1. Confederation of Heads of Young People’s
Services – Annual Convention 5th & 6th
November 2012
Health and Wellbeing in Young People
Karen Turner

2. Mortality in Childhood (0 - 14)
UK compared to European 12

3. Hospital inpatient emergency
admissions for intentional self-
harm among 13-18s
• In 2010/2011, the number of
admissions for those aged 13-18 years
was 17,000. This is a rate of 45 per
10,000 population aged 13-18 years.
• Hospital emergency admissions rates
for intentional self-harm among 13-18
year-olds increased by 16.9 per cent
from 2006/07 to 2010/11.
• Among 13-18s, females are at least
three times more likely to be admitted
for self-harm than males.
Source: Hospital Episode Statistics (HES)
3

4. Under 18 conception rate
• Overall conception rate in under 18s in England in 2010 was 35.4 per 1000
women in this age group.
• The conception rate among under 18s has declined from 40.6 per 1000 women
in 2006. Over the same period the overall conception rate amongst all women
has increased from 78.5 to 82.5 per 1000 women in all age groups.
• Highest rate of under-18 conception is in the North-East (44.3 per 1000 women )
and lowest in the South-East (28.3 per 1000 women).
• Under-16 conception has remained relatively stable from 2006 to 2009, although
it did decline in 2010.
4

5. Substance abuse
• In 2011, around one in six (17%) pupils
reported ever having taken drugs compared
to 29% in a previous survey in 2001. Took drugs in the last month, last Ever taken drugs
Taken drugs in the last year
year and ever: 2001-2011
• 12% of pupils reported having taken drugs in Taken drugs in the last month
35
the last year in 2011, and this has declined
30
steadily from 20% in 2001.
25
• Drug use in the last year was reported by
similar proportions of boys and girls. 20
• Drug use in the last year increased with age: 15
n
P
e
c
r
t
3% of 11 year olds reported taking drugs in 10
the last year, and this increased to 23% 5
amongst 15 year olds.
0
• Early drug use was more likely to be volatile 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
substances in younger pupils while those
aged 14-15 reported taking cannabis as the
first drug they tried.
Source: Smoking, drinking and drug use among
young people in England in 2011, The Health and
Social Care Information Centre
5

6. Smoking prevalence at 15 years
Proportion of 15 year olds who were regular Overall
• Smoking is the primary cause of smokers, England
Boys
preventable morbidity and premature 30
Girls
death. There is a large body of
evidence showing that smoking
behaviour in early adulthood affects 20
health behaviours later in life.
n
P
e
c
r
t
10
• The Tobacco Control Plan sets out the
Government's aim to reduce the 0
prevalence of smoking among both 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
adults and children and includes a
national ambition to reduce rates of • Between 2001 and 2011, the
regular smoking among 15 year olds in proportion of pupils aged 15 who
England to 12 per cent or less by the report that they are regular smokers
end of 2015. fell from 22% to 11% (Regular
smokers are defined as usually
• The indicator shows the number of smoking at least one cigarette per
persons aged 15 who are self-reported week).
smokers as a proportion of the total • In 2011 there was no difference in
number of respondents (with valid smoking between boys and girls.
recorded smoking status) aged 15 Previously girls reported smoking
more than boys.
Source: Smoking, drinking and drug use among young people in England in 2011, The Health and Social Care 6
Information Centre

7. Mental health
• One in ten children aged 5 – 16 years has a clinically diagnosable mental health
problem
• Half of those with lifetime mental health problems first experience symptoms by the
age of 14, and three quarters before their mid-20s
• As part of the ONS wellbeing programme, a children and young people’s wellbeing
project has been set up to ensure that the Measuring National Well-being
Programme covers measures of children and young people’s well-being
• Self-harming in young people is not uncommon (10-13% of 15 – 16 year olds have
self harmed)
• Some children are significantly more likely to experience mental health problems
than others – e.g. those with disabilities, LAC, and those living in families with
complex and multiple problems.
7

8. Mental health
• There is a 49-fold variation across
PCTs in rate of inpatient admissions for
mental health disorders per 100,000
population aged 0-17 years, where London
length of stay was >3 days.
• Rate ranges from 3.4 to 166.1
admissions across PCTs in England
• No statistical correlation between
admission rates and deprivation i.e. the
level of deprivation does not have a
significant impact on the rate of
admissions. This result is borne out by
high rates of admission in South West,
South Central and South East Coast Rate of inpatient admissions >3 days’ duration in
SHA regions. children per 100,000 population aged 0–17
years for mental health disorders by PCT
Directly standardised rate 2007/08–2009/10.
The highest rates are highlighted in dark blue,
lowest rates in light blue
8

9. Children and Young People’s
Health Outcomes Strategy
Secretary of State for Health asked the independent CYP Health Outcomes Forum to:
• Identify the health outcomes which matter most for children and young people,
• How well they are supported by the existing indicators in the Public Health and NHS
Outcomes Frameworks, and
• How the different parts of the health (and wider system) will contribute and work
together in the delivery of these outcomes.

