Barriers to joined-up working, insufficient focus on prevention persist in child health services in new NHS

Dec 18 2013

Barriers to joined-up working and an insufficient focus on prevention appear to persist in child health services in the reformed NHS, according to the results of a survey published today.

The poll of child health professionals and service user representatives carried out by leading children’s charity The National Children's Bureau and the NHS Confederation found that a worrying number (66%) believe acute care is still given priority over prevention, while nine out of ten respondents (89%) feel schools' potential to support good child health is not yet being fully utilised. 

Despite these concerns, the survey did reveal some encouraging findings, with, for example, 63% of recipients being positive about their local health and wellbeing board's ability to engage the right people to improve services for children. In addition, the majority of recipients feel there is a shared agenda for promoting children's health and wellbeing across national government and its arms length bodies. However, a vast number of respondents believed recent reforms have done little or nothing at all to remove structural barriers to integrated commissioning and delivery of child health and related services. There was also some anxiety about ‘fragmentation of commissioning’ expressed in the detailed comments provided by respondents.

In their report on the results from the survey, the National Children’s Bureau and the NHS Confederation call for cross agency working to be supported through greater clarity of responsibilities and facilitation of joined up commissioning and delivery of services. They highlight the need to better harness the contribution of other services such as schools as part of a prioritisation of prevention and early intervention. It is also said that further collaboration is needed to secure effective involvement of children and young people in the health service.

Dr Hilary Emery, Chief Executive of the National Children’s Bureau, said:

"This study provides a useful snapshot of the mood within the NHS and how those commissioning and delivering services for children perceive the impact of recent reforms. There is cause for optimism:  for example there may be a more widely-shared agenda between stakeholders to improve child health. But there are familiar problems too, and work must be done to support the integration of services, particularly for those with complex health needs, while strengthening preventative measures and fully involving children in decision-making."

Dr Johnny Marshall, Director of Policy for the NHS Confederation, said:

"The people we surveyed are at the sharp end of delivering health services for children and young people, and their views give us a crucial 'progress report' on how we are delivering improvements in health services for children and young people. 

"There is no doubt that as the NHS reform programme has been implemented over the past six to nine months, it has required a strong focus to ensure we do not slip backwards in delivering for children. 

"But sustaining our position is not good enough for the future - we owe it to our children and young people to help them live healthy lives, and to involve them in how they want us to do this."