The King’s Fund calls for more health visitors

iHV welcomes today’s briefing from The King’s Fund which considers current state of health and care services for children and lists 10 actions that the government can take to improve children’s health.

The briefing was produced in response to growing concerns for children’s health and wellbeing which has declined in recent years, with children in the UK experiencing some of the worst health outcomes in Europe. Many lifelong health issues are established in childhood and, unless strong and meaningful action is taken to change course, the current generation of children is set to become an unhealthy generation of adults.

The King’s Fund makes it clear that improving children’s health will take comprehensive effort across all of society. The government has committed to raising ‘the healthiest generation of children in our history’, and this King’s Fund briefing focuses on a list of actions that the government should prioritise.

One of the actions for the Department of Health and Social Care is focused on addressing shortages in the child health workforce. Demand on the child health workforce has continued to increase at an unprecedented rate. Combined with shortages across the children’s workforce, ranging from midwifery and health visiting to consultant paediatricians, school nurses and allied health professionals, this means a record number of children are waiting to access health services. Children’s health services have witnessed underinvestment and reprioritisation at system and local levels, with a gap between research and innovation for adult health services and children’s health care. Children’s health services are also frequently out of the scope of government investment.

The King’s Fund is calling for a whole-government approach across all departments to support national prioritisation of children and young people’s health, including greater focus on prevention.

Today’s briefing outlines 10 actions that the government must take to turn the decline in children’s health around and help to create a healthier generation of children – including a recommendation supporting health visiting, urging the government to:

“Place a stronger focus on addressing the shortages in the child health workforce (including in school nurses, health visitors, midwives and consultant paediatricians), and improve staff retention across the medical, nursing and allied health professional specialist children’s workforce when reviewing the NHS Long Term Workforce Plan”.

The King’s Fund said:

“Children’s health has been heading in the wrong direction for too long; the need for change is urgent and requires a multifaceted, multi-system approach. The government has a pivotal role to play in ensuring that every child has a healthier childhood. Adopting the recommendations outlined in this briefing would go a long way to turning the tide and creating a healthier generation of children that is able to reach its full potential.”

Alison Morton, CEO at iHV, commented:

“Today, the highly respected King’s Fund has added their weight of support, calling for more health visitors in their briefing – and we are indebted to them for their advocacy and support for our profession. This comes hot on the heels of a call earlier in the week from the Centre for Mental Health calling for the government to train and employ more health visitors! And a long list of other high-profile organisations and think-tanks with the same message – we need more health visitors to improve child health!

“We hope that the government will heed the collective wisdom and advice of so many, and honour its manifesto commitment to strengthen health visiting and turn this into reality.”

Read the briefing and its 10 recommendations

iHV welcomes new RCPCH report to transform child health services in England

New policy report published today by the Royal College of Paediatrics and Child Health (RCPCH), “From left behind to leading the way”, offers a blueprint for transforming child health services in England.

“Children’s health services could lead the way as part of a transformed health service”.

This important RCPCH report emphasises the urgent need to prioritise children’s health services in the UK. The report shines a light on the chronic underinvestment in children’s health services, challenges faced by children, and the importance of equitable access to healthcare. The report advocates joint working between primary care and paediatric teams, and a Child Rights-Based Approach in planning and delivering health services. It stresses the significance of recognising children as a distinct group with specific health needs and calls for increased investment, workforce strategies, and national oversight to ensure sustainable child health services.

The key role of health visiting services is highlighted and, in particular, the services’ role in crucial areas related to child health and wellbeing. The impact of cuts to health visiting services on children’s health outcomes are reported, including recognition that “many families have been left without the early support that they need”. The report advocates the importance of health visitors in addressing the rising trend of 0-4-year-olds attending Emergency Departments and references our iHV report.

The RCPCH report considers health visiting as a crucial component of child health services, promoting the health and wellbeing of babies, children, young people and their families. It highlights the need to reinvest in health visitors and school nurses to provide earlier help for children and families and reduce reliance on specialist or urgent health services when not needed.

