1. Children, Young People and
Families
- Presentation to NCVYS, July 2013
Eustace de Sousa, Deputy Director – Children, Young People and Families
Iain Mallett, Head of Public Involvement and Communications Manager
Lorraine I Thomas, (Interim) VCS Partnerships Lead

2. Public Health England
About Public Health England
• We are a national executive agency formed in 2013 from a number of expert
organisations in public health. Our status ensures we have operational autonomy and
professional and scientific credibility.
• We protect and improve the nation’s health and wellbeing, and tackle health
inequalities so that the poorest and most poorly benefit most.
• We provide a nationwide, integrated public health service, supporting people to
make healthier choices. We provide expertise, information and intelligence to public
health teams based in local authorities and the NHS to secure the biggest
improvements in the public’s health.
2 Understanding Public Health England

3. Mission
3
“To protect and improve the nation’s
health and to address inequalities,
working with national and local
government, the NHS, industry,
academia, the public and the voluntary
and community sector.”

4. What we do
4
– work transparently, proactively providing government, local government, the
NHS, MPs, industry, public health professionals and the public with evidence-
based professional, scientific and delivery expertise and advice
– ensure there are effective arrangements in place nationally and locally for
preparing, planning and responding to health protection concerns and
emergencies, including the future impact of climate change
– support local authorities, and through them clinical commissioning groups, by
providing evidence and knowledge on local health needs, alongside practical
and professional advice on what to do to improve health, and by taking action
nationally where it makes sense to do so

5. “We exist to serve the public through
the public health system, a system led
locally by elected members where
responsibility for the public’s health
sits alongside responsibility for jobs,
housing and communities.”
Public Health Priorities, 2013/14

6. Our priorities for
2013/14
6
– Sets out Public Health England’s
priorities and actions for the first
year of our existence
– Five outcome-focused priorities –
what we want to achieve
– Two supporting priorities –
how we will achieve it
– 27 key actions to take now
– The start of the conversation – a
three-year corporate plan will follow

7. Outcome-focused priorities
7
1. Helping people to live longer and more healthy lives by reducing preventable deaths and
the burden of ill health associated with smoking, high blood pressure, obesity, poor diet,
poor mental health, insufficient exercise, and alcohol
2. Reducing the burden of disease and disability in life by focusing on preventing and
recovering from the conditions with the greatest impact, including dementia, anxiety,
depression and drug dependency
3. Protecting the country from infectious diseases and environmental hazards, including the
growing problem of infections that resist treatment with antibiotics
4. Supporting families to give children and young people the best start in life, through
working with health visiting and school nursing, family nurse partnerships and the
Troubled Families programme
5. Improving health in the workplace by encouraging employers to support their staff, and
those moving into and out of the workforce, to lead healthier lives

8. Supporting priorities
8
6. Promoting the development of place-based public health systems
7. Developing our own capacity and capability to provide professional, scientific and delivery
expertise to our partners

9. Actions 2013/14
9
4. Giving children and young people the best start in life
• Launch a national programme promoting
healthy weight and tackling childhood obesity
• Partner the Troubled Families programme
• Accelerate improvements in child health
outcomes
• Partner the Early Intervention Foundation

10. Children, Young People
and Families
are everywhere
in PHE’s Priorities and Actions
10

11. Actions 2013/14 (extracts)
11
1. Reducing preventable deaths
• Accelerate efforts to promote tobacco control & reduce the
prevalence of smoking
• Report on premature mortality and the Public Health Outcomes
Framework
2. Reducing the burden of disease
• Improve recovery rates from drug dependency
• Improve sexual health and reduce the burden of sexually
transmitted infections
• Develop a national programme on mental health in public health

12. Actions 2013/14 (extracts)
12
3. Protecting the country’s health
• Reverse the current trends so that we reduce the rates of tuberculosis
infections
• Lead the gold standards for current vaccination and screening
programmes
• Develop and implement a national surveillance strategy
6. Promoting place-based public health systems
• Make the business case for promoting wellbeing, prevention and early
intervention as the best approaches to improving health and wellbeing
• Partner NHS England to maximise the NHS’ impact on improving the
public’s health
• Implement the public health workforce strategy and develop the PHE
workforce

