• • • • • • The London Health Commission: an opportunity for children young people Professor Yvonne Doyle Regional Director, PHE London Dr Marilena Korkodilos Deputy Director, Specialist Public Health Services, PHE London Thursday 9 April 2015
The Need for City-Wide Action • The London Health Commission was requested by the Mayor of London in 2013 • Chaired independently by Lord Ara Darzi • A unique and new opportunity to raise profile of public health • Regional Director of PHE London invited to chair expert group on health and inequalities 2
London Health Commission 3 https://www.youtube.com/watch?v=Oc0w_VKv1cA
2020 principles followed by the London Health Commission • Investing in health through a life course approach • Empowering people and adopting an asset based approach • Tackling non- communicable health challenges • Examining return on investment • Adding value through partnerships 4
What did the Commission initially observe? 5
Excellent Civil Society Engagement 6
London’s Assets…. We looked at our community and environmental assets and compared how other cities had used these for the benefit of their populations. 7
Better children’s services Better health Put London at the centre of the global revolution in digital health 8 London Health Commission (2014) Better Health for London
’ Better parenting • 53% of London’s five year Children in London achieving a good level of olds reach a good level of development at age 5, by level of deprivation, 2010 (2) development and being ready for school • There is wide variation across London linked to deprivation and place • There is no London wide Put London at the centre of systematic focus on pre- the global school and early years revolution in parenting interventions digital health 9 London Health Commission (2014) Better Health for London
Childhood obesity • London has the highest proportion of obese children in all the regions EXAMPLE – the Forest Gate area of Newham of England • Obesity is a particular challenge for some of London’s poorest and its minority communities Put London at • Having a fast food outlet the centre of the global within 160m of a school is revolution in associated with a 5% digital health increase in obesity 10 London Health Commission (2014) Better Health for London
Healthier schools • Schools are the ideal place to get children off to a healthy start to life. Good education improves health, poor health harms education • Physical activity improves motivation, reduces unhappiness and improves learning - only 55% of London’s children are physically active Put London at • Education also lowers the chances the centre of the global of teenage pregnancy and revolution in influences rates of sexually digital health transmitted infections 11 London Health Commission (2014) Better Health for London
Better children’s mental health services • Poor mental health in childhood has a significant impact on educational achievement, health and employment in adulthood • Half of all mental illness starts before a child reaches the age of 14 and three- quarters of lifetime mental health disorders have their first onset before 18 years of age • 1 in 10 children in London have a Put London at diagnosable mental health disorder - 3 in the centre of every class. Between 1 in 12 and 1 in 15 the global revolution in deliberately self harm - admissions to digital health hospital have increased by 68% in 10 years 12 London Health Commission (2014) Better Health for London
Better children’s physical health services • Health and care services for children in London are hard to access, poorly coordinated between primary, secondary and tertiary care and there are inadequate links between them • London’s hospitals need to ensure that there are enough paediatric staff with the right skills, experience and seniority for good clinical decision Put London at Across London there is unacceptably making available every day the centre of wide variation in mortality rates across the global boroughs for both infants and older • There is a lack of planning and children. There is a threefold difference revolution in between the best and worst coordination of services across digital health performing boroughs London 13 London Health Commission (2014) Better Health for London
Recommendations • Health and care commissioners should jointly develop a new model to improve support for parents of vulnerable children under three • The Mayor should use the ‘London Plan’ planning guidance to support local authorities in protecting London’s children from junk food through tighter controls within 400 metres of schools and to promote access to healthier alternatives • Local authorities, the GLA and Public Health England should work with Ofsted to ensure more data is published on school health and wellbeing • Health commissioners and providers should launch a process to address the variation in quality of care for children and to propose actions to improve outcomes 14 London Health Commission (2014) Better Health for London
Ten aspirations for London Give all London’s children a healthy, Enable Londoners to do more to look happy start to life after themselves Ensure that every Londoner is able to Get London fitter with better food, see a GP when they need to and at a more exercise and healthier living time that suits them Create the best health and care Make work a healthy place to be in services of any world city, throughout London London and on every day Help Londoners to kick unhealthy Fully engage and involve Londoners in Put London at habits the future health of their city the centre of the global Care for the most mentally ill in Put London at the centre of the global London so they live longer, healthier revolution in revolution in digital health lives digital health 15 London Health Commission (2014) Better Health for London
Better Health For London: Next Steps “We aim to ensure that all children are school-ready by age 5, achieve a 10% reduction in the proportion of children obese by Year 6 and reverse the trend in those who are overweight ” 1. A city-wide approach 1. Collaborating for London 1. Fostering further partnerships 2. Creating a shared vision for London 16
NHS Transformational Prospectus A collaborative prevention programme in partnership with Public Health England, London Councils and the Greater London Authority. • Embedding health and wellbeing starting with children • Improving workplace health, within and beyond the health and care system • Taking innovative action to reduce smoking and obesity and promote wellbeing • Developing new and stronger partnerships to promote health • Examining opportunities to tackle city- level health challenges 17
Key themes to inform our thinking • Leadership • Knowledge information and outcomes • Existing gaps in service provision • Listening to Need to see how our views and opinions are taken into Focus on what account would help young people to get where they need to – related to their futures 18
London’s CYP: Demography CYP population Children living Children living in in poverty poor housing 1 in 4 3 in 10 1 in 7 PHE London (2014) The health and wellbeing of children and young people in London: An evidence based resource 19 Picture credits: London designed by Housin Aziz from the Noun Project
London’s CYP: Key facts Smoking in Low birth weight Infant mortality of term babies pregnancy 1 in 245 1 in 30 1 in 17 PHE London (2014) The health and wellbeing of children and young people in London: An evidence based resource 20 Picture credit: Scale designed by Cyril S from the Noun Project
London’s CYP: Key facts Did not complete Did not complete DTaP/IPV/Hib at 1 year MMR at 2 years 1 in 10 1 in 8 21 PHE London (2014) The health and wellbeing of children and young people in London: An evidence based resource
London’s CYP: Key facts 4-5 year olds who 5 year olds with 10-11 year olds are overweight tooth decay who are overweight or obese or obese 1 in 4 3 in 10 2 in 5 22 PHE London (2014) The health and wellbeing of children and young people in London: An evidence based resource
London’s CYP: Key facts Young people Did not with a mental complete HPV Teenage mothers health problem at 12-13 years 1 in 10 1 in 5 1 in 39 23 PHE London (2014) The health and wellbeing of children and young people in London: An evidence based resource
London’s CYP: Why invest? Annual Cost (£millions) £200m £195m £35m 24 PHE London (2014) The health and wellbeing of children and young people in London: An evidence based resource
London’s CYP: Why invest? Saves ….. Every £ invested in Targetted parenting programmes £8 to prevent conduct disorders Young people's drug and alcohol £8 services Contraception £11 25 PHE London (2014) The health and wellbeing of children and young people in London: An evidence based resource
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