Vicky Gilroy, iHV Director of Innovation and Research, said:

“The iHV welcomes this comprehensive report from the RCPCH and the recognition of the importance of the role of health visitors as a central component of child health services. The need to reinvest in the crucial role of health visitors should not be underestimated. The impact of the reduction in health visiting services provision over the last decade has a direct impact on child health outcomes. There is an urgent need to prioritise child health and address the needs of babies and young children. Ultimately, we need more health visitors.”

To read the full report click here

Read the full RCPCH press release

iHV responds to NHS Provider’s ‘forgotten generation’ report

90% of trusts say children’s health and wellbeing not high enough national priority
Just 16% of trusts keeping up with demand for CYP services
Three-year waits for some autism and ADHD assessments
Cross-government plan and public health boost needed

A forgotten generation’s life chances are being harmed due to delays accessing care according to a new report “Forgotten Generation: Shaping better services for children and young people” from NHS Providers, published earlier this week.

The NHS is struggling to meet rapidly rising demand and increasingly complex and acute care needs among children and young people.

There is deep concern among leaders of NHS trusts about the long-term harm caused by delays in services for children and young people (CYP), including a widening health inequalities gap.

Now NHS Providers is calling for a cross-government plan to improve the wellbeing of children and young people including more investment in early intervention and preventing ill health.

Waits for a range of essential services including health visiting, speech and language therapy, hearing tests, neurodevelopmental services (such as autism and ADHD) and paediatric surgery add to the stress and anxiety of patients, families, carers and NHS staff.

One trust reported that waiting times for children’s autism assessments had increased from around 14 months pre-pandemic to 38 months now.

Findings include:

Nearly all (97%) trusts responding said demand for CYP services has increased since the Covid-19 pandemic.
86% said waiting times for initial assessments had increased compared to pre-pandemic
90% said that the health and wellbeing of children is not considered enough in national policy
82% said they cannot meet current demand and 75% would be unable to meet anticipated demand in next 12-18 months
86% were concerned about the impact on staff morale of challenges providing care

Alison Morton, iHV CEO, commented:

“This stark report from NHS Providers highlights, yet again, the importance of prioritising child health – we cannot afford to have a forgotten generation. The new government’s commitment to create the healthiest generation of children ever is welcomed and actions need to start immediately to turn this into reality. Currently, millions of babies, children and young people are being left without the support they need, with devastating impacts, both personally and across society. Families, healthcare providers and think tanks are all calling for better healthcare throughout childhood, as well as actions to address the wider determinants of health – this cannot be ignored any longer. Health visitors are an important part of the solution and are ready and willing to rise to the challenge and build a healthier future.”

Read Forgotten Generation: Shaping better services for children and young people report

Also read iHV 2024 General Election Manifesto

iHV responds to the Labour Party’s Child Health Action Plan

Following yesterday’s launch by the Labour Party of their “Health Mission” in Manchester, the party has published its Child Health Action Plan. Labour’s ambition is for this to be the healthiest generation of children ever.

Labour’s Child Health Action Plan to:

Cut waiting lists for children
End the crisis in child mental health
Transform NHS dentistry
Crackdown on smoking and vaping
Ban junk food advertising to children
Introduce breakfast clubs for all primary school children
Protect children from the growth of infectious diseases
This includes delivering on the NHS workforce plan, training more health visitors so parents and babies get the best possible support. Plus reforming the service to allow health visitors to administer routine immunisations to vulnerable and at-risk children, ensuring more are protected from infectious diseases.

Alison Morton, iHV CEO, responded to the Labour Party’s Child Health Action Plan:

“We are delighted to see that the Labour Party is pushing ahead with their plans to grow the health visitor workforce in their Child Health Action Plan. This will build capacity in the service to tackle a wide range of inequalities in child health, as well as supporting families to access healthcare – for example, to improve immunisation uptake for families who do not currently experience easy access to services (and consequently often experience the worst health outcomes), reduce pressures on A&E departments for minor illnesses, and improve oral health. These have always been part of the role of health visitors but have fallen by the wayside in many areas, as services have been reduced to “firefighting” and child protection due to serious workforce shortages.

