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State of Child Health: England – Two Years On

In 2017, our inaugural State of Child Health report brought together the first snapshot of children and young people’s health across the UK. Last year, we could see little progress towards our recommendations, however, we return in this scorecard to a much more positive picture for infants, children and young people in England.

We are delighted to see children and young people at the heart of the recently published Long Term Plan for the NHS. This promises to address many of our calls to prioritise care for our children and young people. In particular, the announcement of a new Children and Young People’s Transformation Programme provides a hitherto missing strategic focus for child health in England, necessary to deliver the Plan’s welcome commitment to providing children and young people up to the age of 25 with a seamless service delivered by an integrated health and care system. This is a powerful and welcome vision for the future.

2018 also saw a number of other major steps in the right direction. Mental health and obesity have rightly been prioritised. The publication of a national mental health survey for young in people in England will support planning of health care services for the one in eight children known to have a mental health problem. All children will now receive mental health education in schools as part of statutory health and wellbeing education from 2020. NHS England has invested in child mortality systems, progressed digital services for children and directed that money for child and adolescent mental health should reach the front line. The Government’s Childhood Obesity: a Plan for Action Chapter 2 announced its bold ambition to reduce childhood obesity by 50% by 2030 and focus on reducing inequalities, with consultations on a range of very welcome measures.

However, it’s not all good news. We remain disappointed and gravely concerned that the Government has made little progress towards reducing child poverty and inequality. UK infant mortality reductions have stalled after a century of improvement, and our recent projection modelling suggests a catastrophic picture by 2030 if this stall is not reversed. Child poverty is predicted to increase over the next decade and lies at the root of many risk factors for infant mortality and children and young people’s health. A recent visit by the UN Special Rapporteur on extreme poverty and human rights highlighted serious concerns about the disparate impact on children of changes to social support and the lack of regard given to the impact of budget decisions on child poverty and inequality.

As we write, we are entering a period of change and uncertainty. We call for more to be done to support our children and our future. The UK’s exit from the EU raises concerns about on-going access to important EU funding for child health and potential detrimental impact with respect to access to medicines and other forms of treatment. Investment into child health research must be prioritised to progress the science of paediatrics.

Universal early years services continue to bear the brunt of cuts to public health services, leaving many of our most vulnerable without access to critical children’s health services. Our Government must do more to tackle poverty and inequality and place a moratorium on further cuts whilst committing to comprehensive impact assessments. The announcement of a cross-government ministerial group on family support from conception to age two provides a platform for action, as does a promised Government green paper on prevention due in 2019, and we look forward to seeing these commitments being developed and implemented in the next 12 months and beyond.

We believe we are witnessing a hugely welcome shift towards prioritising children and young people in health and congratulate those responsible for their bold actions. The NHS Long Term Plan provides a crucial opportunity to provide children and young people with a twenty-first century health service and to focus our system on starting well and staying well. However implementation of the Plan will require significant investment and expansion in the child health workforce, and the promised Workforce Implementation Plan needs to be produced without delay. The voices of children and young people need to be centrally involved through the NHS Assembly and through the local and regional integrated care system. Urgent attention is needed on public health services for children, which offer the most powerful way to improve the health of our whole population.

We urge Government, NHS England and partner agencies to reflect carefully on our recommendations and seize this renewed opportunity to improve children and young people’s health and wellbeing.