Tag: Royal College of Paediatrics and Child Health

Worried and Waiting: Record waiting times for children in NHS Lothian

NHS Lothian has the longest patients waiting times for treatment, with 69.1% of total patients waiting over 12 weeks. 2382 out of 3448 paediatric patients in NHS Lothian waited over 12 weeks for treatment.

In NHS Highland 48.9% of patients were waiting over 12 weeks at that time. This is in comparison to NHS Greater Glasgow and Clyde where over 12 week waits made up only 19.2%, and NHS Grampian which stood at 12.9%.

The report by the Royal College of Paediatrics and Child Health, Worried and waiting: A review of paediatric waiting times in Scotland 2024, stated that –

‘It is worrying that children and young people are waiting longer than 12 weeks to be seen in paediatrics. However, what is the most concerning is that in September 2023, 13 out of 14 health boards in Scotland were experiencing very high waits over 12 weeks, with only NHS Western Isles achieving the national standard rate.‘

Lothian MSP, Miles Briggs, said: “It is extremely concerning that young people in Lothian are waiting over 12 weeks for treatment.

“Over two thirds of young people are now waiting over the 12 week waiting target which is unacceptable.

“SNP mismanagement of our NHS means that hundreds of children are not being seen a quickly as they should be, nowhere more so than in NHS Lothian.

“We urgently need to see our health service properly run. 

“It is also important that NHS Lothian receives funding parity with other health boards.

“This tired SNP Government has had no answers for years.”

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State of Child Health – it’s not good

The RCPCH has today published State of Child Health 2020, the largest ever compilation of data on the health of babies, children and young people across all four UK nations.
The report shows that for many measures of children’s health and wellbeing, progress has stalled, or is in reverse – something rarely seen in high income countries.

Visit the State of Child Heath website

Across most indicators, health outcomes are worse for children who live in deprived areas. Inequalities in some outcomes have widened since the last State of Child Health report in 2017. Progress has also been seriously affected by deep cuts to local authority budgets – used to finance public health initiatives and community services.

The authors highlight that, even where there have been notable improvements in children’s health, the UK is often lagging far behind other countries.  For example, although there has been a fall in the number of emergency asthma admission rates across all four nations, the UK still has one of the highest mortality rates in Europe for children and young people with asthma.

Dr Ronny Cheung, Clinical Lead for RCPCH and co-author of the report, said: “Two weeks ago, the Marmot Review presented a stark picture about life expectancy in England. Now, our own report shows troubling signs for children and young people across the UK.

“The harsh reality is that, in terms of health and wellbeing, children born in the UK are often worse off than those born in other comparably wealthy countries. This is especially true if the child is from a less well-off background.

“Infant mortality is a globally-recognised sign of how well a country is looking after the health of its citizens. Throughout the world, the number of babies dying in their first year has been steadily falling for decades, as incomes rise and mothers and children receive better healthcare.

“Yet UK infant mortality rates have stalled, and in England they actually got worse between 2016 and 2017. For a high-income nation such as ours that should be a major wake up call.”

State of Child Health 2020 brings together 28 measures of health outcomes, ranging from specific conditions – such as asthma, epilepsy, and mental health problems – to risk factors for poor health such as poverty, low rates of breastfeeding, and obesity.

Community paediatrician and co-author Dr Rakhee Shah, said: “Investment in preventative health services must now be prioritised by the new UK Government.

“England has seen a huge decline in spending on local services and I see the results of that every day of my working life especially for my most disadvantaged patients. The cuts to services also have an impact on our NHS – people have fewer places to go to get advice, support, and stay well.”

The authors make a number of policy recommendations for each nation. These include:

  • Introduce a cross-departmental National Child Health and Wellbeing Strategy to address and monitor child poverty and health inequalities.
  • Restore £1 billion of real-terms cuts to the public health grant for Local Authorities.
  • Ensure future investment in public health provision increases at the same rate as NHS funding and is allocated based on population health needs.
  • Implement in full commitments from the prevention green paper, Advancing our health: Prevention in the 2020s.
  • Implement commitments to provide a Youth Investment Fund, with protection of the committed £500m funding.
  • Provide health-based support for children throughout education, including funding for increased numbers of school nurses and school counsellors.
  • Provide renewed investment in services for children and families, which support the child’s school readiness.
  • Ensure that health visiting services are protected, supported and expanded with clear and secure funding.

President of the RCPCH, Professor Russell Viner, said: “We’ve got a lot of work ahead of us if we’re to get a grip on the state of child health in the UK. This report is the only one of its kind to zoom out and look at the full picture and it’s not a pretty sight. On many vital measures we risk lagging behind other European countries.

“There some positive signs – teenage pregnancies have fallen hugely, Scotland is leading the way on reducing youth violence, and we’ve made huge strides in the treatment of conditions like diabetes. These outcomes are invariably the result of good policy, political commitment, and proper funding.