13. Behaviours
Our effectiveness depends on how we behave, so we will:
consistently spend our time on what we say we care about
work together, not undermine each other
speak well of each other, in public and in private
behave well, especially when things go wrong
keep our promises, small and large
speak with candour and courage
13

14. Place-based approach to public health
14
Public health advice
Health and wellbeing boards
Local government CCGs
PHE
centre
NHSE
area team
• EPPR
• Screening and immunisation
• Offender public health programmes
• Specialised commissioning
• Primary care public health programmes
and population healthcare
NHS
providers
Non-
statutory
providers*
People and communities
*Including voluntary and community sector

15. Children, Young People and Families
• Our approach
• Variation
• Examples from:
• Early Years
• Obesity Trends and Inequalities
• Alcohol and Adolescence
• How we can make a difference
15

16. 16
Children, Young
People and
Families: A Life
course approach
Marmot 2010, Fair Society, Healthy Lives: The
Marmot Review

17. Children,Young People and Families
17
Life course approach
Pregnancy Early Years School-aged Adolescents
Reduce
numbers of still
births and infant
deaths
Safe transfer of
Healthy Child
Programme 0-5s
Settings approach
– healthy schools
and FE
Reaching C&YP
out of school
Healthy Weight
and Physical
Activity, NCMP
Adolescent public
health
improvement
framework –
targeting children &
young people with
multiple
vulnerabilities
Corporate
priority
Improving health outcomes
Healthy weight and tackling childhood obesity
Troubled Families
Early Intervention
Cross-
cutting
Reduce numbers of under 18s killed or seriously injured in road traffic collisions
Promote resilience/ improve mental health and wellbeing
Ensure children, young people & families shape, inform our work
Life-stage
priority

18. Variation in Health Outcomes
18
England Best England Average England Worse
Smoking in pregnancy 2.9 13.2 29.7
Preventable Infant Mortality 2.2 4.4 8.0
MMR immunisation (by age
2 years)
97.2 91.2 78.7
Killed/seriously injured in
road accidents
4.4 22.1 47.9
Obese children (4-5 years) 5.8 9.5 14.5
Hospital admissions due to
alcohol specific conditions
16.9 55.8 138.3
A&E attendances (0-4
years)
136.3 483.9 1,187.4
Source: Child and Maternal Health Intelligence Network, PHE, May 2013

19. Early Years
19

20. Why Early Intervention Matters
20
• A child’s early experience has a long lasting impact on the neurological
architecture of their brain and their emotional and cognitive development
• Pregnancy and birth a key time for change – parents have an instinctive
drive to protect their young and want their child to be healthy and happy
and do well in life
• Evidence that effective preventive interventions in early life can produce
significant cost savings and benefits in health, social care, educational
achievement, economic productivity and responsible citizenship
• There is scientific consensus that origins of adult disease are often found
in pregnancy and infancy

21. Consequences of neglect
21
Bruce Perry, Child Trauma Academy

22. Obesity -
Trends and Inequalities
22

23. 23
10.7%
9.1%
19.0%
15.8%
10.4%
8.8%
20.0%
16.6%
10.3%
8.9%
20.0%
16.5%
10.5%
9.2%
20.4%
17.0%
10.1%
8.8%
20.6%
17.4%
9.9%
9.0%
20.7%
17.7%
Receptionboys Receptiongirls Year 6 boys Year 6 girls
2006/07 2007/08 2008/09 2009/10 2010/11 2011/12
Prevalence of obesity by school year and sex
NationalChildMeasurementProgramme2006/07to2011/12
Child obesity: BMI ≥ 95th centile of the UK90 growth reference. 95% confidence intervals are displayed on the chart

24. 24
Obesity prevalence by deprivation decile
NationalChildMeasurementProgramme2011/12
Child obesity: BMI ≥ 95th centile of the UK90 growth reference
12.8%
14.4%
15.5%
17.0%
17.9%
19.7%
21.0%
22.5%
23.9% 24.2%
6.2%
7.2%
7.8% 7.9%
8.6%
9.5%
10.0%
10.8%
11.7%
12.4%
0%
5%
10%
15%
20%
25%
Least
deprived
Most
deprived
Obesity
prevalence
Index of Multiple Deprivation 2010 decile
Year 6
Reception

