Report of the Children and Young People's Health Outcomes Forum

In January 2012, the Secretary of State for Health launched the development of a Children and Young People’s Health Outcomes Strategy by establishing a Forum composed of individuals with a wide range of expertise and a shared commitment to improving health care for children and young people.

The Forum was asked to:

• identify the health outcomes that matter most for children and young people; consider how well these are supported by the NHS and Public Health Outcomes Frameworks, and
• make recommendations; and
• set out the contribution that each part of the new health system needs to make in order that these health outcomes are achieved.

This is the report of the Forum’s work. It is the result of a conversation with some two thousand people – children, young people and their families and those working in the wider health and social care system. Their messages are the building blocks of our recommendations.

This is a summary of the most important messages for the Secretary of State for Health:

Too many health outcomes for children and young people are poor, and for many this is involved with failures in care. Despite important improvements – for example, reductions in the number of young people smoking1 and of teenage pregnancies – and in some areas of specialist healthcare, more children and young people under 14 years of age are dying in this country than in other countries in northern and western Europe. There is enormous and unexplained variation in many aspects of children’s healthcare, and the UK is worse than other countries in Europe for many outcomes that could be improved through better healthcare and preventative interventions. This alone makes a compelling case for change. The work the Secretary of State asked the Forum to do can lead to the changes that are necessary. We have identified key areas where improvements are urgent.

Outcomes for children and young people will be improved if the wider health system pays more attention to inequality. Infant mortality, obesity, childhood accidents and teenage pregnancy all affect more children and young people from disadvantaged backgrounds. Children who have a disability, who are looked after or are in the criminal justice system face even poorer health outcomes. It is not just their health that is affected – it is their social and economic potential.
Children, young people and their families really struggle to get their voices heard and to be involved in decisions about their own health. This makes it difficult for them to take responsibility for their treatment and care. They know what needs to be done to improve the services they use. Their voices must be heard throughout the health system.

Many clinical staff have inadequate training in paediatrics and child health. Some have training only in adult healthcare, while others do not have sufficient training in physical and mental health to be able to undertake their work with children and young people safely and well. This is one of the most important reasons why children and young people’s health outcomes are poor in so many areas. Improving education and training would deliver real improvements in their health outcomes.
Those who work with children outside the healthcare system, such as teachers and youth workers, have an important contribution to make to improving health outcomes – but again their training in physical and mental health is too often minimal or non-existent.

The NHS and social care have been designed around the system, rather than the individual. To children, young people and their families, that system feels fragmented and often means they have to tell their story repeatedly, striving unsuccessfully to be heard and get the properly joined up care they need. Designing and planning health and healthcare round the needs of the individual child or young person, taking account of their changing needs over time, will improve their experience of the service and their health outcomes – not just at a point in time, but for the longer term – and improve their lives enormously.

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