“If we’re serious about improving the health of our nation’s children, it is imperative that health visitors get back to their core “health” function, working with families to prevent, identify and treat problems before they reach crisis point.”

At the iHV, we have been working with all political parties and government officials to ensure that the health of our nation’s babies and young children is taken seriously. We have shared our Vision for health visiting and call for more health visitors as an important part of the solution to tackling the current poor state of child health and widening inequalities. We will continue in our efforts to influence policies affecting health as all parties set out their manifesto plans for child health ahead of a general election expected this year.

Read Labour’s Child Health Action Plan

Child health in England falling behind other European countries

A new report, published today by The Royal College of Paediatrics and Child Health (RCPCH) ,warns that child health in England is lagging behind other European countries, with child mortality potentially 140% higher than other comparable nations by 2030 and reported mental health problems set to increase by 60%.

The ‘Child health in 2030 in England: comparisons with other wealthy countries’ report compares England with European and other western countries known as the EU15+. With the combination of England’s current poor standing for key outcomes in line with the averages in the EU15+, and our slower rates of improvement for key outcomes, the report finds that child health outcomes in England will not only compare very poorly to similar countries in 2030, but that we will be falling even further behind. The marked health inequalities between the most and least deprived children in most key outcomes are also set to widen over the next decade – presenting real challenges for health services in ensuring and improving access to those who need them most.

Dr Cheryll Adams CBE, Executive Director at the Institute of Health Visiting said:

“It feels very timely for the RCPCH to produce this report – ‘State of Child Health 2030’ to alert MPs and policy makers to the risks of not taking action now to strengthen all services for children. Health visitors are already very concerned by the impact of current issues for children such as increasing childhood poverty, mental illness and obesity set against a decommissioning of essential services such as health visiting and school nursing due to recent reductions in public health budgets.

“These challenges faced by children and families are not just worrying for their impact on the life course of those affected. We also now have good evidence that they will also be having significant impacts on the economy now and in the future. We recommend ministers heed the advice of Nobel prize winner James Heckman and invest into the very early years to reduce later fiscal expenditure. We believe that the benefits to the economy would quickly be felt by government.”

Amongst the report’s key findings are:

Mortality rates may be 140% higher for infants in England than in comparable wealthy nations by 2030
Reported mental health problems are set to increase by 60%, based on current trends
1 in 3 of the most deprived boys in England will be obese by 2030 without urgent implementation of the Childhood Obesity Plan and additional measures
A&E attendances for children may increase by 50% and outpatient attendances by 48%

In response, RCPCH is urging NHS England to develop and implement a Children and Young People’s Health Strategy as part of its long-term plan. They believe that a holistic CYP Health Strategy is essential to drive forward the ambitious actions, coordination and leadership needed to address the complex factors underpinning their findings. The long-term plan offers a critical opportunity to put children and young people at the heart of our health service, at every level, and the report demonstrates the risks of not taking action as soon as possible.

Download RCPCH State of Child Health short report: Child health in 2030 in England: comparisons with other wealthy countries

Download State of Child Health short report: Child health in 2030 in England - Recommendations

PHE: 2018 child health profiles

Annual update of data in the child health profiles interactive tool. Profiles providing an overview of child health and wellbeing for each local authority in England.

The profiles draw together information to present a picture of child health and wellbeing in each local area in a user-friendly format.

Those working in local government and health services can use the profiles as a tool to help:

understand the needs of their communities
improve the health and wellbeing of children and young people
reduce health inequalities

Go to PHE Child Health Profiles

Fragmented approach to child health damaging long term health of nation warns Royal College of Paediatrics and Child Health (RCPCH)

Child health is suffering at the hands of a disjointed approach from central Government is the warning from the Royal College of Paediatrics and Child Health (RCPCH) as it publishes its “State of Child Health: One year on” scorecard today.

