Children's Services

Hampshire's Children and Young People's Plan

Priority 2: Securing children and young people’s physical, spiritual, social, emotional and mental health, promoting healthy lifestyles and reducing inequalities

Key win

Reducing the rate of teenage conceptions among girls aged 15-17.

Health inequalities experienced in childhood can have a lasting impact throughout life, so we will work together to promote and support healthy lifestyles from an early stage. Giving children the best start in life begins with promoting health and well-being in pregnancy and childhood, and ensuring that universal healthcare services are available for all children and families. National Health Service and public health professionals will work in partnership with children’s centres and schools to identify those who need extra support, or treatment, and help them to access services. We will strive to integrate services and plan care jointly wherever possible, for example for disabled children and their families.

Proposed national reforms to health and social care will change the way public health services are delivered. In part, this means that the Children’s Trust will work closely with the emerging Health and Well-being Board and Clinical Commissioning Groups to champion the needs of children, young people and families. This includes ensuring that the priorities of this Plan and the new Joint Health and Well-being Strategy are aligned, with partners working together to secure consistent access to high-quality health services across the county.

Key activity areas:

  • ensuring that the best universal services are available for all children and families
  • supporting parents/carers through universal, high-quality maternity care from early pregnancy, with targeted interventions for vulnerable women and families
  • offering preventative care through the Healthy Child Programme (0–19 years), including: health visitors, school nurses, promoting breastfeeding, and immunisations for children
  • providing a range of targeted services in the community to meet local need and reduce health inequalities, eg: through children’s centres
  • providing information, advice and support to enable parents/carers, children and young people to make healthy choices, eg: healthy eating, being smoke free and increasing physical activity
  • implementing the Hampshire Healthy Weight Strategy for children and families
  • developing and implementing a children and young people’s care pathway for substance misuse
  • ensuring that the newly commissioned integrated sexual health services are easily accessible
  • reducing teenage conceptions and delivering a targeted approach to improving outcomes for the most vulnerable first-time teenage mothers
  • improving access to specialist advice for universal services, in order to improve support for children and young people’s emotional health and well-being
  • building resilience and personal confidence for children and young people, promoting rights, respect and responsibilities
  • supporting schools to develop spiritual, social and cultural work in line with the new Ofsted framework.

How this has improved since 2009:

Reduced levels of obesity

Progress in tackling childhood obesity has been good, with steady reductions in the percentage of school pupils found to be obese in the national measurement programme. The proportion of Reception Year pupils who are obese has fallen from 8.4% in 2009/10 to 7% in 2010/11, whilst the percentage of Year 6 pupils recorded as obese has fallen from 16.1% in 2009/10 to 15.6% in 2010/11. Implementation of the Healthy Weight Strategy includes providing routine feedback to parents/carers on their child’s weight, healthy weight co-ordinators educating parents/carers and children in areas with the highest rates of obesity, implementing the national Change4Life programme at a local level, and the development of resources such as Be Inspired 4 Life for schools.

Sexual health

Poor sexual health is a major source of health inequality. Chlamydia is the most common sexually transmitted infection in the country. The numbers of 15–24 year olds screened in Hampshire has increased, while the percentage with a positive diagnosis has reduced. Our sexual health strategy has ensured that appointments for Genitourinary Medicine clinics are offered within 48 hours of contacting the service, access to long-acting reversible contraception (LARC) is good, and over 120 community pharmacies provide free emergency hormonal contraception (EHC). Hampshire’s dedicated sexual health website Get it on, lists all sexual health services and won an NHS South Central Innovation Award.

Health of children in care

Health providers give priority to children in care, with good access to appropriate health services following assessment by specialist nurses. A strong strategic lead is provided by the Children in Care Health Strategy Group (jointly chaired by the Designated Nurse for children in care). There is a good inter-agency education programme covering sexual health, smoking, drugs and relationship issues. The percentage of children in care who had their annual health assessment has increased from 78.0% in 2008/09 to 84.6% in 2010/11. The proportion of children in care whose immunisations were up to date was 74.1% and 82.8% in 2011/12, the fifth year of continuous improvement and significantly higher than 2006/07 (33%).

Mental health services

Child and Adolescent Mental Health Services (CAMHS) have recently been improved, with Tier 2 and 3 services (some of the more specialist services) being provided by Sussex Partnership NHS Trust since April 2011. These new arrangements have been put in place to ensure that there is timely and equal access to services across the county.