10. The Forum’s 8 themes
•Health outcomes that matter most for children, young people and their families
• Putting children, young people and their families at the heart of what happens
• Acting early and intervening at the right time
• Integration and partnership
• Safe and sustainable services
• Workforce, education and training
• Knowledge and evidence
• Leadership, accountability and assurance

11. Young People’s Voices and Rights
The Forum found:
• Young people felt that insufficient attention was paid to their health and well-being
needs and
• Too many public health campaigns are aimed at adults
The Forum said:
• Young people have the right to be involved not just in their own health, but the wider
system
• Young people want and need to be involved in the commissioning, design and
development of public health campaigns and services aimed at young people
• Young people need relevant, age-appropriate information to enable them to make
informed choices and take responsibility for their own health and well-being

12. Overview of key Forum
recommendations
• 9 new indicators for the Public Health Outcomes Framework and changes to other
indicators.
• 5 new indicators for the NHS Outcomes Framework and changes to other indicators.
• A number aimed at organisations within the health system, e.g. NHS CB, PHE, the
MHRA, NICE, CQC, Monitor, on the contribution that they need to make in order that
improved outcomes can be delivered .

13. NHS Outcomes Framework
Proposed New Indicators:
1. Integrated care – developing a new composite measure.
2. Effective transition from children’s to adult services.
3. Age-appropriate services – with particular reference to teenagers.
4. Time from first NHS presentation to diagnosis or start of treatment
A range of other ‘stretch’ indicators, for example:
• By 2013/14, DH and the NHS CB should incorporate the views of children and young
people into existing national patient surveys in all care settings.

14. Public Health Outcomes
Framework
Proposed New Indicators:
• Number of children and young people living in decent housing
• Educational attainment and progress for all children and young people with LTCs
• Proportion of children who experience bullying
• Proportion of children and young people with mental health problems who experience
stigma and discrimination.

15. Public Health Outcomes
Framework (cont’d)
• Proportion of children and young people who play games on a computer 2+ hours on
weekdays
• Proportion of mothers with mental health problems, including postnatal depression
• Proportion of parents where parent child interaction promotes secure attachment in
children age 0-2
• Proportion of parents with appropriate levels of self-efficacy
• Children, young people and families have access to age-appropriate health
information to support them to lead healthy lives

16. Next steps
• DH, with organisations in the new system, to produce the action plan
• SofS to launch the Children and Young People’s Health Outcomes Strategy before
Christmas
• Establish new governance arrangements for delivering the Strategy, with CMO chaired
Children and Young People’s Health Board
• Re-establish the Forum under Christine Lenehan and Ian Lewis as co-Chairs, with
amended membership
• First meeting of the new Forum 13 February 2013
• First Annual Summit to be held in September 2013.

17. Child and adolescent mental health
service - Promoting good health
and improving practice
Time to change – anti stigma campaign
• New children and young people’s work-stream
• Pilot to test approaches to tackling mental health stigma and discrimination in children
and young people

18. Children & Young People’s Mental
Qu
Dr ality Health e-portal Evi
ive de
n bas nce
ed
1) e-learning modules for:
• non-NHS staff in universal settings; teachers, youth workers,
police, clergy, social workers
• NHS staff in universal settings; GPs, paediatricians, nurses, other
health professionals,
• School, FE and University counsellors
• NHS funded staff with a specific focus on CYP with mental health
problems
2) e-therapies
Ou Us
tc info er
foc omes rme
uss d
ed

19. Evidence based interventions: Children
and Young People’s IAPT
(Improving Access to Psychological
Therapies)
• Evidence based practice, outcomes monitoring
• Service Transformation for CAMHS
• Funding £8 million a year 2011/12 - 2014/15
• Additional £22 million over 2012/13 - 2014/15

20. Salford Year 1 Sites
Collaborative
HEI - Manchester
University
CAMHS
Partnerships
Derby
Manchester &
Salford
Pennine North
Pennine South
Barnsley
Reading London
Collaborative Collaborative
HEI – Reading
University HEI – UCL/KCL
CAMHS CAMHS
Partnerships Partnerships
Ox and Bucks Lambeth &
Wilts, Bath & NE Southwark
Somerset Herts
Gloucs Sussex
Swindon Westminster
Bournemouth, Haringey
Dorset & Poole Cambridge
Wandsworth
Greenwich

21. Salford Year 2 Sites Northumbria
Collaborative Collaborative
HEI – Manchester HEI –
University Northumbria
CAMHS University
Partnerships CAMHS
Central Lancashire Partnerships
North Lancashire Tees
Bolton Durham
Reading
North Yorkshire
Collaborative Darlington
Rotherham
HEI – Reading
Doncaster
University
CAMHS
Partnerships London
Berkshire Collaborative
Bedfordshire
Luton HEI – UCL/KCL
South-West Kensington & CAMHS
Chelsea Partnerships
Collaborative Tower Hamlets
HEI - Exeter Hackney
University Camden
CAMHS Islington
Partnerships Waltham Forest
Devon Richmond
Torbay Bromley
Plymouth Croydon

22. Delivering better health outcomes
through the new health system
• Young People’s Voices → HealthWatch
• Health and wellbeing boards
• JSNAs/JHWS
• Commissioning for improved health outcomes (public health and treatment and care)

23. JSNAs and joint health and wellbeing strategies –
tools for shared leadership
HWB provides forum for
What services do we need to commission (or de-
repositioning JSNA as truly
commission), provide and shape; both separately
jointly owned and leading to
and jointly? – commissioning plans
joint commissioning decisions
to serve the whole population.
So what are our priorities for collective action, and how will we
achieve them together? – the JHWS
Explicit link
from evidence
to service What are we doing now, how well is it working and how
planning efficient is it? - a analysis on our progress
So what does that mean they need, now and in the future and what
assets do we have? – a narrative on the evidence - the JSNA
What does our population & place look like? – The intention of JSNA is
evidence and collective insight to link local needs with
commissioning
decisions – by adding
Engagement
the layer of the JHWS
with users
HEALTH & WELLBEING this link is being made
and the public
BOARD easier for local areas to
understand.