NHS staff and parents to gain access to crucial child health information

NHS Digital | April 2019 | NHS staff and parents to gain access to crucial child health information

A new live service which enable access to important child health information at the point of care for health professionals has been launched by the NHS.

The service, the National Events Management Service, securely publishes information on key health interventions for children. Parents and health professionals can securely receive information digitally and use it to inform decisions on care and treatment, the service is the result of collaboration between NHS Digital and NHS England with IT suppliers.

hearth-1674896_640.png

The service shows which preventative interventions a child has received; improving the speed of diagnosis and treatment by giving health visitors and parents access to the same information sources at the same time.

The service has initially launched in North East London in partnership with North East London Foundation Trust (NELFT) and their health visiting and child health services. IT suppliers which already support the Trust have connected their products to the new service.

Full details from  NHS Digital

 

Teenage mothers and young fathers: support framework

Public Health England | April 2019 |Teenage mothers and young fathers: support framework

Public Health England’s (PHE) framework for supporting teenage mothers and young fathers- Teenage mothers and young fathers: support frameworkhas been updated.

Commissioners and service providers can use this framework as a multi-agency self-assessment tool to review local services, identify gaps in provision and look at the likely impact and effectiveness of each aspect of local support for young parents.

The teenage parent outcomes modelling tool should be read alongside this framework because it brings together data and evidence about factors that affect outcomes for teenage parents and their children.

The teenage pregnancy narrative reports bring together key data and information for local authorities to help inform commissioning decisions to reduce unplanned teenage conceptions and improve outcomes for young parents.
The document is available from PHE

Introducing asthma guidance in Shropshire schools

NHS England | April 2019 | Introducing asthma guidance in Shropshire schools

School nurses in Shropshire have developed and implemented asthma management guidance to provide support and treatment for school children with asthma. 

At the outset the school nursing team undertook an audit of primary and secondary children across Shropshire. Responses demonstrated that:

  • 10% of pupils with asthma had an asthma care plan in place
  • 44% of schools had written guidelines on managing an acute asthma episode
  • 57% of schools had received education and training to support them to manage children with asthma conditions
  • 50% of asthma inhalers kept by schools weren’t appropriate for pupils to use efficiently during an attack

children-602977_640.jpg

As a result of this a steering group was established and the group produced guidance on managing asthma in school:

  • Schools should have an identified asthma lead who will act as a key contact and take responsibility in ensuring oversight and coordination of the guidance principles into practice, as well as staff education, training and support;
  • School staff should ensure that children with asthma have their relieving medication with them in school and take steps where this isn’t the case to maximise safety;
  • Children with asthma should have easy access to their relieving medication at all times while in school;
  • Children with asthma should have an individual healthcare plan highlighting their specific triggers and symptoms;
  • School staff should document when children take their medication, self-administered or otherwise; and,
  • School staff should be equipped and trained to manage an acute asthma attack within the school setting. (Source: NHS England)

 

 

Global, national, and urban burdens of paediatric asthma incidence attributable to ambient NO2 pollution: estimates from global datasets

Achakulwisut, P., Brauer, M., Hystad, P., Anenberg, S. | 2019 | The Lancet Planetary Health | DOI:https://doi.org/10.1016/S2542-5196(19)30046-4

Paediatric asthma is associated with exposure to traffic-related pollution (TRAP) but this burden remains poorly quantified. A global study (which used data from 194 countries) from George Washington University finds that around 13 per cent of new cases of asthma worldwide are caused by pollution.  Nitrogen dioxide (NO2) is a major component and common proxy of TRAP; this study estimated the annual global number of new paediatric asthma cases that could be attributed to NO2 exposure.  The research team recommend that the WHO’s guidelines for ambient  NO2 concentrations might need to be revisited as new diagnoses of paediatric asthma are in areas within WHO levels.

architecture-asian-bird-s-eye-view-186537.jpg

 

Background

Paediatric asthma incidence is associated with exposure to traffic-related air pollution (TRAP), but the TRAP-attributable burden remains poorly quantified. Nitrogen dioxide (NO2) is a major component and common proxy of TRAP. In this study, we estimated the annual global number of new paediatric asthma cases attributable to NO2 exposure at a resolution sufficient to resolve intra-urban exposure gradients.

 

Methods

We obtained 2015 country-specific and age-group-specific asthma incidence rates from the Institute for Health Metrics and Evaluation for 194 countries and 2015 population counts at a spatial resolution of 250 × 250 m from the Global Human Settlement population grid. We used 2010–12 annual average surface NO2 concentrations derived from land-use regression at a resolution of 100 × 100 m, and we derived concentration-response functions from relative risk estimates reported in a multinational meta-analysis. We then estimated the NO2-attributable burden of asthma incidence in children aged 1–18 years in 194 countries and 125 major cities at a resolution of 250 × 250 m.