Supporting the emotional health and well-being of BME and Traveller new arrivals in schools

The Hampshire Young Interpreter Scheme now runs in 30 Hampshire schools, with over 200 young interpreters aged between five and 16, speaking 25 different languages. The scheme delivers support and intervention for new arrivals in a wide range of languages, or through child-friendly English.

Parenting support

Parenting support programmes based on strong evidence of what works, such as Triple P (Positive Parenting Programme) have helped parents/carers create a stable family environment, teach their children skills to get along with others, deal positively and consistently with problem behaviour, and encourage positive behaviour. In 2010/11, 952 parents/carers participated in Level 4 Triple P, with 95% saying that they thought the programme had helped them to deal somewhat more effectively, or had helped a great deal, with their child’s behaviour. In addition, 91% thought their child’s behaviour had slightly improved, improved or greatly improved.

Parenting specialists provide targeted support and interventions for parents and carers where: parent/carer substance misuse or mental health impacts on parenting ability, there is a risk of the child being taken into local authority care, or there is a risk of the child committing a crime.

Healthy Schools programme

The vast majority of Hampshire schools are now Healthy Schools – developing initiatives such as school councils, better accessibility to drinking water, healthier tuck shops, and establishing buddy and peer mentoring schemes. We will continue to promote health and well-being through Healthy Schools and our new Healthy Early Years Programme.

Why this is still a priority:

Teenage conceptions

The rate of conceptions among 15-17 year old girls in Hampshire decreased from 34.0 per 1,000 in 2008 to 25.2 per 1,000 in 2010. The rate varies significantly across the county, from 47.1 per 1,000 in Gosport, to 17.1 per 1,000 in Hart. Since 1998/2000, the largest reductions have been seen in Fareham and Rushmoor, whilst in Eastleigh and East Hampshire the rate has increased.

Immunisations

The percentage of children receiving recommended vaccinations by ages one, two and five has increased in Hampshire over recent years, as shown in table 1 and 2. However, coverage for most of these vaccinations remains below the levels advised by the World Health Organisation, particularly the measles, mumps and rubella vaccine.

Table 1

Age one %

Age two %

Age five %

DTaP/IPV/Hib

PCV

Hib/MenC

MMR 1

DTaP/IPV

MMR 2

Quarter 3,
2011/12

95.27

91.09

91.83

91.69

89.80

87.62

2010/11

95.80

90.65

93.78

91.07

89.96

86.49

2009/10

95.62

90.94

93.83

91.51

89.25

85.75

Abbreviations:
(DTaP/IPV/Hib): Diphtheria, Tetanus, Polio, Pertussis, Haemophilus influenza type b
(DTaP/IPV): Diphtheria, Tetanus, Polio, Pertussis
(PCV): Pneumococcal infection
(MMR): Mumps, Measles, Rubella
(Td/IPV): Tetanus, low dose Diphtheria, Polio

Table 2

Vaccine

2009/10 %

2010/11 %

% difference

School leaver booster
Td/IPV

42.54

62.24

+19.7

Human Papilloma Virus

72.53*

75.70

+3.17

*mop-up clinics in subsequent academic year increased this uptake to 91.5%.

The national target for these vaccines is 90%. Both these vaccines are delivered by school nurse teams.

Greater integration of services for children with disabilities

The development of a countywide Children with Disabilities Service in 2011 established a platform for the continued integration of services for disabled children. Health providers and the County Council have introduced a countywide panel to approve all allocations of overnight short break services and specialist social care provision. This is ensuring that services are provided equally to all children and families across the county on the basis of need. In addition, the new Continuing Health Care Protocol and Panel has strengthened the shared approach to children with disabilities, including how we allocate resources through joint commissioning.

The way we work in partnership with parents and carers was transformed as part of the Aiming High for Disabled Children programme. We are now improving this further, as Hampshire is taking part in the national Special Educational Needs and Disability Pathfinder. This programme involves developing integrated assessment and planning processes across health, education and social care, so that children have one plan for their care and support. We are also working to develop personalised budgets, where service users choose what services they want to spend their budgets on. We are also improving access to services, by providing a single point of information and being clear about the services on offer locally. To make sure we get it right, parents and carers are heavily involved in this work.

In future, this work will be incorporated into the remit of the new Health and Well-being Board as it’s role overlaps with some aspects of the Children’s Trust.