In care

Draft public health guidance from NICE focuses on the physical and emotional health and wellbeing of looked after children. The guidance, which has been developed by NICE and the Social Care Institute for Excellence (SCIE), is expected to be released in its final form in September. Key recommendations include the need to commission services that are “integrated, preferably on the same site,” provision for the team around the child of a “consultancy service to help consider and work collaboratively on complex cases and situations” and access to specialist services for babies and children under 5 “which offer early and preventive interventions for babies and young children to avoid placement breakdown.” Also, because of the high level of emotional and mental health issues amongst looked after children and young people, there is, throughout the recommendations, a strong focus on Child and Adolescent Mental Health Service (CAMHS) input. Responses should reach NICE by 16 April 2010.

All change

More annual reporting, this time from Change4Life, which is also a year old. But have the delightful plasticine figures made a difference? Targeting families with children aged 5-11, the strategy has made a definite hit on the brand recognition front and (according to their own tracking group) mothers have made changes to their children’s diet or activity levels. Change4Life analysis also looked at food buying behaviour. In a pilot study using Tesco Clubcard data, researchers found that the Change4Life households did “contain a large proportion of lower income families” and that there had already been some changes in purchasing, such as choosing low-sugar drinks.
Recent articles from BMC Public Health take a slightly more sober view of lifestyle change interventions: Is there a demand for physical activity interventions provided by the healthcare sector? and The influence of a high intensity physical activity intervention on a selection of health related outcomes both provide interesting reading.

How are we doing?

The Oneplace initiative and the Comprehensive Area Assessment which under pins it, offers the public a scorecard view of local service provision via a website. Oneplace has published a report of its first year, bringing together judgments from a range of inspectorates, including the Audit Commission, the Care Quality Commission, Ofsted and others. The report provides a rather broad brush approach (red and green flags) but includes the usual examples of good practice.

Language gap

The educational charity, the Sutton Trust, has published a report on the impact of "cognitive gaps in the early years," as shown especially in language skills. Using the Millennium Cohort Survey, researchers found that children from the poorest families are nearly a year behind their peers from middle income families at age 5. The report identifies good parenting and a supportive home environment as key factors and suggests, amongst other ideas, that outreach projects from Sure Start are the way ahead.

New Deal for Health?

More evaluation of the New Deal for Communities programme (see Fair's Fair 19 January for earlier reports), this time looking at health outcomes. There's a focus on projects in the four NDC case study areas, Fulham, Hackney, Salford and Sandwell, as well as considering more generally how NDC partnerships work and looking at how these kinds of initiatives can be sustained.

A healthy start

The Audit Commission has cast its beady eye over local implementation of government policy for children aged 0-5 during the past ten years. Giving children a healthy start looks at the impact of government funding on the health of under fives, considering how well local agencies manage the finances on offer and how far they are providing value for money. The report also discusses means to improve service delivery to vulnerable and hard-to-reach populations, such as lone and teenage parents and BME groups. Initiatives like Sure Start and the Healthy Child Programme are duly namechecked. However, criticism, when it comes, is reserved for lack of strategic commitment, with under fives' health "not always reflected in strategic plans, and ... rarely given priority in local area agreements (LAAs)." Along with the report, there's also a video showcasing some local initiatives.

February's issue of the European Journal of Public Health has a focus on environmental inequalities and health, ahead of the WHO Ministerial Conference on Environment and Health in Parma on 10-12 March. Articles cover ambient air quality, waste management and housing amongst other topics.