Meeting the needs of children and young people

The rate of infant deaths has fallen to 5 per 100,000 but things are not improving as quickly for the least well-off and people in deprived areas, where mothers are more likely to smoke during their pregnancy and less likely to initiate breastfeeding. Children in these areas are more likely to be obese, suffer an accidental injury, experience mental illness and teenage pregnancy.

Childhood obesity
Smoking and drug use
Diabetes
Hospital and mental health services
Meeting the needs of vulnerable children
Child protection
Transition from children's to adult services
Our recommendations

Childhood obesity

Obesity in childhood is increasing, which presents a serious challenge for healthcare services, as obese young people become adults with more circulatory diseases, cancer and diabetes.

Smoking and drug use

The Government's long-term target for reducing smoking among 11-15 year olds in England to 9% has been achieved.

There has been a 29% increase in hospital admissions of under 16s related to alcohol in the last ten years.

Diabetes

All types of diabetes are increasing among children and young people. Only 17% of under-16s are achieving blood sugar control targets.

Some children and young people with diabetes do not get access to the support services they need, and in a third of primary care trusts children and their families do not have access to a structured education programme. Systems for transferring young people with diabetes to adult care may not always be adequate.

Hospital and mental health services

The quality of inpatient services for children was mostly found to be ‘good' or ‘excellent', but across the full range of services offered by hospitals quality was mostly ‘fair'.

Where children are treated by specialist paediatric services their needs are better met than where they are treated by more general services. Progress in meeting the broader needs of children was generally poor, and our review highlighted serious concerns about the quality and safety of care for children in a small minority of units.

More mental health services for children are needed and access needs to improve. The NHS is not currently planning and purchasing child and adolescent mental health services in an informed way.

Meeting the needs of vulnerable children

We found poor monitoring and assessment of the needs of vulnerable children especially:

• children with disabilities
• looked after children
• young offenders

Young people with physical or mental health needs, or needs related to drug and alcohol misuse, are not always appropriately referred.

Child protection

Child protection is still too weak in a minority of NHS trusts. In 2006/2007 one in 20 NHS trusts in England was not compliant with statutory child protection standards. Our review of children's hospital services found that levels of training in child protection were not adequate.

Transition from children's to adult services

Young people making the transition from children's to adult services are poorly served, e.g. in reviews and studies on;

• diabetes
• mental illness
• services for children with disabilities
• looked-after children and young offenders
• palliative care

Our recommendations

We have found that NHS trusts need to do more to ensure that they have effective systems for protecting children, and ensure that staff who work with children have comprehensive, up-to-date training. Particular attention should be given to the needs of adolescents.

Download the chapter 'Meeting the needs of children and young people' (PDF 275kb) (Opens new window)
Download the State of Healthcare 2007 report (PDF 1510kb) (Opens new window)