Submitted by Ben Nunn on 27-01-2012

Equity and excellence for children and young people

"Outcomes for children amongst the best of the world" that was the pledge of the Health Secretary yesterday at the launch of the Children's and Young People’s Forum which has been tasked with developing the first outcomes strategy for young people.

After a January which has seen his reforms face fresh criticism from the health community and the Conservative-led Health Select Committee, Mr Lansley used his speech at Liverpool's Alder Hey children's hospital to reiterate his commitment to reforming the NHS towards delivering a clinically-led health service based around the needs of patients of all ages.

With a social care system in “crisis” and the majority of people with long-term conditions being over the age of 65, many working to improve children’s health can sometimes feel like it is being overlooked and evidence shows that NHS services are consistently failing to meet the needs of young people. 

Child mortality rates are worse than the European average, teenage pregnancy rates in the UK are some of the highest in Europe, and one in three children still grow up in poverty.  What’s more, in 2010, the Department of Health’s review of young people’s services in the NHS found there to be considerable variation in the quality of services for younger people with pockets of good practice “in a sea of mediocrity, or worse”.  

So why are services failing?  Despite some improvements in recent years, there continues to be a lack of coordination between health services and other relevant agencies, for example children who are in care or have special educational needs.  In addition, national guidance and information on NHS services is usually written from an adult perspective, and, as the Health Secretary pointed out yesterday, people under the age of 16 do not have their experience of care monitored or recorded. 

It is against this backdrop that the health reforms present a unique opportunity to make a real difference to the health and wellbeing of young people. 

Nationally, the Department of Health has ensured that the NHS and public health outcomes frameworks have a strongerfocus onthe outcomes for children and young people, with the inclusion of an indicator relating to improving children and young people’s experience of healthcare.  Meanwhile health and wellbeing boards, by bringing together health and children’s services, provide the formal arrangements to help drive greater integration between services at a local level.

Over the next three months, members of the Children's and Young People’s Forum will be consulting on what should be included within the outcomes strategy, before reporting back to Government later in the year.  For any strategy to be effective, it is vital it is based not only on the needs of young people but looks beyond the NHS and towards the wider determinants of poor health – such as education and housing. 

Andrew Lansley’s speech yesterday should be welcomed and his ambition applauded.  The challenge now is devising an effective strategy for implementation during an uncertain commissioning environment and when money is tight.  This is the task awaiting the Children’s and Young People’s Forum and one which could be essential to deliver real Equity and excellence in health.