Children & young people with potentially acute health conditions – advice for practitioners
The contribution of multi-agency partners in supporting children, young people, parents and carers to safeguard children with acute and chronic health conditions should not be underestimated.
Case reviews have identified that families do not always understand the seriousness of their child’s medical condition, and the potential worst case scenario outcome of death, if they do not act appropriately.
Moreover multi-agency workers, including social workers, do not always understand the seriousness of some medical conditions
Key learning includes:
- the importance of full multi-agency information sharing regarding the safeguarding concerns and clarity about the impact on the child’s health and medical needs.
- referrals for children with medical conditions need to capture:
- the voice of the child; and
- the impact on the child from their medical condition in addtion to safeguarding concerns
- it should be clear what the professional making the referral wants to happen
- referrals from health services need to be of a good quality and clearly demonstrate what the risks are – and how serious the concerns are
- for example if a parent smokes what is the risk to a child with brittle asthma and what does that child need to stay safe (ie. a smoke free environment)
- the importance of multi-agency partners working with health colleagues, including paediatricians, specialists nurses, therapists and universal health practitioners (health visitor, school nurse and GP) to request clarification on how the safeguarding and health issues impact on the child’s wellbeing
- to inform the level of need it is essential to have a clear understanding of a child’s medical needs and the impact of the safeguarding concerns on the child’s wellbeing given the specific medical concerns
- it is essential that there are conversations with the child’s lead health professional to clarify the child’s health needs
- the child’s lead health professional will depend on the nature and the severity of the child’s health/ medical needs
- the key worker for a child with a multi-agency plan should have a simple map of the range of health staff, contact numbers and email addresses so that all health staff are invited to child in need and child protection conferences/core groups
- young people should be supported to engage in managing their own condition
- Manchester Targeted Youth Support Service should be considered in the support package.
- agencies such as housing have a clear role in discussions about the home environment and the multi-agency group need to be explicit as to how this may impact on a child’s health needs.
A new video by Public Health England demonstrates the role of health and care professionals in tackling childhood obesity. The video, part of the ‘All Our Health’ campaign, outlines the role health and care professionals have in supporting children, young people and families in maintaining a healthy lifestyle through exercise and a balanced diet.
Find the video at www.youtube.com/644087_Childhood+Obesity
The video highlights the importance of balanced nutrition and an active lifestyle before and during pregnancy, and explains the positive effects of breastfeeding and recommended weaning practices on children’s health. You’ll also hear about how much time children of different ages should spend being physically active each day, and tips on appropriate portion sizes for children’s meals.
The All Our Health resource is constantly evolving and can be found at www.gov.uk/all-our-health-personalised-care-and-population-health
Other sources of information:
Childhood obesity: a plan for action
Statistics show that nearly a third of children aged 2 to 15 are overweight or obese and younger generations are becoming obese at earlier ages and staying obese for longer. Obese adults are seven times more likely to become a type 2 diabetic than adults of a healthy weight, which may cause blindness or limb amputation.
Not only are obese people more likely to get physical health conditions like heart disease, they are also more likely to be living with conditions like depression.
Obesity rates are highest for children from the most deprived areas and this is getting worse. Children aged 5 and from the poorest income groups are twice as likely to be obese compared to their most well off counterparts and by age 11 they are three times as likely.
Obesity is a complex problem with many drivers, including behaviour, environment, genetics and culture.
The government aims to significantly reduce England’s rate of childhood obesity within ten years – read Childhood obesity: a plan for action on the website www.gov.uk/childhood-obesity-a-plan-for-action
Tackling childhood obesity requires support from all levels of influence
During the primary school period, from the age of 4 to 11 years, the proportion of children who are very overweight doubles (rising from 10 per cent to 20 per cent). This increasing trend continues to adulthood, but the steepest increase occurs during childhood.
Furthermore, during this period inequalities emerge. At school entry, there is little difference in the likelihood of being overweight between groups. However, by age 11, children from minority ethnic groups and those from more deprived backgrounds, compared to more affluent backgrounds are more likely to be overweight.
Excess weight in children is linked to multiple health, emotional and social problems. Schools could provide a critical setting for prevention. Overviews of previous research suggest that school programmes could reduce the proportion of children who are overweight. However firm recommendations could not be made because of weaknesses in these studies.
Researchers in the Institute of Applied Health Research at the University of Birmingham worked with school staff, parents, children and community members to develop a programme of activities aimed at preventing the rise in obesity in children. Around 1,500 children aged five to six years from 54 West Midlands primary schools took part in the research funded by the National Institute of Health Research (NIHR), making this one of the largest such studies in the UK. However, after 15 and 30 months, there was no significant difference in weight status or other measures in children who were in the schools with or without the programme.
This finding that a school-delivered skills-based programme was not able to impact on the likelihood of children becoming overweight is similar to findings from two other recent UK studies. Although subgroups of children may benefit, we have consistent evidence from UK studies that overall, school-delivered diet and physical activity programmes are unlikely to halt the rise in childhood obesity. Read more at www.birmingham.ac.uk
The UK government’s childhood obesity plan puts much emphasis on activities that schools can do to tackle the problem. It is important that policymakers break the cycle of focusing on schools to reduce the childhood obesity epidemic. Different approaches are needed that consider broader influences from the family, community, media and the food industry.
More information about potentially acute health conditions in children & young people
QualityWatch is a major research programme providing independent scrutiny into how the quality of health and social care is changing. Developed in partnership by the Nuffield Trust and the Health Foundation, the programme provides in-depth analysis of key topics and tracks an extensiverange of quality indicators. It aims to provide an independent picture of the quality of care, and is designed to help those working in health and social care to identify priority areas for improvement.
The QualityWatch website www.qualitywatch.org.uk presents key indicators by area of quality and sector of care, together with analysis of the data. This free online resource also provides research reports, interactive charts and expert commentary.
QualityWatch Focus On reports are regular, in-depth analyses of key topics. These studies exploit new and innovative methodologies to provide a fresh view of quality in specific aspects of health and social care.
The QualityWatch Focus on: Emergency hospital care for children and young people can be accessed at www.qualitywatch.org.uk/cyp
Children and Young People’s Health Services Statistics can be accessed atcontent.digital.nhs.uk/maternityandchildren/CYPHSmonthly
The Children and Young People’s Joint Strategic Needs Assessment (JSNA) for Manchester has been produced in recognition of the fact that improving the health outcomes of children and young people in Manchester requires a multi-agency approach to the collation, analysis, presentation and publication of data, research and intelligence relating to the health and wellbeing of children, young people and families across the city.
The Children and Young People’s JSNA is a ‘living’ resource that will be expanded and developed over time through consultation with key stakeholders and will incorporate the views of children and young people and can be found at www.manchester.gov.uk