive comments reflect the discussion we are having about ‘personalised care AND population health’ - not different things but both key to improving and protecting the health and wellbeing of our children and young people. The ‘developing years’ featured strongly in your comments. This is a really important area and featured in the CMO Annual report. We are continuing to develop our programme on the potential for school nurses as providers , coordinators and leaders of Healthy Child Programme 5-19. We would really welcome your ideas for future blogs on children’s and young people’s health.