UK Government

Department of Health: From minus nine months - How children’s services should be shaped from conception

Press Release   •   Sep 17, 2010 10:19 BST

A huge cultural shift is required across health services in order to meet the needs of children and young people and take the service from its current ‘mediocre state’, according to Professor Sir Ian Kennedy’s review published today.

The review, Getting it right for children and young people - Overcoming cultural barriers in the NHS so as to meet their needs, states that the single most important change in the NHS will be able to make sure children’s health services are prioritised, as highly as adult services are, from ‘minus nine months’; the moment a child is conceived.

Welcoming Sir Ian’s report, Secretary of State for Health Andrew Lansley today published an engagement document, Achieving Equity and Excellence for Children. This sets out what the recent White Paper will mean for children, and explores how the challenges Sir Ian poses can be better tackled in future.

Professor Kennedy found that although there are some excellent services from which others might learn, a large number are in need of significant improvement. Standards of care across the country were shown to vary, with some health services lacking co-ordination and struggling to communicate effectively across the complex array of organisations, units and teams.

Data collection, necessary for effective management of services, is described as poor or non-existent in many areas of healthcare for children and young people. The findings also call for a review of how young patients are progressed from children’s to adult care. Currently, under what Professor Kennedy describes as “a phenomenon created by the system”, young patients are arbitrarily moved from children’s services to adults services because they turn 16 or 18, regardless of their needs.

The review recommends focus be given to getting policy right, for GPs to be given additional paediatric training and for  investment to be shifted towards  children and young people’s health services.

Other key recommendations of the review include:

· creation of a single point of responsibility for children’s health and wellbeing, linked in to other public services used by children, with an identified funding stream for their health and healthcare. This will ensure a more unified and holistic approach to their welfare and should be a Local Partnership;

· a shift of investment by the NHS, especially towards early years and mental health, to improve lives in the long-term, as well as improve cost effectiveness;

· a focus on prevention, early intervention and wider well-being instead of the current model of treating illness and injury;

· responsibility for policy relating to children’s healthcare and wider well-being be brought together; and

· the professionals caring for children should train together, to a common curriculum. This will foster the mutual trust and teamwork that are at the core of high quality services.

Professor Sir Ian Kennedy, said:

“As I’ve gathered evidence for this review, I have seen enthusiasm, commitment and a real sense of duty in the health service. I am grateful to all those who have helped me with their insights.

“Unfortunately, in assessing how the NHS meets the needs of children and young people, I have found many barriers. They were created, and operate, at a staggering number of levels, from Whitehall right down to patients. These myriad systems can make life  impossible for the children, young people and their families who desperately need the services that the NHS exists to provide.

“We must shift investment towards  children and young people and the staff who work tirelessly to help them. This has to happen now, and be there from the moment a child is conceived.”

Secretary of State for Health, Andrew Lansley, commented:

“Sir Ian Kennedy’s review has revealed the true scale of the issues facing the health service. It tells us important things about the lack of effective, integrated and responsive services we have inherited. Sir Ian reminds us just how important the start of life is for children and young people’s future physical and mental development.

“In our new vision for the NHS, and in preparing for our public health White Paper later this year, we are determined to provide for children and young people as an essential and integral part of delivering better health outcomes.

“We are today ensuring that, informed by Sir Ian's report and in line with the new focus in the White Paper on patient-centred care, we shape the future of children and young people's services to meet their needs more effectively by improving health outcomes to be amongst the best in the world, through more devolved, locally integrated service provision.

“We welcome views on the action needed, locally and nationally to make this vision a reality.”

Sir David Nicholson, Chief Executive of the NHS, said:

"I would like to thank Sir Ian for such a thorough review. I commissioned this review as we can do more to meet the needs of children and young people. Changing the whole culture of the health service won't be easy, and it can't be done without invaluable advice from the health professionals and other experts, including voluntary groups and, of course, families, who dedicate their lives to it. We can tackle the issues head on, together."

A copy of the review can be found by visiting:

www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_119445

Notes to editors

  • Professor Sir Ian Kennedy’s review, Getting it right for children and young people - Overcoming cultural barriers in the NHS so as to meet their needs, can be downloaded here: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_119445
  • The Government’s White Paper Equity and Excellent: Liberating the NHS, can be downloaded here: www.dh.gov.uk/liberatingthenhs
  • The engagement document, Achieving Equity and Excellence for Children can be downloaded here: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_119449
  • For media enquiries, please contact the Department of Health news desk on 020 7210 5221.
  • Biographical information: Professor Sir Ian Kennedy LLD is a lawyer who, for the past few decades, has lectured and written on the law and the ethics of healthcare.  He was chairman of the Healthcare Commission from its inception in 2003 until its merger into the Care Quality Commission in 2009. He is also Emeritus Professor of Health Law, Ethics and Policy at the School of Public Policy, University College of London and Visiting Professor at the London School of Economics.  He is a former Dean of the Law School (1986-96) at King’s College London and President of the Centre of Medical Laws and Ethics, which he founded in 1978.  He gave the Reith Lectures in 1980.  He was a member of the GMC for nine years and has been a member of the Medicines Commission and the Department of Health’s advisory group on AIDS, Chairman of the public inquiry (1998 – 2001) into paediatric cardiac surgery at Bristol, a government inquiry (1997), into xenotransplantation (the use of animal-to-human transplants), and an inquiry (1998) that recommended changing the law relating to quarantine for animals being brought into the UK from abroad. He is a Fellow of the British Academy (FBA) (2002) and a Fellow of both King’s College, London and University College, London.  He was awarded an Honorary DSc by the University of Glasgow in July 2003. He is an Honorary Fellow of the Royal College of General Practitioners (2002), Royal College of Physicians (2003), Royal College of Paediatrics and Child Health (2004), Royal College of Anaesthetists (2004) and Royal College of Surgeons of Edinburgh (2005).  He was awarded an honorary degree of Doctor of Medicine by the University of Birmingham (2006).  He was Knighted for services to medical law and bioethics in 2002. Professor Sir Ian Kennedy is currently chair of the Independent Parliamentary Standards Authority.
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