Burden of child and adolescent obesity on health services in England. 

Viner RM, Kinra S, Nicholls D, et al. Burden of child and adolescent obesity on health services in England. Archives of Disease in Childhood Published Online First: 01 August 2017. doi: 10.1136/archdischild-2017-313009

Abstract

Objective To assess the numbers of obese children and young people (CYP) eligible for assessment and management at each stage of the childhood obesity pathway in England.

Design Pathway modelling study, operationalising the UK National Institute for Health and Care Excellence guidance on childhood obesity management against national survey data.

Setting Data on CYP aged 2–18 years from the Health Survey for England 2006 to 2013.

Main outcome measures Clinical obesity (body mass index (BMI) >98th centile), extreme obesity (BMI ≥99.86th centile); family history of cardiovascular disease or type 2 diabetes; obesity comorbidities defined as primary care detectable (hypertension, orthopaedic or mobility problems, bullying or psychological distress) or secondary care detectable (dyslipidaemia, hyperinsulinaemia, high glycated haemoglobin, abnormal liver function).

Results 11.2% (1.22 million) of CYP in England were eligible for primary care assessment and for community lifestyle modification. 2.6% (n=283 500) CYP were estimated to be likely to attend primary care. 5.1% (n=556 000) were eligible for secondary care referral. Among those aged 13–18 years, 8.2% (n=309 000) were eligible for antiobesity drug therapy and 2.4% (90 500) of English CYP were eligible for bariatric surgery. CYP from the most deprived quintile were 1.5-fold to 3-fold more likely to be eligible for obesity management.

Conclusions There is a mismatch between population burden and available data on service use for obesity in CYP in England, particularly among deprived young people. There is a need for consistent evidence-based commissioning of services across the childhood obesity pathway based on population burden

Reducing antibiotic prescribing for children presenting to primary care with acute respiratory tract infection

Blair, P.S. et al. (2017) BMJ Open. 7:e014506

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Objective: To investigate recruitment and retention, data collection methods and the acceptability of a ‘within-consultation’ complex intervention designed to reduce antibiotic prescribing.

Conclusion: Differential recruitment may explain the paradoxical antibiotic prescribing rates. Future cluster level studies should consider designs which remove the need for individual consent postrandomisation and embed the intervention within electronic primary care records.

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GPs struggle to support patients sent far from home for mental healthcare

GPs warn they are struggling to support young patients with mental illness after BMA research found seven in 10 children and adolescents with severe mental health problems were admitted to hospitals outside their local area | GPonline

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A total of 69% of child and adolescent admissions for severe mental health issues in 2016/17 were classed as ‘out of area’, according to data obtained from hospitals by the BMA.

Figures obtained under the Freedom of Information Act show that the proportion of children admitted to hospital out of their area rose 12 percentage points in 2016/17 compared with the previous year.

The BMA warned that the figures – published to coincide with Mental Health Awareness Week – showed worsening access to specialist beds.

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Commissioning ophthalmology services for children

The approaches to the prevention of vision/eye conditions and promotion of good visual health for children require very different approaches to those used in adult services | The Royal College of Ophthalmologists

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Image source: RCO

This briefing document will help inform commissioners of the key issues to consider when commissioning services for:

  • Children with conditions that cause (or may cause) visual impairment (VI), severe visual impairment (SVI) or blindness (BL) (WHO definition i.e. corrected acuity in better eye of LogMAR 0.5 or worse)
  • Children with common eye conditions that cause (or may cause) unilateral or milder reduction in vision
  • Children with isolated refractive error alone or those with mild/acute/self-limiting conditions (e.g. conjunctivitis)

This briefing document sets out the themes and issues relevant to commissioning of ophthalmic services for children, on behalf of the Paediatric Sub-committee of The Royal College of Ophthalmologists.

Read the full overview here

Read the full briefing here

Children and Young People’s Health Services Monthly Statistics: England

July 2016 to September 2016, Experimental statistics | NHS Digital

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Image source: NHS Digital

This is a report on NHS-funded Community Services for children and young people aged 18 years or under using data from the new Children and Young People’s Health Services (CYPHS) data set reported in England for activity between July 2016 and September 2016. The CYPHS is a patient-level dataset providing information relating to NHS-funded community services for children and young people aged 18 years or under. These services can include health centres, schools and mental health trusts. The data collected includes personal and demographic information, diagnoses including long-term conditions and childhood disabilities and care events plus screening activities.

Find all the reports here

Read the overview here

Specialist substance misuse services for young people

A rapid mixed methods evidence review of current provision and key principles for commissioning

Public Health England (PHE) commissioned The Children’s Society to undertake scoping research in early 2016, to understand some of the opportunities and challenges currently facing those now responsible for commissioning and delivering young people’s specialist substance misuse services and to outline some critical good practice principles.

Four main commissioning principles have been developed for the commissioning and provision of specialist substance misuse provision for young people, based on the findings, research and evidence based guidelines.

This document is designed to provide prompts around some core principles for consideration when local authorities are commissioning specialist substance misuse provision, but is not intended to be a comprehensive commissioning guide.

Full review available here

Children’s Mental Health Funding Not Going Where it Should

YoungMinds analysis reveals that many local health bodies are diverting some of the new funding received for children’s mental health services to other priorities.

In 2015, the government pledged an extra £1.4 billion over five years to “transform” Child and Adolescent Mental Health Services (CAMHS). Research undertaken by YoungMinds into the responses of 199 Clinical Commissioning Groups (CCGs) from Freedom of Information requests has revealed that:

  • Fewer than half of the CCGs who responded were able to provide full information about their CAMHS budgets. If CAMHS services are to improve, there needs to be far greater accountability about where money is being spent.
  • In the first year of extra funding (2015-16), only 36% of CCGs who responded increased their CAMHS spend to reflect their additional government funds. Nearly two-thirds (64%) of CCGs used some or all of the extra money to backfill cuts or to spend on other priorities.
  • In the second year of extra funding (2016-17), only half of CCGs (50%) who responded increased their CAMHS spend to reflect their additional government funds. The other half (50%) are using some or all of the extra money for other priorities.

Read the full news story here