Improving children's health together

Andrew Christie
Tuesday, July 9, 2013

A national partnership of organisations charged with improving children and young people's health and wellbeing launched last week. Andrew Christie, chair of the Association of Directors of Children's Services committee on health, care and additional needs, explains how it will go about it.

The Children and Young People's Health Outcomes Forum report, published in July 2012, set out a call to action for all of us about not losing sight of children's health during the implementation of reforms to the NHS and thereafter.

Earlier this year, 24 partner organisations signed a pledge - Better health outcomes for children and young people - to put children at the heart of the new system. Last week, many of those partners launched the National Children's Health and Wellbeing Partnership (CHWP) to take that commitment one step further.

The partnership is co-chaired by Jon Rouse, director general for social care at the Department for Health, and Mark Rogers, chief executive at Solihull Council, and chair of the Society of Local Authority Chief Executives' children's and education network. It will provide national leadership to address those issues that we know can only be tackled by working together, building on the leadership provided by local health and wellbeing boards.

Improving outcomes

This joint chairing highlights the commitment, by local and central government, to share both the responsibility and leadership for improving outcomes for children and young people.

We know we can do better by our children and young people and while there have been some notable improvements in recent years, the rate at which outcomes for children in the UK are improving is much slower than in comparable countries in some other parts of Europe. For example, we know that 75 per cent of hospital admissions of children with asthma could have been prevented with better primary care. More than a third of short stay admissions into hospital by infants with minor illnesses could have been managed in the community and there were "potentially avoidable factors" in 43 per cent of childhood deaths.

This provides us with a stark challenge to improve, and do so quickly. When children and young people were asked about their views on their healthcare priorities for the Health Outcomes Forum report, the messages that came through loudest were for their views to be listened to by services, and to receive treatment in a setting that was appropriate to their age and their condition.

Our challenge is to make all services work so that children receive the care they need when they need it, in a setting that is suitable for them, avoiding unnecessary admissions to hospital and managing illness so they can enjoy their lives as much as possible. All of this is part of a shared aim to prevent and reduce illness and avoidable death in children, which involves all agencies, communities and families themselves.

As the chair of the ADCS health, care and additional needs policy committee, I will be representing the association on the CHWP. Part of the role of the ADCS committee is to identify ways in which directors of children's services can ensure that health and wellbeing boards understand and address children's issues. There are some fantastic examples we have heard of partners working together, sharing knowledge and information to improve the experience of young people.

The Itchy, Sneezy, Wheezy integrated health and wellbeing project in north-west London is one example of a range of partners coming together to tackle childhood allergies, reducing pressures on all our children's services at the same time.

The ADCS committee regularly identifies examples of good practice locally, but some of these challenges need to be addressed nationally, and my role is to take these examples back to the national partnership to make sure that best practice locally can be shared and replicated on a national level.

The return of public health responsibilities and resources to local authorities provides us with an exciting opportunity to work holistically and on a population-level basis to improve our communities' health. At a national level, Public Health England is a key partner of the CHWP and one of our first priorities is to design the process for the safe transfer of public health commissioning for nought to five-year-olds from NHS England to local government in 2015. Commissioning of the Healthy Child Programme across local services, including health visitors, children's centres and early years settings, will provide a unique chance for local authorities to improve each child's start in life.

Right care for people

The new national partnership is acutely aware of the challenges and opportunities of integration. During the Spending Round, the government introduced a new single £3.8bn pooled budget for adult health and social care to ensure the right care for people when and where they need it.

A more integrated approach to commissioning of services holds just as much potential benefit for children as adults. So while we hope that pooled budgets become a reality for children in the future, the new national partnership is our way of providing strategic national leadership outside of a formal funding mechanism.

The ADCS looks forward to working with all the other partners on the CHWP to ensure that improved outcomes do become a reality. If we can work together on a national and local level to get this right, the improvement in the experience of care for children and their families could be huge, leading to better outcomes and more efficient service delivery in the future.

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