 

Findings

Globally, we estimated that 4·0 million (95% uncertainty interval [UI] 1·8–5·2) new paediatric asthma cases could be attributable to NO2pollution annually; 64% of these occur in urban centres. This burden accounts for 13% (6–16) of global incidence. Regionally, the greatest burdens of new asthma cases associated with NO2 exposure per 100 000 children were estimated for Andean Latin America (340 cases per year, 95% UI 150–440), high-income North America (310, 140–400), and high-income Asia Pacific (300, 140–370). Within cities, the greatest burdens of new asthma cases associated with NO2 exposure per 100 000 children were estimated for Lima, Peru (690 cases per year, 95% UI 330–870); Shanghai, China (650, 340–770); and Bogota, Colombia (580, 270–730). Among 125 major cities, the percentage of new asthma cases attributable to NO2 pollution ranged from 5·6% (95% UI 2·4–7·4) in Orlu, Nigeria, to 48% (25–57) in Shanghai, China. This contribution exceeded 20% of new asthma cases in 92 cities. We estimated that about 92% of paediatric asthma incidence attributable to NO2 exposure occurred in areas with annual average NO2 concentrations lower than the WHO guideline of 21 parts per billion.

Interpretation

Efforts to reduce NO2 exposure could help prevent a substantial portion of new paediatric asthma cases in both developed and developing countries, and especially in urban areas. Traffic emissions should be a target for exposure-mitigation strategies. The adequacy of the WHO guideline for ambient NO2 concentrations might need to be revisited.

Early access to mental health support: Over a third of local areas in England reduce real terms spending on low level children’s mental health services

Children’s Commissioner | April 2019 |Over a third of local areas in England reduce real terms spending on low level children’s mental health services

The Children’s Commissioner has published a report today (Wednesday 10 April) that looks at the amount spent on “low-level” mental health support. These are preventative and early intervention services for treating problems like anxiety and depression or eating disorders, for example services provided by school nurses or counsellors, drop-in centres or online counselling services.

The report highlights variations between between areas in how much funding is available: the top quarter of local areas spent at least £1.1 million or more, while the bottom 25 % spent £180,000 or less. The overall total spending figure of £226 million
includes a small number of very high spending areas masking a larger proportion of low spending areas.

cyclone-fence-daylight-looking-2019352

The report identifies a regional variation on low level mental health spend:

In the financial year 2018/19, reported per child spend on low-level mental health services was higher in London and the North East, and lower in the East Midlands, the East and the South East. In London, local authority spending per child was £17.88 per child, compared to only £5.32 per child in the East of England. CCG spend per child is highest in the North of England (£12.76 per child) and lowest in the Midlands & East (£5.83 per child). Spend per child in predominantly urban areas was slightly higher than in more rural areas.

Although the total spend on low-level mental health services across all areas in England increased by 22% between 2016/17 and 2018/19 in cash terms, and by 17% in real terms, over a third of areas around the country still saw a real-terms fall in spending – with nearly 60% of local authorities seeing a real-terms fall. Given the focus on improving access to children’s mental health, these reductions are concerning.

The report recommends that the government increase its focus on local spending on early access support for children with mental health problems, and that it repeat this data gathering exercise to monitor what progress has been made.
There should also be more pressure on LAs and the NHS to work together to ensure that each area has a joined-up plan to support children who do not require specialist care, and those areas which are reducing funding must be held to account (Source: Children’s Commissioner).

Press release: Over a third of local areas in England reduce real terms spending on low level children’s mental health services

Report: Early access to mental health support

Early access to mental health support technical report 

In the news:

BBC News Children’s mental health services ‘postcode lottery’

The Guardian Children who need help with mental health face postcode lottery – study

Child sexual exploitation: prevention and intervention

Public Health England | April 2019 | Child sexual exploitation: prevention and intervention

Public Health England (PHE) have updated the report Child sexual exploitation: prevention and intervention. PHE have produced an evidence summary and framework to support local public health leaders to prevent and intervene early in cases of child sexual exploitation.

The report  summarises the emerging evidence from the UK on the issue of child sexual exploitation. It provides practice examples to support local public health leaders to establish a public health framework for prevention and intervention.

The literature search is a summary of the latest international research about effective interventions to prevent child sexual abuse and child sexual exploitation (Source: Public Health England) .

Child sexual exploitation: how public health can support prevention and intervention

Literature search to identify the latest international research about effective interventions to prevent child sexual abuse and child sexual exploitation