The Best Start in Life for All Our Children and Young People

Viv Bennett Chief Nurse PHE

Faculty of Public Health and the Royal College of Nursing‘Public health in a cold climate: melting hearts and minds with evidence’

Brighton, 15th June 2016

2 *Annual Report of the Chief Medical Officer 2012

Our Children Deserve Better: Prevention Pays*

“…events that occur in early life (indeed in foetal life) affect health and wellbeing later…it makes sense to intervene early”“…the evidence still points to room for improvement. We need everyone in the public services to ‘think family and children and young people’ at every interaction”CMO 2012

The first years of life are a critical opportunity for building healthy, resilient and capable children, young people and adults

Best Start for All Our Children

Why? The crucial first weeks and months

4 Inequality in early cognitive development of children in the 1970 British Cohort Study, at ages 22 months to 10 years

Environment matters for short, medium and long term outcomes

Annual Report of the Chief Medical Officer 2012 (2013) Our children deserve better: Prevention pays

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Pregnancy Mothers are more likely to be in poor health, have more psychological problems in pregnancy, gain less weight, smoke more and their babies to weigh less and be born early, with increased risk of infant mortality.

Infancy Those in the lowest social economic group are nine times more at risk of sudden unexpected death in infancy. Death rates from injury and poisoning have fallen in all groups except this one and are now 13 times higher than those for more privileged children.

Children Poorer children are more likely to be admitted to hospital and to be smaller.

Mental health

There is evidence of more attention deficit hyperactivity disorder, bed wetting and deliberate self-harm

1. Annual Report of the Chief Medical Officer 2012 (2013) Our children deserve better: Prevention pays

Health inequalities in early and developing years

What? Best Start in Life

• Evidence for prevention and early Intervention

• National support for local leadership (PLACE)

• Parent/public information

• Reducing inequalities• Increase breastfeeding• Improve oral health• Support development of speech, language and communication• Reduce injury from accidents

• Immunisation

‘Healthy Maternity’

Ready to Learn at 2

Ready for School at 5

Reducing Childhood Obesity

6 Getting it Right in Early Years

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What? Importance of Healthy Pregnancy

Promoting adoption of positive health behaviours

Reducing risk factors

Longer Lives

What? Breastfeeding

8 Getting it Right in Early Years

What? – Oral health

9 Getting it Right in Early Years

Reducing inequalities: tooth decay in children

Tooth decay is the most common chronic disease in childhood even though it is largely preventable.

Tooth decay accounts for high numbers of child general anaesthetics and in areas it is the top cause for child non-emergency admissions.

The oral health of children has been identified by the Government as a priority area with a public health outcome measure around tooth decay in children aged 5 years.

This recognises the need for local areas to focus on and prioritise oral health and oral health improvement initiatives.

10 Getting it Right in Early Years

How? A Healthy Start (health protection and promotion)

Longer Lives 11 Getting it Right in Early Years

How?: Transformed child and family services

12 Getting it Right in Early Years

How?: Pathways HCP 0-5 (0-19) years

How?: Co-ordination, Communication, Community Assets

Using asset based community development approaches to build sustainable change for families within their communities.

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How?: Place-based commissioning for children young people and families

Source: A New Home for public health services for children aged 0-5: A Resource for Local Authorities. Local Government Association, Sept 2015 http://www.local.gov.uk/web/guest/publications/-/journal_content/56/10180/7507693/PUBLICATION

How?: Data and information

Florence Nightingale

Social reformer, nurse and statistician, .

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Outcomes – Early years profiles

17 17 Getting it Right in Early Years

1 2 3 4Co-ordination and leadershipStrong local leadershipEarly years and health services working together(Sustainability and Transformation plans)

Commissioning

Integrated whole systems commissioning

Communication

Community engagement: needs and preferences and of the local population to develop effective services

(Care) pathways

Vital to support sustained improvements in service delivery and quality

Korkodilos M, Earwicker, R, Perry M, Thorpe A Perspectives in Public Health 133(1):2013 Tackling Inequalities in Infant and Maternal Health Outcomes

Summary: success requires sustained integrated approach

Data from the Public Health Outcomes Framework that are relevant to the Early Years Low birth rate of babies Breastfeeding prevalence Smoking status at time of delivery Under 18 conceptions Excess weight at age 4-5 years Vaccination coverage Infant mortality Tooth decay in children age 5

Caring for populations across the lifecourse

Measuring success: PHOF

19 Getting it Right in Early Years

Measuring success: School readiness:

Increase in percentage of children achieving a good level of development at the end of reception (age 5 years)

• 64.0% in 14/15• Ranging from 50.7 % to 77.5%

47.8% for children eligible for free school meals

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DIMENSIONS• Personal• Social• Emotional• Physical• Communication• Language• Maths• Literacy

Protecting and improving the nation’s health 20 Getting it Right in Early Years

Success will mean …..

Healthy pregnancy

21 Getting it Right in Early Years

“No child left behind”

Getting it Right in Early Years 22 Getting it Right in Early Years