25. Alcohol and
Adolescence
25

26. 26
Alcohol use among young people in
England, 2011
• 45% of pupils had drunk alcohol, a decrease from the peak of 61%
in 2001
• 12% of pupils had drunk alcohol in the last week compared to 26%
in 2001
• 7% of pupils said they usually drank at least once a week,
compared with 20% in 2001
• Drinking alcohol in the last week is associated with age, ethnicity,
and other risky behaviours (smoking, drug taking and truancy)
The Health and Social Care Information Centre 2012

27. 27
Smoking, drinking and drug use
Smoking,drinkinganddruguseamongyoungpeopleinEnglandin2011
http://www.natcen.ac.uk/
0
10
20
30
40
50
60
70
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
%
Year
Ever drank alcohol
Ever smoked
Ever taken drugs

28. 28
Substance UseAmong Students in 36
European Countries
ESPAD2011
UK European Average
Alcohol use last 30 days 65% 57%
Heavy episodic drinking
past 30 days
52% 39%

29. Public involvement and participation
29 Presentation title - edit in Header and Footer
Understanding Public Health England
29

30. Public involvement benefits
Benefits will include:
• Supports the delivery of PHE’s Priorities for 2013-14 and help embed the
PHE Quality Framework in our work.
• Public health advice and services can be evaluated by the intended
recipients i.e. the people who should benefit from them.
• Help to validate our actions and plans by providing evidence which can be
both quantitative and qualitative.
• Meet the requirement for research funding bodies to have a public
involvement component in proposed projects.
30 title - edit in Header and Footer
Understanding Public Health England
30

31. Delivering our priorities
Public Involvement will enable PHE to:
• Involve the public in the promotion of a new narrative about prevention
and early intervention as well as the social determinants of health.
• Involve and work with people from ‘seldom heard’ communities so that
the health needs of those on the margins and otherwise overlooked have
national visibility.
• Work with partners especially in the community and voluntary sector to
improve the health and wellbeing of our citizens.
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Understanding Public Health England
31

32. Principles of PHE public involvement
• Work with the public as partners both directly and through advocates in the voluntary
and community sector to protect and improve the public’s health and well-being.
• When necessary, coordinate public consultations and share good practice across
PHE and with our health and care system partners.
• Listen to and value the contribution of the public, patients, service users, healthcare
professionals, managers, scientists and colleagues from partner agencies.
• Bring clarity to the purpose of involvement and how we will take forward suggestions
including explaining when we cannot do as the public ask.
• Ensure PHE involves and works with people from seldom heard and marginalised
communities whenever possible, using a community development approach.
• Go to where people are instead of expecting them to come to us.
• Incorporate evaluation into the way the PHE plans and delivers its public involvement
work.
• Report and provide evidence which demonstrates how public involvement contributes
to service improvement and development.
32 Understanding Public Health England

33. Methods of involvement
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Understanding Public Health England
33
There are a range of mechanisms for directly involving the public in PHE work. These
can include (not exhaustive):
• Public PHE meetings (Board meetings other programme boards)
• Participating in national or local meetings organised by community organisations
• Subject or condition specific focus groups
• Review / citizen panels
• Online feedback and surveys
• Social media
• Through representative groups and community organisations

34. Ladder of
participation
34 Presentation title - edit in Header and Footer
– Information
– Consultation
– Deciding together
– Acting together
– Supporting community
initiatives
Understanding Public Health England
34
Information Providing information to the public about new and emerging diseases such as a new
strain of pandemic influenza or providing advice on how to improve their health and
well being.
Methods include – print, broadcast and social media as well as leaflets, websites and
social marketing.
PHE activities: Public relations and marketing activities
Consultation Asking the public what they think about PHE strategies, plans and policies as well as
how it responses in emergencies, for example feedback on our priorities, business
plans and equality objectives.
Methods include – special meetings, discussion groups, questionnaires, online
surveys and forums.
PHE activities: People’s Panel questionnaires and discussion groups. (Level 1 and
2) See Appendix1 for definition of involvement levels.
Deciding
together
Developing ideas together with the public deciding about what improvements are
needed to the current services, priorities for change and what sort of solutions might
be appropriate for PHE to implement.
Methods include – deliberative events and community development activities
including those aimed at the hard to reach and marginalised.
PHE activities: Equality Forum hosting seminars for stakeholders or running Citizen’s
Juries. (Level 2)
Acting together All the stages of deciding together but in addition would include an element of public
involvement in the implementation phase – e.g. involvement in planning, writing and
producing public health information.
Methods include – partnership building working through partnership bodies.
PHE activities: Members of the People’s Panel who sit on PHE working groups and
committees. (Level 3)
Supporting
community
initiatives
A group of people who have experience of health inequality eg developing a
community-led resource to improve the health and well-being of a hard to reach
community.
Methods include – capacity building through advice, support and funding.
PHE activities: Engaging with the public through voluntary and community sectors
organisations