“In many areas of healthcare, we’ve led the rest of the world. But we’re in danger of failing a generation if we don’t turn this situation around. The government has made welcome commitments on childhood obesity and young people’s mental health but we need to see delivery in these and other areas.

“We have the evidence, the experience and the expertise to make real progress in the life of this government. It’s now time to deliver for children and young people.”

KEY HIGHLIGHTS 

Infant mortality

  • The UK is fifth from bottom among 27 European countries for infant (under one year of age) mortality. Infant mortality in England stalled between 2013 and 2018 at 3.9 per 1,000 livebirths, with a slight rise in 2017 to 4.0.
  • In England and Wales infant mortality is more than twice as high in the most deprived areas compared with the least deprived areas.

Healthy weight

  • The prevalence of children aged 4-5 who are overweight or obese has not improved significantly in any of the four countries since 2006-7.
  • Trends among 4-5 year olds are stable across the UK with around 25% of children overweight but this increases to around 34% for 10-11 year olds in England.
  • Childhood obesity is more prevalent in deprived areas. In England, the prevalence of severe obesity among 4-5 year olds was almost four times as high in the most deprived areas (3.8%) than the least deprived areas (1.0%) in 2017/18.

Child poverty (new indicator)

  • A total of 4.1 million children live in relative poverty in the UK (after considering housing costs) – an increase of 500,000 between 2011-12 and 2016-17. From 2016/17 to 2017/18, the numbers in England rose from 30% to 31% of children and in Wales from 28% to 29%
  • Child poverty in Scotland plateaued at 24% and in NI decreased from 26% to 24%.
  • Across the UK, rates of child poverty have increased for all types of working family. Lone parents working part time and households with only one working parent have seen the sharpest increases in poverty over the last three years.
  • Nearly half of children (47%) in working lone parent families live in poverty.

Immunisations

  • In 2018, all four UK nations fell short of the 95% WHO target for the second dose of MMR.
  • In 2018, the uptake rates of two doses of MMR vaccine at 5 years ranged from 86.4% in England, 91.2% in Scotland to 91.8% in Northern Ireland and 92.2% in Wales.

Youth violence (new indicator)

  • While rates of physical violence among young people are broadly similar across the four nations, England is the only country in which rates are increasing – most notably for 20-24 year olds. Between 2012 and 2017, the rate of physical violence among that age group increased from 297.7 to 315.49 per 100,000.
  • In Wales, Scotland and Northern Ireland, physical violence among young people aged 10-24 shows an overall downward or stable trend from 2012-2017.

Long term conditions

  • Emergency admission rates for asthma have fallen since 2003/4 across the UK. However, the UK has among the highest mortality rates in Europe for children and young people with the underlying cause of asthma.
  • Epilepsy had until recently seen similar falling rates of emergency admissions. However, in 2017/18 rates rose slightly in England, Wales and Scotland. In Scotland, children with epilepsy from the most deprived areas were twice as likely to have an emergency admission to hospital than those from the least deprived.
  • There has been continued improvement in blood glucose control among children and young people with Type 1 diabetes across all four nations, and it is encouraging that there have been increases in the completion of key health checks for those with diabetes.

2020 indicators

  • Mortality – Infant mortality; Child mortality (1-9 years); Young people’s mortality (10-19 years)
  • Maternal and perinatal health – Smoking during pregnancy; Breastfeeding
    Prevention of ill health – Immunisations / vaccinations; Healthy weight; Oral health
  • Injury prevention – Accidental injury; Road traffic accidents; Youth violence (new indicator)
  • Healthy behaviours – Smoking in young people; Alcohol and drug use in young people; Conceptions in young people
  • Mental health – Prevalence of mental health (new indicator); Mental health services (new indicator); Suicide
  • Family and social environment – Child poverty; Education – not in education, employment or training (NEET) (new indicator); Young carers (new indicator); Children in the child protection system; Looked After Children (new indicator)
  • Long term conditions – Asthma; Epilepsy; Diabetes; Cancer; Disability and additional learning needs
  • Workforce – Child health workforce (new indicator)

SOCH-SCOTLAND2-03.03.20

CHILD DEATHS AND POVERTY: GREENS URGE ACTION ON RCPCH REPORT

Alison Johnstone MSP, Health spokesperson for the Scottish Greens, today urged Scottish Ministers to act on the recommendations of a major report which concludes that 400 Scottish child deaths each year are potentially avoidable. The State of Child Health report by the Royal College of Paediatrics & Child Health says the Scottish Government should adopt a ‘child health in all policies’ approach to decision making.

The report urges support for families through financial inclusion services, like Glasgow’s Healthier Wealthier Children scheme which Green MSPs have persuaded Scottish Ministers to roll out across the country. It calls for all schools to deliver comprehensive sex and relationships education and also calls for 20 mph speed limits in built up areas to create safe places for children to walk, cycle and play.

Alison Johnstone, Health spokesperson for the Scottish Greens and MSP for Lothian, said: “The link between poverty and poor health is well established and this shocking report shows we need a transformation in how Government approaches the issue. Four hundred preventable child deaths each year must prompt serious action.

