24 June - Non-executive directors - Population health: what about the children?

This week’s webinar opened in conversation with Anna Gill OBE, Vice-Chair Cambridgeshire Community Services NHS Trust, who said: “Sadly, we’re not anything like as good on children and adolescent health as we might think we are or hope we are. We’re shifting down the scale on being leaders in care. Children are 25% of the patients and users of NHS services but are we spending 25% of our time talking about them?

“We can’t really have this conversation without a quote from [Sir Michael] Marmot: ‘The foundations of virtually every aspect of human development – physical, intellectual and emotional – are laid in early childhood.’ We can’t be successful as ICS systems without thinking about the young people within those systems.

“Deprivation and poverty have some of the biggest impact on children’s health. In 2012, 26% of children’s deaths were identifiable as a failure of direct care and sadly very little has changed. Child mortality is an important marker of the overall health of a nation. With OECD data, 25 European countries are listed and only two of them have worse child mortality than we do: Poland and Latvia. So we’re not doing well.

“Children and young people are your future patients and your future service users. Our preventable admissions for diabetes and asthma are really poor. Our mortality for asthma is the worst in Europe. So we have a lot of issues to address and if we don’t do it now, we’re building up massive long-term problems across the system – and there’s a strong role for non-execs to be involved in this.

“Children waiting for speech and language therapy, for autism assessments… the long delay in getting your language and communication skills sorted impacts hugely: 60% of adults in the judicial system have speech and language and communication needs.”

“The vast majority of children are well but need access to things like vaccinations, and our vaccination figures are getting lower and lower. We’re even seeing scares in the news over things like polio.

“Health inequalities are the biggest drivers. Where you live, what you can access, are the biggest indicators of your health in later life. Early interventions and much more integrated services are very important. We mustn’t just sit around the table talking about acute waiting lists otherwise we’ll be talking about a whole lot of different problems in ten years’ time. This is our chance to change that. But early intervention isn’t a very exciting political conversation and it’s very hard to measure outcomes.

“As non-execs we need to be asking the difficult questions, we need to be challenging. The first thing to do in an ICS is to ask the question: what about the children?”

Also overheard during the call:

“The focus within local authorities has moved to older people because they are allowed to raise additional funds directly to fund this. The steer from government has been very clear and local government has responded appropriately.”

“Having been a member of council at two universities, it's clear that students are also really struggling - but they fall through all the cracks. They’re too old for CAMHS or for the uni to contact their parents, and often not registered with a GP while counselling services at university are often overwhelmed.”

“There is hope within ICSs, but it falls to us as chairs and non-execs to make sure these issues are exposed and that within ICPs we hold the ICS boards to account when it comes to children.”

“How can we use data and research better to clearly understand the impact on future adult social care, society etc? This impacts the child and future lives and also the financial impact in the future. At the end of the day all stakeholders are looking for the same (or very similar) outcomes. We need to align.”

These meetings are by invitation and are open to all NHS non-executives directors, chairs and associate non-executive directors of NHS providers. Others may attend by special invitation.

If you have any comments, questions or suggestions about these webinars, please contact: events@good-governance.org.uk