Inconsistency in how the needs of babies, children and young people are addressed in local health plans highlights the need for better national guidance and support.
- Less than half of local strategies mention integration with other key services such as education and social care.
- 61% of strategies do not consider the capacity of the children’s workforce. Almost a third (27%) of Joint Forward Plans do not set specific targets for addressing inequalities to improve health outcomes
Inconsistency in addressing the needs of babies, children and young people in local health plans highlights the need for stronger guidance from national government, finds a new report by the Children and Young People’s Health Policy Influencing Group (HPIG).
The report analysed strategies and plans produced by Integrated Care Systems (ICSs), and how well they reflected different aspects of children’s health. It sheds light on the first year of the new ICSs, introduced by the Health and Care Act 2022, and also acknowledges the good work being developed in the challenging context of increased demand and stretched budgets.
However, too few ICSs consider integration with other key services in children’s lives - such as education settings (only 32% of ICSs) and children’s social care (42%) – a critical component to improving children’s health outcomes.
While ICSs did generally identify priorities for children’s mental health, obesity, early development, special educational needs and disabilities (SEND), and inequalities, the rationale for these decisions was often not articulated. Furthermore, children with major and long-term conditions were absent in the majority (59%) of strategies and almost a third of JFPs (27%) did not set specific targets to address inequalities to improve health outcomes.
Clearly identified leadership and accountability for the health outcomes of babies, children and young people was also found to be lacking. Despite a requirement to identify named board members to lead work for children and young people’s services, safeguarding, and SEND, over half (57%) of Joint Forward Plans failed to do so.
Key elements of a clear implementation strategy were also often missing, with less than two-fifths (39%) of strategies addressing capacity in the children’s workforce, and over half (59%) of JFPs failing to address the challenges around data and information sharing about babies, children and young people.
To effectively meet children and young people’s needs, their voices must be central when planning and designing services, yet the report discovered that they were rarely consulted in strategic planning. Only 6% of strategies and 17% of JFPs stated how babies, children and young people had influenced their work.
Evidence shows that to improve population health, tackle health inequalities, and prevent poor health later in life, there must be a stronger focus on babies, children and young people. As political parties outline their plans to shift the health system towards prevention, this report provides useful insights on where greater action is needed to ensure ICSs plan effectively to address child health outcomes.
The report makes a number of recommendations for national government and ICSs, including:
- Supporting integration across ICSs, children’s social care and education by adding a focus on integration for children to the Better Care Fund and sharing examples of good practice across systems.
- Setting greater requirements for ICSs to outline who is responsible for delivering on commitments made around babies, children and young people’s health and how they can be contacted.
- Adopting an inclusive approach to involving children and young people in ICS strategic planning, and clearly setting out how their feedback has been actioned.
- Providing clear guidance to ICSs on addressing the needs of children with major and long-term conditions, as well as other minority and vulnerable groups.
Matthew Dodd and Amanda Allard, Co-Chairs of the Children and Young People’s Health Policy Influencing Group, said:
“Babies, children and young people are too often an afterthought in conversations about addressing inequalities and improving overall life expectancy and wellbeing. The Health and Care Act 2022 was a step in the right direction, helping focus the attention of Integrated Care Systems on babies, children and young people. But legislation is only part of the puzzle, and we must not become complacent about ensuring children’s needs are met in practice. We know that integrated and co-produced services across health, children’s social care and education can improve children’s outcomes and prevent costlier interventions further down the line and we look forward to continuing our work with national government and local systems to ensure this becomes a reality.”
The Health and Care Act 2022 requires Integrated Care Boards (ICBs) to set out the steps they will take to address the needs of children and young people under the age of 25 in their five-year Joint Forward Plans (JFPs). Integrated Care Partnerships (ICPs) are also required to develop an integrated care strategy.
HPIG monitored the publication of ICP strategies and ICB JFPs throughout the year and, as of September 2023, completed a review of those ICSs that had publicly published their strategies and JFPs. We analysed 31 strategies and 31 JFPs from the same ICSs, a reach of 74% of the total sector.
About the National Children’s Bureau
For 60 years, the National Children’s Bureau has worked to champion the rights of children and young people in the UK. We interrogate policy and uncover evidence to shape future legislation and develop more effective ways of supporting children and families. As a leading children’s charity, we take the voices of children to the heart of Government, bringing people and organisations together to drive change in society and deliver a better childhood for the UK. We are united for a better childhood.
For more information visit www.ncb.org.uk
About the Council for Disabled Children
The Council for Disabled Children is part of the National Children’s Bureau family. We are the umbrella body for the disabled children's sector with a membership of over 300 voluntary and community organisations and an active network of practitioners that spans education, health and social care.
About the Children and Young People’s Health Policy Influencing Group (HPIG)
The Children and Young People’s Health Policy Influencing Group (HPIG) is a strong, independent voice advocating for improvements to the health of babies, children and young people. As a group of influential charities and Royal Colleges, we look to ensure that the particular and unique health needs of babies, children and young people are a focus for the health system.