The scorecards for England, Scotland and Wales describe progress against the series of recommendations made a year ago in the RCPCH’s landmark State of Child Health report.

The England scorecard reveals progress in some areas including the launch of a Digital Child Health Strategy, the publication of a new Tobacco Control Plan, the initiation of some specialist service reviews in paediatrics and the implementation of the sugar tax. However, there has been no improvement in several fundamental areas, including:

No plans for an overarching child health strategy
No junk food advertising ban
No way of measuring UK breastfeeding prevalence
No increased investment in child health research

The greatest areas for concern are the deepening public health cuts which have worsened in the last year and are disproportionately affecting children’s services. The scorecard marks this ‘black’, quoting latest statistics that show public health spending is over 5% lower in 2017/18 compared with 2013/14.

Professor Neena Modi, President of the RCPCH, said:

“The science exists for all to see; invest in the health of children and make a huge difference to their health in later life and hence to their economic productivity. For example, four-fifths of obese children will remain obese as adults and this will result in them losing between 10-20 years of healthy life. That’s a very frightening statistic and something that Government must get to grips with. It’s no wonder the NHS is burgeoning under the weight of ill health. This is time for a long vision for the sake of the nation’s wellbeing and prosperity yet the focus remains short-term and ineffective.”

Dr Cheryll Adams CBE Executive Director of the iHV said:

“Sadly the scorecard results are not a surprise, the Institute is repeatedly warning that cutting public health budgets is a false economy and will impact, not only on children now, but also on future generations and the fiscal spend. In particular the reduction in health visiting numbers we are seeing following such a very short lived, but exciting growth up until 2015, means that according to our own survey many children are not being seen by a health visitor at all after the 6-8 week contact. There is a research base clearly demonstrating why prevention matters and its very encouraging to see other countries responding to this by investing in child and family health. The Institute hopes that England’s ministers respond to the report by reinvesting into public health and particularly the early years and poverty reduction.”

The scorecards reveal that the Scottish and Welsh Governments are making greater strides in enacting policies to improve child health. For example, in Scotland there has been:

The passing of the Child Poverty (Scotland) Act with defined poverty reduction targets
A new Mental Health Strategy including a commitment to improve transition to adult services
An announcement of plans to expand the number of health visitors by an additional 500 by the end of 2018 through the full roll-out of the Family Nurse Partnership programme
A commitment from Scottish Government to ensure specialist breastfeeding advice and support is delivered to women

And in Wales:

The Public Health (Wales) Act has been enacted which includes extending bans on smoking in public places to school grounds, playgrounds and NHS grounds.
A new state of the art facility in Cardiff has opened to expand capacity for child health research

Professor Russell Viner, RCPCH Officer for Health Promotion, said:

“Child health isn’t being given the political attention it deserves in Westminster, which is disappointing given the real commitments from the Scottish and Welsh Governments. While policies such as the soft drinks industry levy and new tobacco control plan are to be applauded, the approach is piecemeal.

“Getting it right in childhood means setting up future generation for a lifetime of better health. Investing in children is an investment in the entire population.”

The RCPCH is calling for each national government to commit to a ‘child health in all policies’ approach, meaning that whenever legislation is passed, the impact on child health must be considered. The RCPCH also wants to see a cross-party committee established to develop a child health strategy.

Professor Modi added:

“We need parity of esteem between acute and preventive healthcare. It is no good only throwing money at treating established problems; there must be far better investment in prevention, which will reap immeasurable long term benefits. This means much bolder public health policies and a reversal of the current destructive cuts to preventive services.”

View the full report and summary here.

BMJ launches new open access paediatrics journal

British Medical Journal (BMJ) will be launching a new journal, BMJ Paediatrics Open, which will be dedicated to publishing original research, clinical reviews, and protocols that deal with every aspect of child health. It particularly welcomes research in the neglected diseases that disproportionately affect children in low and middle income countries.

