All children are equal…..but outcomes are not. Peter Lauener Director, Local Transformation DCSF Health inequalities conference 20 May 2008

“children wish for so much but can arrange so little of their own lives which are so often dominated by adults without sympathy for children’s priorities ” Bruno Bettleheim, recollection and reflections (1990)

CSR07 Performance Framework Be Healthy Stay Safe Enjoy & Achieve Positive Contribution Economic Wellbeing PSA 12 Improve the health and wellbeing of CYP PSA 13 Improve CYP safety PSA 10 & 11 Raise educational achievement and narrow achievement gap PSA 14 Increase the number of CYP on the path to success PSA 9 Halve child Poverty by Eradicate by 2020 (HMT) National Indicator Set Local Area Agreements

60,000 looked after at any one point in time two thirds in foster care 66% looked after as a result of abuse or neglect half 5-17 yr olds with a mental health disorder (4 times higher than all children) 46% of children in prison have been looked after one in ten children in care attained 5 good GCSEs in 2005, compared with more than half of all children 6% of 19 year olds go into higher education compared with 40%+ of all young people Outcomes for looked after children

Priority health challenges for children and young people in EnglandHealth inequalities issue? Accidents Oral health Obesity Substance misuse Low birth weight and infant mortality Sexual health Life chances for children with disabilities Outcomes for acute episodes of illness Communicable disease Mental and emotional health Life-limiting diseases Long-term conditions Many of the major challenges for children’s health in England are particularly problematic for children from more disadvantaged backgrounds And while these conditions may not always be more prevalent in poorer families, poorer families often find them harder to manage

Top 20 most commonly proposed national indicators where there is a match between Government and local areas’ priorities in Local Area Agreements RankNI ref no Top 20 Indicators in LAAS LAA s to 18 year olds who are not in education, employment or training (NEET) Under 18 conception rate Per capita reduction in CO2 emissions in the LA area Number of affordable homes delivered (gross) Obesity among primary school age children in Year Proportion of population aged for males and for females qualified to at least Level 2 or higher97 716Serious acquisitive crime rate Net additional homes provided Stopping smoking89 101% of people who believe people from different backgrounds get on well together in their local area86 114% of people who feel they can influence decisions in their locality All-age all cause mortality rate83 138Adult participation in sport and active recreation Re-offending rate of prolific and other priority offenders Assault with injury crime rate Social Care clients receiving Self Directed Support per 100,000 population Carers receiving needs assessment or review and a specific carer's service, or advice and information Young people's participation in positive activities Rate of hospital admission per 100,000 for alcohol related harm New business registration rate75

1.NI 117 – 16 to 18 year olds who are not in education, employment or training (NEET) = NI 112 – Under 18 conception rate = NI 56 – Obesity among primary school age children in Year 6 = 98 4.NI 120 – All-age all cause mortality rate = 88 (DH indicator, with a DCSF interest) 5.NI 110 – Young people's participation in positive activities = 77 6.NI 111 – First time entrants to the Youth Justice System aged 10 – 17 = 74 7.NI 19 – Rate of proven re-offending by young offenders = 48 (MoJ indicator, with a DCSF interest) 8.NI 116 – Proportion of children in poverty = 48 9.NI 51 – Effectiveness of child and adolescent mental health (CAMHs) services = NI 79 – Achievement of a Level 2 qualification by the age of 19 = 36 Top 10 Indicators for children in LAAS

Integrated Working Children’s Trusts “to have in place by 2010 consistent high quality arrangements to provide identification and early intervention for all children who need additional help” Essential features targeted early intervention services integrated with universal settings, e.g. through multi-agency teams in and around schools more specialist services easily available and accessible from universal settings processes and pathways connecting up services, e.g through embedding the CAF schools and other universal settings knowing the children they work with and, if necessary, assessing needs though CAF and engaging targeted/specialist services universal settings and staff in wider services working together to provide joined up support coordinated by a lead professional

Universal Targeted Specialist 0 19 a continuum of support and opportunity Children’s Trusts

Universal Targeted Specialist Specialist Services Health Early Years and Children’s Centres Schools Youth Services 0 19 a continuum of support and opportunity Children’s Trusts

Specialist Services multi-agency locality teams Universal Targeted Specialist 0 19 a continuum of support and opportunity Workforce Health Early Years and Children’s Centres extended Schools integrated Youth Services Lead Professionals CAF ContactPoint Parents Third sector Children’s Trusts

Integrated Working

Key Delivery Challenges Improvement Support – where it’s needed with the right expertise School of the 21 st century Co-location of services and integrated working Development of the whole children’s workforce Children’s Trusts Better commissioning