3.42. A key message from stakeholders during the development of the Long Term Plan was that the needs of children are diverse, complex and need a higher profile at a national level. We will therefore create a Children and Young People’s Transformation Programme which will, in conjunction with the Maternity Transformation Programme, oversee the delivery of the children and young people’s commitments in this Plan.

3.43. We will prioritise improvements in childhood immunisation to reach at least the base level standards in the NHS public health function agreement. The programme will also work closely with other areas of government and key programmes such as the Healthy Child Programme.

3.44. Children and young people account for 25% of emergency department attendances [103] and are the most likely age group to attend A&E unnecessarily [104]. Many of these attendances could be managed effectively in primary care or community settings [105]. As set out in Chapter One, local areas will design and implement models of care that are age appropriate, closer to home and bring together physical and mental health services. These models will support health development by providing holistic care across local authority and NHS services, including primary care, community services, speech and language therapy, school nursing, oral health, acute and specialised services. The Starting Well Core initiative is supporting 24,000 dentists across England to see more children from a young age to form good oral health habits, preventing tooth decay experienced by a quarter of England’s five year olds.

3.45. From 2019/20 clinical networks will be rolled out to ensure we improve the quality of care for children with long-term conditions such as asthma, epilepsy and diabetes. This will be achieved though sharing best clinical practice, supporting the integration of paediatric skills across services and bespoke quality improvement projects.

3.46. Over the next five years, paediatric critical care and surgical services will evolve to meet the changing needs of patients, ensuring that children and young people are able to access high quality services as close to home as possible. Paediatric networks, which will involve hospitals, NHS staff and patients and their families, will ensure that there is a coordinated approach to critical care and surgical services, enabling children and young people to access specialised and non-specialised services in times of urgent, emergency and planned need.

3.47. Selectively moving  to a ‘0-25  years’ service will improve children’s experience of care, outcomes and continuity of care. Currently children can ‘transition’ to adult services from as young as 12 years old. Failure to achieve a safe transition can lead to disengagement, failure to take responsibility for their condition and ultimately poorer health outcomes. By 2028 we aim to move towards service models for young people that offer person-centred and age appropriate care for mental and physical health needs, rather than an arbitrary transition to adult services based on age not need.

References

103. RCPCH. (2018) Child health in 2030 in England: comparisons with other wealthy countries. Available from:
https://www.rcpch.ac.uk/sites/default/files/2018-10/child_health_in_2030_in_england_-report_2018-10.pdf

104. McHale, P., Wood, S., Hughes, K., Bellis, M., Demnitz, U. & Wyke, S. (2013) Who uses emergency departments inappropriately and when – a national cross-sectional study using a monitoring data system. BMC medicine. 11. 258. 10.1186/1741-7015-11-258

105. McHale, P., Wood, S., Hughes, K., Bellis, M., Demnitz, U. & Wyke, S. (2013) Who uses emergency departments inappropriately and when – a national cross-sectional study using a monitoring data system. BMC Med. 11, 258. Available from: https://doi.org/10.1186/1741-7015-11-258