The challenges ahead for improving outcomes for children and young people
Team wanted: “for survival of children, perilous journey, invariable scrutiny, much frustration, many years of constant work. Gratitude of families and society immeasurable in case of success.” It was (supposedly!) Shackleton’s advertisement for a crew that came to mind, when a pledge by 17 organisations was released in February relating to Children and Young People’s services in England, committing them to improving the health outcomes of our children and young people so that they become amongst the best in the world. The ambitions state that:
- Children, young people and their families will be at the heart of decision-making, with the health outcomes that matter most to them taking priority.
- Services, from pregnancy through to adolescence and beyond, will be high quality, evidence based and safe, delivered at the right time, in the right place, by a properly planned, educated and trained workforce.
- Good mental and physical health and early interventions, including for children and young people with long term conditions, will be of equal importance to caring for those who become acutely unwell.
- Services will be integrated and care will be coordinated around the individual, with an optimal experience of transition to adult services for those young people who require ongoing health and care in adult life.
- There will be clear leadership, accountability and assurance and organisations will work in partnership for the benefit of children and young people.
It feels as if we’ve been preparing for a journey to improve outcomes for children and young people for an incredibly long time. Ten years ago the National Service Framework for England stated ‘Children and young people deserve the best care because they are the life-blood of the nation and are vital for our future economic survival and prosperity’ but in 2012 the Children’s Outcomes Forum report for England stated: ‘it is becoming increasingly evident that health outcomes for children and young people in our country are poor. This is not what most people believe. The system and country appears to be both sentimental and complacent’. Yet ‘there is a deep wish within the system to try and get it right and improve many of the longstanding shortcomings for children and young people.’ 1,500 children might not die every year We have much to do, a confidential inquiry into child deaths found ‘identifiable failure in the child’s direct care’ in 26% of deaths, with potentially avoidable factors in a further 43%. (Pearson G 2008). Wolfe et al (2011) state that death rates from illnesses that rely heavily on first access services — for example, meningococcal disease, pneumonia, and asthma, are higher in the UK than in Sweden, France, Italy, Germany, and the Netherlands, most poignantly, ‘if the UK health system performed as well as that of Sweden, as many as 1500 children might not die each year’. My recent trip to Liberia with Save the Children, http://www.youtube.com/watch?v=WrrlNMdQV2c&feature=youtu.be as a health care ambassador highlighted that so much importance is given to reducing and preventing maternal death in Liberia, each, is reported to the President. Would reporting of every child death to the Prime Minster create the urgency required to address the limitations we currently face in child health care provision in the UK? Our challenges are clear, the national Child and Maternal Health Observatory (ChiMat) provides information and intelligence www.chimat.org.uk and the NHS Atlas of Variation in Healthcare for Children and Young People provides an overview of the variation in Healthcare in England for Children and Young People. We are data rich but as yet outcome poor. Good health and wellbeing It is not just professionals but also the public we need to mobilise for the journey ahead and this month sees the distribution of NHS primary school resources to over 19,000 primary schools in England promoting the importance of good health and well being, along with information about the range of NHS Services. If you haven’t seen Monkey’s travels across the NHS please do take a look: http://www.youtube.com/user/MonkeysMission?feature=watch There’s also a very catchy NHS song: http://www.youtube.com/watch?v=rmRud5-3t8A&list=PLystaNw37GX5of7_zuAmZUdUYTmC3ZbU&index=15 The development of these resources have been a true collaboration between parents, children and professionals, find out more at: http://www.ahhapublications.com/nhs-primary-resources-pack A national conversation A national conversation is starting to put child health centre stage and engaging children, young people, parents and carers in this discussion is essential, to listen to what children, young people and families want from Health Services. We recently did this across East of England, with the support of Anna Geyer of www.newpossibilities.co.uk A ‘shared purpose’ not just of professionals involved in Child Health, but of society as a whole is essential. We all have a part to play in enhancing outcomes for Child Health, children, young people, families and carers alongside professionals. Will you become a crew member and what part will you play as this journey unfolds? I have learnt so much… thank you On the 31.3.13 the NHS Institute for Innovation and Improvement closes I complete my post as Children and Young People’s Emergency and Urgent Care Lead with very mixed emotions. It has been a privilege it been to work with so many organisations, in the NHS, the third sector and Education on the Children and Young People’s programme nationally. I have learnt so much from so many, thank you all. From the 01.04.13 I’ll be taking up my new post as Head of Patient Experience for Children and Young People at the National Commissioning Board in England and look forward to being an enthusiastic and hard working crew member for the ongoing journey ahead in improving Child Health which I’ll continue to share on twitter @kathevans2 if you wish to follow me. Courtesy of Kath Evans @kathevans2 at Ayrshire Health Useful links Better health outcomes for children and young people (2013) Improving Children and Young People’s Health Outcomes: a system wide response (2013) Department of Health (2012) Report of the Children’s Outcomes Forum National Service Framework for Children, Young People and Maternity Services (2004) To find out more about Save the Children’s work please visit: www.savethechildren.org.uk