Face to faith

A study of religious differences as represented in the Health Survey for England reveals patterns of health inequality and their relation to socio-economic status and ethnicity. Another article in Ethnicity and Health looks at how faith affects communication between healthcare professionals and Pakistani Muslim patients, focusing particularly on long-term conditions.

Home and Health visiting update

The government's commitment to increasing health visitor numbers is afirmed in the Health Visitor Implementation plan, covering 2011-2015. Health and Social Care in the Community provides a report on the effectiveness of Family Nurse Partnership interventions mediated by an interpreter.

Because it's worth it

Early years intervention to reduce inequalities is the current mantra. The Greater London Authority's Economics unit has published a report setting out the economic case for early intervention, designed to underpin the Mayor's health inequalities strategy. Amongst the programmes highlighted as effective interventions include the US Nurse Family Partnership (a model currently being trialled in the UK as Family Nurse Partnership) and early years education programmes. There's also an emphasis on the need to target programmes. The Cabinet Office early intervention review team has issued an interim report on financing early intervention, following on from Graham Allen's review issued in January. The final report is due out in May.

Start as you mean to go on

Nearly half of all 5 year olds in the UK are not reaching a good level of development was the story that the news media picked up from the Marmot review team's latest publication, issued on the anniversary of the original Marmot Review. This figure is based on assessment of children during their first year of school (the Early Years Foundation Stage Profile) and attention on this and other social determinants like young people not in education, employment or training (NEET) plays to the big theme in the Marmot Review, that inequalities are established in childhood. What the headlines omitted was that the EYFSP trend is rising, from 49% of children reaching "a good level of development" in 2008, when the assessment was first introduced, to the present 56%, and the fact remains that the area with the highest EYFSP score, the London Borough of Richmond, only reaches 69%.

Personality disorder

It is estimated that,while up to 11% of the general population is affected by pesonality disorder, the prevelance amongst prisoners is something like 60 - 70%. A guide to working with personality disordered offenders from the National Offender Management Service has just been issued, designed to assist offender managers and others such as mental health nurses working in secure accomodation and the community.

Care and compassion?

All over the news in the past day or so is the Health Service Ombudsman's report on NHS care for older people, which makes challenging reading. Like the earlier Six lives report on treatment of people with learning disabilities, Care and compassion highlights particular cases to make its point. And it pulls no punches: "it is incomprehensible that the Ombudsman needs to hold the NHS to account for the most fundamental aspects of care: clean and comfortable surroundings, assistance with eating if needed, drinking water available and the ability to call someone who will respond." Of the 9 000 complaints properly made to the Parliamentary Ombudsman in 2010, 18% concerned the treatment of older people and of these 226 were accepted for investigation: "more than twice as many as for all other age groups put together."

Child Protection

An interim report from the Munro review of child protection offers some early recommendations for change in such areas as inspection, performance monitoring, and referral and assessment. The final report, due out in April, will examine these issues in more detail. Themed around the child's journey "from needing help to receiving it," this interim report takes a long hard look at the proliferation of reporting and documentation, observing dryly that the core guidance, Working together to safeguard children, "is now 55 times longer than it was in 1974," when it was first published. Separating out the statutory guidance from professional advice is one key task recommended, along with changes in the role and practice of Special Case Reviews and a focus on leadership in most areas and at all levels. Local Government Improvement and Development, along with the London Safeguarding Children Board, has produced a strategic quality assurance framework for safeguarding children.