35. PHE People’s Panel
• ‘People’s Panel’ - almost 1000 people across England are part of the panel
forming the largest consumer panel of its kind in the country. The People’s
Panel was established as an innovative way to engage with the public about
health priorities, information and services. Membership was drawn from two
national random samples giving a unique and valuable insight into public
health issues that the public feels are important and how they understand
and respond to health information.
35

36. Public involvement at local level
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Existing structures for local PHE to involve the public include:
• PHE has made it a priority for local centres to be active partners in their health
system; this includes the voluntary and community sector. PHE national will help
to support the sharing of good practice to raise awareness of local initiatives.
PHE will also promote existing national initiatives. At regional and local level, the
voluntary and community sector have a clear role to play as advocates,
mediators and facilitators at local level and across specific community groups.
• There are opportunities to build on involvement with HealthWatch. Currently a
member of the national steering group for HealthWatch England sits on the PHE
Equality Forum and members have taken part in workshops to set up
HealthWatch in their various local authority areas. This contributes to the
assurance element of the PHE Quality framework for a ‘Public Voice’.
Understanding Public Health England
36

37. Working in partnership with and through the
Voluntary and Community Sector (VCS)
PHE will work in partnership with the VCS to achieve progress on improving
the public’s health and wellbeing, and tackling inequalities.
‘Wewillworkalongsidethevoluntarysectoranddoallwecantohelpgetthem“intotheroom”
toco-designservicesthatareintegratedaswellas,ofcourse,deliveringthem.Onewithoutthe
otherrathermissesthepoint.
…itisinconceivablethattheVCScouldnotbeapartnerinrelationtothediscussionsabout
howtomakethingsbetter.
…Itwouldtakethestatutorypublichealthsystem10yearstohaveafractionoftheirimpactand
reach… Thereisanarmywaiting–everythingfromfaithgroupstotheBritishRedCross.Itis
stunning.’ Duncan Selbie, Chief Executive, Public Health England:
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38. Working in partnership with the VCS
WhatwehaveheardsofarfromSectorleaders:
• an open and honest relationship with regular communication
• early involvement with a focus on action – be clear and practical about purpose,
use ‘task and finish’ groups
• avoid a single approach to the Sector; adapt to organisations and purpose
• regular one to one contacts or forums for organisations across the Sector
• some saying avoid siloed engagement with the Sector but create purposeful,
dynamic engagement across Sectors
• use existing forums, e.g. Strategic Partner Programme, Active Communities
Development Group where possible and align engagement with other system
leaders
• collaborate and share information and resources with the community – e.g. in
health promotion materials and campaigns
38 Public Health England and VCSE Sector

39. How can we make a difference?
• Use knowledge about risk and what builds resilience
• Promote evidence and learning from practice about what works
• Combine targeted help for those most at risk with universal interventions
• Take a life course and place-based approach –schools, families, and
communities
• Work in partnership, taking a coordinated and collaborative approach,
recognising strengths of different partners and using resources effectively
• Listen and act on what children, young people and carers tell us
39

40. PHE Contacts
PHE’swebsiteis www.gov.uk/phe
YoucanfollowusonTwitter@PHE_uk
Seealso
• www.chimat.org.uk
• www.hscic.gov.uk/
• www.earlyinterventionfoundation.org.uk
Ifyouwouldliketogetintouchpleasecontact
EustacedeSousa –eustace.desousa@phe.gov.uk
Iain.Mallett –iain.mallett@phe.gov.uk
LorraineThomas –lorraine.thomas@phe.gov.uk.
40 Public Health England and VCSE Sector