BMJ Paediatrics Open is an open access journal and is an official journal of the Royal College of Paediatrics and Child Health (RCPCH). The provision of child health is multidisciplinary and international.

The journal welcomes papers from all health care professions from anywhere in the world. Papers dealing with paediatric specialties, paediatric surgery, public health, or healthcare provision will all be accepted.

Go to BMJ Paediatrics Open

iHV supports call for next UK Government to take urgent action on poverty

The iHV welcomes and supports the call from the Royal College of Paediatrics and Child Health (RCPCH) and Children Poverty Action Group (CPAG) on the next UK Government to take urgent action on poverty to ensure a healthier future for the UK’s infants, children and young people.

Poverty and low income is seriously affecting the health of UK children according to paediatricians – and any new Government must tackle health inequalities or risk storing up health problems for future generations. That’s according to a new report from the Royal College of Paediatrics and Child Health (RCPCH) and Child Poverty Action Group (CPAG) launched today.

The report “Poverty and child health: views from the frontline” is based on a survey of more than 250 paediatricians across the country, whose comments provide an insight into the grave reality of life for the millions of UK children living in poverty.

Latest figures show that 30% (4 million) children in the UK live in poverty – with projections suggesting this could rise to 5 million by the end of the decade.

Dr Cheryll Adams CBE, executive director, iHV, commented:

“The iHV welcomes and supports the call from the Royal College of Paediatrics and Child Health (RCPCH) and Children Poverty Action Group (CPAG) on the next UK Government to take urgent action on poverty to ensure a healthier future for the UK’s infants, children and young people.

We particularly welcome the call to reverse public health cuts to ensure universal early years services, including health visiting and school nursing, are prioritised and supported financially, with additional targeted help for children and families experiencing poverty. The recent reduction in health visitor numbers impacts the vital support that babies, young children and families need at such a critical time in their lives – we want to ensure that every child has the best start in life.”

The report looks at a number of areas including food insecurity, poor housing and worry, stress and stigma – and their effect on the health of children. It reveals that:

More than two-thirds of paediatricians surveyed said poverty and low income contribute ‘very much’ to the ill health of children they work with
Housing problems or homelessness were a concern for two thirds of respondents.
More than 60% said food insecurity contributed to the ill health amongst children they treat 3
40% had difficulty discharging a child in the last 6 months because of concerns about housing or food insecurity
More than 50% of respondents said that financial stress and worry contribute ‘very much’ to the ill health of children they work with

The RCPCH and CPAG are calling on whoever forms the next Government to tackle poverty urgently through:

The restoration of binding national targets to reduce child poverty, backed by a national child poverty strategy.
The adoption of a ‘child health in all policies’ approach to decision making and policy development, with Her Majesty’s Treasury disclosing information about the impact of the Chancellor’s annual budget statement on child poverty and inequality.
The reversal of public health cuts to ensure universal early years services, including health visiting and school nursing, are prioritised and supported financially, with additional targeted help for children and families experiencing poverty.
The reversal of cuts to universal credit which will leave the majority of families claiming this benefit worse off.

Download full report (PDF, 1.1 MB) or read summary here.

PHE: Child Health Profiles 2017

The 2017 Child Health Profiles, produced by Public Health England (PHE), were released on Tuesday 7 March 2017.

The profiles draw together information to present a picture of the health of children and young people in each local area in a user-friendly format. They provide a snapshot of child .health and wellbeing for each local authority in England using key health indicators which enable comparison locally, regionally and nationally. They are a valuable tool for local government and health services in helping them to understand the needs of their community, so that they can work to improve the health and wellbeing of children and young people and reduce health inequalities.

There is a four-page profile for each local authority in England which includes:

An ‘At a glance’ summary description of child health in the area which highlights key findings
Maps and charts showing how the health of the area compares to the national view and other local authorities in England
A ‘spine chart’ health summary showing the difference in health between the area and the England average for 32 indicators within the five domains of the Public Health Outcomes Framework.

Go to PHE 2017 Child Health Profiles