Presentation at the Faculty of Public Health annual conference 2016

1. 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. 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 forAll Our Children

3. Why? The crucial first weeks and months

4. 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

5. Annual Report of the Chief Medical Officer 2012 (2013) Our children deserve better: Prevention pays5
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

6. 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

7. Presentation title - edit in Header and Footer
What? Importance of Healthy Pregnancy
Promoting adoption of
positive health behaviours
Reducing risk factors

8. Longer Lives
What? Breastfeeding
8 Getting it Right in Early Years

9. What? – Oral health
9 Getting it Right in Early Years

10. 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

11. How?AHealthy Start (healthprotectionandpromotion)
Longer Lives11 Getting it Right in Early Years

12. How?: Transformed child and family services
12 Getting it Right in Early Years

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

14. How?: Co-ordination, Communication,
Community Assets
Using asset based community
development approaches to build
sustainable change for families within
their communities.

15. 15
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

16. How?: Data and information
Florence
Nightingale
Social reformer,
nurse and
statistician,
.
16

17. Outcomes – Early years profiles
17
17 Getting it Right in Early Years

18. 1 2 3 4
Co-ordination and
leadership
Strong local
leadership
Early 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

19. 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

20. 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
20
DIMENSIONS
• Personal
• Social
• Emotional
• Physical
• Communication
• Language
• Maths
• Literacy
Protecting and improving the nation’s health20 Getting it Right in Early Years

21. Success will mean …..
Healthy pregnancy
21 Getting it Right in Early Years

22. “No child left behind”
Getting it Right in Early Years22 Getting it Right in Early Years