“Green MSPs have been pushing for an anti-poverty budget from Scottish Ministers, and we’ve already secured a guarantee that Glasgow’s Healthier Wealthier Children project, which boosts incomes for vulnerable families, will be rolled out across Scotland. We need to see other interventions such as an allowance for young carers, promotion of the Living Wage to stop in-work poverty, and a more humane approach to social security.

“We also need to see a shift in spending to make it easy to be active every day. The lack of funding for walking and cycling while motorways and air travel are set to benefit, and the deep cuts planned to sports agencies and council services, show that Scottish Ministers haven’t grasped how serious the situation is.”

The full report is available at:
www.rcpch.ac.uk/state-of-child-health

State of child health: The report at a glance

This is a comprehensive list of 25 measures of the health of UK children, ranging from specific conditions such as asthma, diabetes and epilepsy, risk factors for poor health such as obesity and a low rate of breastfeeding, to child deaths. The data provide an “across the board” snapshot of child health and wellbeing in the UK.

Key messages

Key actions – UK wide

Recommendations for UK, Scottish and Welsh Governments and decision makers

Key messages

Nearly one in five children in the UK is living in poverty and inequality is blighting their lives, with those from the most deprived backgrounds experiencing much worse health compared with the most affluent. Despite some improvements in the health of UK children over the last decades, there is clear disparity with Europe, and major cause for concern.

Child deaths

The UK ranks 15 out of 19 Western European countries on infant (under one year of age) mortality and has one of the highest rates for children and young people in Western Europe.

There is a strong association between deprivation and mortality, for example infant mortality is more than twice as high in the lowest compared with the highest socio-economic groups.

Smoking in pregnancy

The prevalence of smoking during pregnancy in the UK is higher than in many European countries (for example 5% in Lithuania and Sweden, compared with 19% in Scotland, 16% in Wales and 15% in Northern Ireland).

Smoking in pregnancy increases the likelihood of death, disability, and disease (for example stillbirth, cot death and the risk of respiratory disease across the life-course).

There is marked variation in smoking in pregnancy across the UK with a strong association with deprivation; for example in Scotland over a quarter (25.9%) of women in the most deprived areas acknowledged smoking following the birth of their baby, compared with 3.3% in the least deprived areas.

Breastfeeding

Breastfeeding in England and Scotland has shown minimal improvement since data recording commenced in 1975, with no improvement over the last five years, and remains lower than many other comparable high-income countries.

At 6 months, only 34% of babies in the UK are wholly or partially breastfed, compared to 71% in Norway

Breastfeeding has substantial health benefits for mothers and babies.

Across the UK, 46% of mothers in the most deprived areas breastfed compared with 65% in the most affluent areas.

Obesity

Across England, Scotland and Wales more than one in five children in the first year of primary school are overweight or obese.

There has been minimal improvement in the prevalence of child overweight and obesity over the past decade.

Obesity leads to substantially increased risk of serious life-long health problems, including type 2 diabetes, heart disease, and cancer.

In 2015/2016, 40% of children in England’s most deprived areas were overweight or obese, compared to 27% in the most affluent areas.

Smoking

The percentage of 15-year-old children smoking regularly is 6% in England and 8% in Wales and Scotland.

Smoking continues to be the greatest single cause of avoidable mortality in the UK.

Starting to smoke during adolescence increases the likelihood of being a life-long smoker.

The prevalence of child smoking is much higher amongst children from the most deprived areas; for example in Scotland’s most deprived areas, at least 1 in 10 young people are regular smokers.

Alcohol

In 2013/2014, 13% of 15-year-olds surveyed in Wales, 11% in England and 13.5% in Scotland reported drinking alcohol at least once a week.

Alcohol abuse continues to be a problem across the social spectrum.

Key actions – UK wide

  • Each UK Government to develop a child health and wellbeing strategy, coordinated, implemented and evaluated across the nation
  • Each UK Government to adopt a ‘child health in all policies’ approach
  • UK Government to introduce a ban on the advertising of foods high in saturated fat, sugar and salt in all broadcast media before 9pm
  • Each UK Government to develop cross-departmental support for breastfeeding; this should include a national public health campaign and a sector wide approach that includes employers, to support women to breastfeed
  • An expansion of national programmes to measure the height and weight of infants and children after birth, before school and during adolescence
  • A reversal of public health cuts in England, which are disproportionately affecting children’s services
  • The introduction of minimum unit alcohol pricing in England, Wales, and Northern Ireland, in keeping with actions by the Scottish Government
  • UK Government to extend the ban on smoking in public places to schools, playgrounds and hospitals
  • UK Government to prohibit the marketing of electronic cigarettes to children and young people
  • National public health campaigns that promote good nutrition and exercise before, during and after pregnancy

Recommendations for Scottish Government and decision makers

SOCH recommendations – Scotland 

 

State of Child Health – full report