1. People Group FROM FRAGMENTATION TO INTEGRATION Children’s Health and Wellbeing in the West Midlands Wendy Fabbro Strategic Director - People Services Warwickshire 4 December 2012

2. Common themes for Munro and Marmot.. People Group Putting children, young people and their families at the heart of what happens Acting early and intervening at the right time Integration and partnership-Multi agency systems approach Safe and sustainable services Priority focus on early years High quality workforce and training Investment in programmes that work- evidence base incentives

3. On a national level we know that.. People Group 45% of looked after children (and 72% in residential care) have a mental health disorder; Two thirds of looked after children have at least one physical health complaint; Almost half of young women leaving care become pregnant within 18 to 24 months; 32% of young people leaving care report problems with drugs or alcohol a year later; and Looked after children and care leavers are between four and five times more likely to attempt suicide in adulthood

4. The UK remains very low on international rankings of social mobility. Parental income continues to exert a very powerful influence on the academic progress of children The influence of parental income on the income of British children is the strongest in the OECD and over 50% stronger than in Canada, Germany or the Netherlands (Sutton Trust) “ the best thing you can do for your childs health is to read to them” (Marmot) Attainment of FSM students at GCSE 5A-C =28% Attainment of non FSM students=59%

5. Does your Health and Well-being Board.. Link effectively with the CTB, SCB, CCG Have an agreed process to ensure children's issues receive sufficient focus Contribute to early help offer Make use of mechanisms to listen to children, YP and families Analyse health needs for CYP Factor in staff views Have a method to engage with schools Have a plan to use public assets to improve health outcomes for children Embed the CAF in the local partnership People Group

6. Dartington work programme Aligning services better to the specific needs of children at the ‘edge of care’ Developing community based alternatives to becoming looked after Improving the ways in which we manage the looked after service Supporting our staff in developing their practice in assessing needs and planning and delivering effective help to these vulnerable families.

7. People Group Public Health, NHS & CYP Outcomes Frameworks Improvements in measured outcomes for CYP is at a slower rate in the UK CYP Health outcomes strategy being developed, Specific interventions in relation to pregnancy, early years LAC routinely experience poor health outcomes AND Their outcomes remain less positive than others (impact of poverty, poor parenting, chaotic lifestyles and abuse or neglect

8. People Group CCGs with their local authority partners to ensure sufficient clinical expertise and leadership for looked after children, including a designated doctor and nurse; Directors of Children’s Services to be responsible for overseeing the overall quality and delivery of health and wellbeing for looked after children, leading to a measured reduction in their health inequalities; All health organisations (including health watch) must demonstrate how they have listened to the voice of children and young people Social workers to be responsible for ensuring LAC (and particualrly 18-25)are registered with GP CYP Health Outcomes Strategy identifies the need for

9. People Group The NHS CB only accepting GPs on the local performers list who can demonstrate competences set out in, Looked after children: knowledge, skills and competencies of healthcare staff (2012); The NHS CB ensuring work to develop a tariff for the statutory health assessments for looked after children is implemented Regulators to promote and prioritise the issue of integrated provision. NHS number to be used!

10. People Group Public Health Outcomes Framework measures that can only be delivered through effective partnerships with children’s services School readiness Pupil absence Infant mortality rates 16-18 year olds not in education, employment or training People with mental illness of disability in settled accommodation Emotional wellbeing of looked after children Smoking prevalence amongst 15 year olds Under 18 conception rates Chlamydia diagnosis (15 – 24 year olds)

11. People Group Life course approach and Pathways Networks to bring together the fragmentation Public health-Lead for training Child health records accessible for patients and professionals Needs of the CYP population in the JSNA, especially those with disabilities or ltc Leadership- set out responsibilities, budget, national leadership required Thematic reviews Regulators working together The integration word

12. People Group