No child left behind - GOV.UK

1 No child left behind A public health informed approach to improving outcomes for vulnerable children No child left behind : public health informed approach to improving outcomes for vulnerable children 2 About Public Health England Public Health England exists to protect and improve the nation s health and wellbeing and reduce health inequalities. We do this through world-leading science, research, knowledge and intelligence, advocacy, partnerships and the delivery of specialist public health services. We are an executive agency of the Department of Health and Social Care, and a distinct delivery organisation with operational autonomy.

2 We provide government, local government, the NHS, Parliament, industry and the public with evidence-based professional, scientific and delivery expertise and support. Public Health England Wellington House 133-155 Waterloo Road London SE1 8UG Tel: 020 7654 8000 Twitter: @PHE_uk Facebook: Crown copyright 2020 You may re-use this information (excluding logos) free of charge in any format or medium, under the terms of the Open Government Licence To view this licence, visit OGL. Where we have identified any third-party copyright information you will need to obtain permission from the copyright holders concerned.

3 Published September 2020 PHE publications PHE supports the UN gateway number: GW-1202 Sustainable Development Goals No child left behind : a public health informed approach to improving outcomes for vulnerable children 3 Contents About Public Health England 2 Executive summary 4 Identifying and meeting needs 6 Social determinants and vulnerable children 7 Reducing risk and building protective factors 8 Risk and protective factors 8 PHE resources to support action on childhood vulnerability 12 Supporting positive parenting 13 Preconception and pregnancy 15 Early years (0 to 4 years) 15 School-age and young adulthood (5 to 24 years)

4 17 Working at the local level 25 Conclusions 26 Glossary 27 References 30 No child left behind : a public health informed approach to improving outcomes for vulnerable children 4 Executive summary This report is intended for leaders and practitioners nationally, regionally and locally concerned with improving outcomes for children and young people. It aims to support directors of public health, working with their local partners, to inform coordinated approaches to reduce the number of children who are vulnerable to poor health and wellbeing and to take action to mitigate risks of poor outcomes.

5 It will be of interest to integrated care systems in planning services which are preventive and protective. Our aim is to promote an approach that considers both the adversities children experience and also factors likely to make children more vulnerable to poor outcomes. For the purposes of this report, vulnerable children are defined as any children at greater risk of experiencing physical or emotional harm and/ or experiencing poor outcomes because of one or more factors in their lives. The report sets out how adopting a public health informed approach offers substantial opportunities to reduce inequalities and improve health and wellbeing outcomes for the most vulnerable children.

6 The approach advocates for action across organisations to reduce vulnerability and the potential harm of adverse childhood experiences. The report sets out an approach which encompasses preventing such occurrences, intervening early when problems arise and creating an environment throughout the life course where negative impact is mitigated. Action is required that considers: the individual level, where the approach emphasises that poorer circumstances and adverse experiences in a person s early life do not lead inevitably to poorer opportunities and outcomes but places children at increased risk of disadvantage family and other care settings which provide a safe and secure environment are an essential protective factor so that, even when circumstances may mean that a child is at greater risk of poorer outcomes, they are more resilient.

7 Thus reducing the potentially harmful impact a place based public health approach to prevention emphasises the role of the community in creating environments where the right conditions are in place to support children to thrive By using a public health informed approach to primary prevention, early intervention and mitigation, Public Health England (PHE) intends to promote action with partner No child left behind : a public health informed approach to improving outcomes for vulnerable children 5 organisations across sectors to ensure that every child grows up healthy, safe and able to achieve their full potential, regardless of where they live or their family circumstances.

8 The COVID-19 pandemic raises specific considerations which can be usefully placed in the broader context of childhood vulnerability discussed in this report. Current research suggests that, while children of all ages have been diagnosed with COVID-19, symptoms are generally mild and death very rare (1). PHE, NHS England and partners have developed a framework for vulnerability to support child and young person-centred recovery for 3 broad groups which are: a group of children who may be more clinically vulnerable to COVID-19 because they have underlying health conditions or the pandemic has in some way delayed or curtailed their access to health services.

9 Children and families who are at increased risk due to family and social circumstances where there is a statutory entitlement for care and support (education, health and care plan and those with a social worker) children who may be at higher risk due to being negatively impacted through wider determinants of health and/or family stressors and social circumstances and may not be known to services Children may be in more than one group, and children not previously identified as vulnerable may have become so, as the economic and social impact of the pandemic are felt in the family.

10 Studies also indicate that children and young people are being affected by the changes the pandemic has brought to their lives, including to their education, time with family and to their emotional health and wellbeing (2). More generally, the underlying wider community and social conditions which can make children more vulnerable which existed before the pandemic are likely to remain; these are the focus of this report. We summarise PHE actions and resources to improve outcomes for children, young people and their families and how the work of public health and its partners can help children realise their full potential, drawing on work from across the UK (3-6).