Our overarching priorities for prevention
We know that primary prevention that begins before birth is crucial to the success of the NHS Long Term Plan. Improvements in service provision will only provide a sticking plaster if the circumstances in which the country’s poorest children grow up do not improve. Prevention is an integral part of the solution to many of the problems that children face, from increasing mortality rates, to high prevalence of obesity, to widening social and health inequalities.
As such, we consider these five priorities to be crucial in preventing ill health and safeguarding the wellbeing of children and young people.
1. Tackling inequalities with greater focus on the most vulnerable children, young people and families
As child poverty is expected to increase to 40% by 2030, RCPCH recommends specific targets are introduced for reducing health inequalities.
2. Investment in the workforce, in particular in school nurses and health visitors
Health visitors act as a frontline defence against multiple child health problems – from providing advice to parents on nutrition and feeding, to early identification of risk factors for mortality, to increasing breastfeeding rates. However, health visitor numbers are falling dramatically.
3. Greater coordination of services, strategies, plans and programmes that are designed to prevent negative outcomes
This should be delivered through a cross-government Children and Young People’s Health Strategy.
4. A moratorium on public health funding cuts
Cuts to public spending have reduced the capacity of local authorities to provide public health services, which are vital for many prevention policies supporting mothers and children.
5. A life course approach, recognising that good prevention starts before birth
Maternal health is vital to the outcomes of children, especially in their early years. Women should be supported during pre-conception, antenatal care, labour, birth and the postnatal period.
Our vision for child health: prevention and early intervention
As noted by the Health and Social Care Committee in February 2019, one of the six founding principles of high quality local services for children, young people and families is prevention and early intervention.
Child health and the factors that affect it are complex. The principles of our vision for child health address diverse components of child health policy and encompass interventions that can help prevent negative outcomes or prevent certain causes and factors behind negative outcomes. These principles are outlined below.
Give children a healthy start in life
The early years of a child’s life are critical, shaping their long-term health and quality of life. Children in the UK experience particularly poor outcomes in the earliest stages of their lives compared to similar wealthy nations, as numerous studies have shown.
Our vision looks in particular at smoking during pregnancy, maternal health, oral health, breastfeeding, infant feeding and marketing, immunisation and health visiting.
Key recommendations include:
- All women have access to tailored smoking cessation services during pregnancy with targeted support available for areas of greatest deprivation and young mothers.
- Funding for public health services should be protected so that health visiting, smoking cessation programmes and breastfeeding support are accessible to all pregnant women and new mothers.
- All children in the UK should receive their first check up as soon as their first teeth come through, and by their first birthday, and have timely access to dental services for preventative advice, with targeted access for vulnerable groups.
- Routine collection of data on breastfeeding at regular intervals must be coordinated, including reinstating the UK-wide Infant Feeding Survey.
- The Government should develop mandatory guidelines on the free sugar content of infant foods for under 2s to encourage reformulation of baby food, including commercial weaning foods, supporting greater exposure of babies to a wider range of tastes, rather than predominantly sweet flavours.
- Further research should be undertaken into methods to improve vaccination uptake amongst families who make a conscious decision not to vaccinate their child.
- A more coherent, consistent and comprehensive approach is taken to planning the child health workforce. Each part of the UK requires a bespoke child health strategy to address staffing shortages by identifying the needs across the child health workforce, including health visitors, nurses, midwives, allied health professionals and paediatricians.
Ensure children grow up healthy
Child health is everyone’s responsibility. As children and young people grow up, there is a shared duty across society to ensure they are supported to have safe and healthy childhoods, learn positive behaviours and move into adulthood with everything they need to live long and happy lives. Prevention is inherently at the heart of this cross-society commitment to protect and promote child health.
Our vision looks in particular at childhood obesity, children and young people’s mental health, adverse childhood experiences and resilience and tobacco control.
Key recommendations include:
- Digital capacity in primary care and across child health professionals should be strengthened with the necessary IT systems so that information on a child’s weight is accessible to all child health professionals who need it.
- The Care Quality Commission’s recommendation for piloting and evaluating a statutory ‘local offer’ for mental health is supported nationally, mirroring the local offer for special educational needs introduced by the Children and Families Act 2014.
- All services that see and look after some of the most vulnerable children and young people (including those living with substance-dependent parents, migrants and young offenders) are supported to take a trauma-informed approach to working with these children.
- Government should extend bans on smoking in public places and cars to include schools, sports fields, playgrounds and NHS premises.
Ensure the world we live in promotes child health
Ensuring that the world our children and young people live in contributes to positive health outcomes must be a fundamental focus of the Green Paper on Prevention. The UK won’t be able to give every child the healthy childhood they deserve until it takes clear action to address the societal problems and inequalities that disadvantage too many children in our country.
Our vision looks in particular at social and health inequality, air pollution and child safety and accident prevention.
Key recommendations include:
- Each government department should explicitly commit to a ‘child health in all policies’ approach and put appropriate measures in place to assess impacts of policies on child health and to develop policies that improve child health.
- Children must be prioritised within a cross-government action plan on air quality.
- Government should introduce graduated driving licences in Great Britain for novice drivers.
We recommend focus in the following three areas in order to enable delivery of the Prevention Green Paper:
- A Children and Young People's Health Strategy
- Strengthening primary care
- Increased public health funding