We must do more to improve our children’s health – this is the call for action from the Chief Medical Officer for England in her latest Annual Report.
In a hard-hitting analysis, Dame Sally Davies has set out the main challenges for all of us. The extensive report uses data and evidence to support the argument that ‘our children deserve better,’ a point best encapsulated by two key facts.
Firstly, if we compare England with the country with the lowest mortality for children and young people (Sweden), even after controlling for population size and other variables five extra children under the age of 14 die every day.
Secondly, variation in health and wellbeing outcomes between local areas highlights what good looks like and where we need to improve.
Of the 24 recommendations, 13 refer specifically to Public Health England (PHE), either as a system leader or supporting other organisations. PHE has welcomed the report and its recommendations, as we believe that it will provide fresh impetus to improve child health outcomes.
So, what is PHE doing to meet the challenge?
Nationally we have agreed that ‘giving every child and young person the best start in life’ is one of our top five corporate priorities. To oversee delivery, Professor Viv Bennett (Director of Nursing at PHE and DH) chairs a Corporate Programme Board to scrutinise and challenge our progress.
We are also working closely with the Department of Health and NHS England on a wide range of priorities - from improving the health offer for early years, to strengthening our understanding of the positive role schools and colleges can have in health outcomes, through to improving the health outcomes of adolescents and vulnerable groups of children. The CMO’s recognition of the importance of Health Visitors and School Nurses is something we will build on, playing a critical part in early intervention as well as at a population level.
The important work led by PHE’s Child and Maternal Health Intelligence Network continues to be instrumental in providing high quality knowledge and data to all of us working on child health. Their local area profiles, intelligence hubs for professionals and on-topics, are extensively used to inform local and national planning.
Central to our ambition across PHE is the drive to break the generational cycle of inequalities. This work engages with national initiatives, such as increasing the numbers of health visitors, giving greater clarity to the role of school health services, health’s offer in the Troubled Families programme, and the work across Government on youth policy.
Again, the importance of working in an integrated way, whether that is at national or local level, cannot be stated strongly enough if we are to scale up, and widen our reach, in improving health outcomes for children and young people. An example of this is our work to reduce childhood obesity is taking shape through a partnership with the Local Government Association. Using the model of peer reviews, we are developing a partnership approach that is owned locally. This will be underpinned by a series of briefings to inform commissioners of the latest evidence base.
As the public health systems settles down following reorganisation, our energies and expertise need to be marshalled and focused. We work most effectively when we work with others, using the evidence and expertise of our partners, and promoting what is working at a local level. This includes recognising the social determinants of health - looking at the impact of housing, employment, education, and safety to name just a few.
Welcoming this challenging report is just the start for public health – now we need to act with purpose and conviction so that when the CMO next reports on child health, we can look back and say that together we made a positive difference for children and young people.