Our Networks

Best Start in Life Network

Introduction

The WMADPH Best Start in Life Network works to support the children & young people’s priorities for the year, as set by national and local priorities, it continues to share best practice and resources to enhance local delivery that reduces variation in health inequalities.
The network connects the wider public health system and offers peer support to enable local delivery of the Healthy Start programme across the West Midlands, working with Learning for Public Health and Health Education West Midlands to develop Continuing Professional Development activity and maintain links with the PH workforce in the region; identifying best practice, contributing towards the development of strategy and support evidence based commissioning.

Introduction toAdverse Childhood Experiences

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A Summary of Child Health Profiles in the West Midlands

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Health Visiting and School Nursing Products February 2017

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Public Health England Conference Publications - Children and Young people

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Anti-depressants given to children soar by nearly 30 per cent in 10 years | The Independent

http://www.independent.co.uk/news/science/antidepressants-childhood-children-use-statistics-30-per-cent-10-years-unhappiness-a7231756.html

British Journal of Midwifery

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Adverse Childhood Experiences

As described in our national priorities Evidence Into Action: Opportunities to protect and improve the nation’s health[i] Public Health England in the West Midlands (PHEWM), advocates the importance of ensuring that every child has every opportunity to achieve the best start in life and we do so by taking a life course approach.

Delivering improvement requires action across the whole system and in support of this PHEWM provides advocacy and leadership, facilitating the sharing of robust evidence and best practice. We also have a role in developing intelligence and benchmarking data, working with the system to build capacity and providing networking opportunities system. Childhood experiences, both positive and negative, have a tremendous impact on future violence victimization and perpetration, and lifelong health and opportunity. As such, early experiences are an important public health issue and much of the foundational research in this area has been referred to as Adverse Childhood Experiences (ACEs) . ACEs and the development of health harming behaviours was first explored in the USA by Felitti and colleagues . This ACE study used a large sample of adults (over 17,000) who were receiving medical assessment for a health insurance company, asking them about their past childhood experiences and measuring current health status and behaviours.

Findings indicated a strong graded relationship between the number and categories of childhood exposures and the risk of adults developing diseases including ischemic heart disease, cancer, chronic lung disease, skeletal fractures and liver disease. Further, the more ACEs individuals had, the more likely they were to report engaging in harmful behaviours including smoking, problem alcohol use, illicit drug use, risky sexual behaviour, low physical activity and involvement in violence. Whilst this ACE study was conducted nearly two decades ago, this dose response finding has been replicated in recent studies in America and Europe (Bellis et al., 2014a). Adverse Childhood Experiences (ACE) refer to some of the most intensive and frequently occurring sources of stress that children may suffer early in life. It has been shown that considerable and prolonged stress in childhood has life-long consequences for a person's health and well-being . It has also been associated with disruption of early brain development – leading to compromised functioning of the nervous and, separately people’s immune systems.
The wide-ranging health and social consequences of ACEs underscore the importance of preventing them before they happen By identifying adults who have been assessed as having experienced multiple childhood traumas based upon a specific set of questions and putting support in much earlier with the right families, agencies will be better placed to support individuals to break the negative cycle of intergenerational problems. Adverse Childhood Experiences (A.C.E.’s) are causally and proportionately linked to poor physical, emotional and mental health outcomes and also have a significant impact on social and educational outcomes.

Research suggests that people are not routinely asked about traumatic and adverse experiences as part of routine practice and it can take an average of 10 years for individuals to spontaneously disclose something that happened to them in childhood or earlier in life. It follows that routine and systematic enquiry into ACEs should be put in place in order to reduce the burden on health and social care services, with the potential of reducing demand for GP visits and A&E attendances and also a reduction in need for specialist social care services .

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Young People Health and Wellbeing Framework and Best Start In Life Consultation Events.

This report provides specific feedback on two conferences . 0-5 and young people from adolescent and beyond 19 (25 with a disability)

The first conference was held on 1st October 2015, over when 60 people attended a one-day event hosted by PHEWMs. This was one in a series of nationally led conversations where PHE engaged local practitioners in a dialogue about the Best Start in Life.
Participants came from a broad range of organisations covering the 14 local authorities that make up the West Midlands. The objective was to engage with the local system, hear their views about existing priorities and suggest further areas to explore. The event featured presentations from partner organisations including:
•     The Early Intervention Foundation (EIF) who shared learning about integrating early years work and the importance of getting in right for families;
•     The Child Accident Prevention Trust who showcased good practice in relation to accident prevention and;
•     Birmingham Community NHS Trust who shared their experience of delivering work around the two year development checks and school readiness.

Facilitated workshops provided valuable discussion and feedback on a number of themes

The second event brought together 65 delegates from across the West Midlands. The purpose being to engage stakeholders, share their experience and explore further priorities. Delegates included representation from health, housing, education including schools and colleges, the NHS, police, fire service, voluntary and community sector and young people from Birmingham Children’s Hospital Young People’s Advisory Group. Delegates discussed through workshops how to further develop services for young people. The national team presented the newly launched Young People Health and Wellbeing Framework Improving young people’s health and wellbeing: a framework for public health - a resource to enable local areas to deliver services for young people within the context of public health. It poses questions for councillors, health and wellbeing boards, commissioners and providers to help them support young people to be healthy and to improve their outcomes. Delegates heard about behavioural insight and using social marketing to bring about behaviour change. CHIMAT presented data and health profiles to help delegates understand young people’s health and wellbeing at a local level. Blackburn and Darwen presented their work on Adverse Childhood Experiences (ACEs). They shared evidence to suggest that the simple act of enquiring about ACEs may reduce the burden on health and social care services, e.g. fewer GP and A&E visits and reduced the need for specialist social care services.

Workshop sessions were structured around the six principles outlined within the Young People’s Health and Wellbeing Framework. Delegates were provided with a series of questions for discussion to support them to improve their service offer to young people.

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