FROM FRAGMENTATION TO INTEGRATION Children’s Health and Wellbeing in the West Midlands Setting an Agenda Adrian Phillips Director of Public Health Birmingham

WHY? National focus on academic performance NHS focus on Adults Some political emphasis on Health Visitors Child poverty losing appeal BUT –Biggest demographic change –Large cultural change –Massive communication change

WHAT? Early intervention –Adults who were looked after children comprise 25 – 40% of prison inmates –Looked after children are single biggest group of youth offenders –Children living in “abuse” or “violent” families are more likely to become a victim or perpetrator of abuse or violence

WHAT ELSE? Prevention –Infant mortality West Midlands remains an outlier (apart from Hereford) –Obesity It is a real issue across the region

Emerging Evidence Real evidence –Dartington, Warwick, Bangor etc., Evidence can be applied at scale –USA First check: –Are services evidence-based? –Are services applied at scale? –Are services getting the right children? Then: –Are ineffective services being decommissioned?

Some interesting issues.. Infant Mortality –Why are we different? –Is it real? What do the demographic and cultural changes mean? Why has teenage pregnancy rates dropped? What else should we look at? What are the long term effects of high youth unemployment?

Integration for Better Outcomes Children to People –Life course care –Dependency of adults on their childhood Safeguarding to Vulnerability –Safety and shelter –Partners and partnerships Ill-health to Wellbeing –Disability –Healthy choices and behaviour Theory to Practice –Practical interventions, esp CCGs Information to Intelligence –Seizing opportunities of rapid change –Using local intelligence