Top PDF PALLIATIVE CARE SERVICES FOR CHILDREN AND YOUNG PEOPLE IN ENGLAND

3.29 Children’s hospices and hospice-at-home services offer an incredibly important service to both parents and children and also help alleviate considerable pressure on the statutory sector – particularly hospitals – by providing respite care and complex symptom management. However, not every family has ready access to a children’s hospice and some hospices themselves operate different entry criteria (such as age limit and the expected life span of the child), again meaning that some families cannot gain access. 3.30 diverse communities, such as black and minority ethnic (BME) communities, asylum seekers and socially deprived families, may also find it hard to access children’s hospices for cultural or language reasons. Some, for example, have problems with the concept of a short break in which children are cared for by people outside the family, while different translations can also create a barrier, for example, in some languages “hospice” translates as “orphanage”.

The health and wellbeing of children and young people in London has improved in many ways over the past two decades. However there are areas that have improved little for London’s children, such as child poverty and health inequalities. Comparisons have been uniformly made between London and the England average, which may not always be the most suitable comparison for the capital. 3 Population demographics in London are markedly different to that of many parts of England and large urban areas are likely to have a range of health disadvantages (e.g. crowding, pollution) and potential health advantages (eg better access to health services) than rural areas. It is therefore useful to compare London with other major urban centres in England, which are likely to share issues related to urbanicity, demographics and health care. Such a comparison would show where other cities are doing better than London in order to identify opportunities for improving the health of children and young people in London.

We also know that infants under the age of 1 are more likely to be victims of homicide than any other age group. While one child aged under 16 died as a result of cruelty or violence each week in England and Wales in 2008/09, two-thirds of them were aged under five. 6 Evidence also shows that younger children (those under 8) are less likely to be consulted or involved in decision making. 7 Anecdotal evidence indicates that some professionals consider young children incapable of engaging in discussions leading to decisions about their lives, an attitude which denies them their say when many of them are in fact able to do so. Some welfare reforms introduced via the Welfare Reform Bill Act 2012 will also have a disproportionate effect on children and young people. Research produced by the Children’s Society has shown that 75% of people affected by the benefit cap to be imposed under s96 of the Act will be children - 210,000 children in all – and that children are nine times more likely than adults to be affected. 8

The Mental Health of Children and Young People (MHCYP) survey was conducted with 5 to 15 year olds living in Britain in 1999 and 5 to 16 year olds living in Britain in 2004. The 1999 and 2004 surveys sampled from Child Benefit records. For the 2017 survey a stratified multistage random probability sample of 18,029 children was drawn from NHS Patient Register in October 2016. Children and young people were eligible to take part if they were aged 2 to 19, lived in England, and were registered with a GP. Children, young people and their parents were interviewed face-to-face at home using a combination of Computer Assisted Personal Interview (CAPI) and Computer Assisted Self Interview (CASI), between January and October 2017. A short paper or online questionnaire was completed by a nominated teacher for children aged 5 to 16 years old. Data collection varied with the selected child’s age:

At 31 March 2010 there were approximately 64,400 children in the care of local authorities in England. Whilst this represents an increase of 3,500 in the last year, the figure has remained relatively unchanged for a number of years (Department for Education 2010). There is no universal right to advocacy for looked after children and children and young people only have an entitlement to advocacy in certain circumstances; dependent on their care status, their health, or whether they are in secure accommodation. Their entitlement is established in legislation, policy and guidance. However, it is encouraging that some, but not all, local authorities are prepared to go further than a child’s legal entitlement; providing advocacy for a variety of circumstances.

In recognition of this, the YJB and the Welsh Assembly Government outlined their plans for young people from Wales entering custody as part of The All Wales Youth Offending Strategy 12 in 2004. A commitment was made to ensure that all Welsh children and young people entering custodial facilities in England are afforded the same rights as their English counterparts and as other children and young people in Wales. The principal aim is that children and young people from Wales who serve a custodial sentence should do so within an environment that maintains their connection with their families, their culture and their communities.

The Mental Health of Children and Young People (MHCYP) survey was conducted with 5 to 15 year olds living in Britain in 1999 and 5 to 16 year olds living in Britain in 2004. The 1999 and 2004 surveys sampled from Child Benefit records. For the 2017 survey a stratified multistage random probability sample of 18,029 children was drawn from NHS Patient Register in October 2016. Children and young people were eligible to take part if they were aged 2 to 19, lived in England, and were registered with a GP. Children, young people and their parents were interviewed face-to-face at home using a combination of Computer Assisted Personal Interview (CAPI) and Computer Assisted Self Interview (CASI), between January and October 2017. A short paper or online questionnaire was completed by a nominated teacher for children aged 5 to 16 years old. Data collection varied with the selected child’s age:

The Mental Health of Children and Young People (MHCYP) survey was conducted with 5 to 15 year olds living in Britain in 1999 and 5 to 16 year olds living in Britain in 2004. The 1999 and 2004 surveys sampled from Child Benefit records. For the 2017 survey a stratified multistage random probability sample of 18,029 children was drawn from NHS Patient Register in October 2016. Children and young people were eligible to take part if they were aged 2 to 19, lived in England, and were registered with a GP. Children, young people and their parents were interviewed face-to-face at home using a combination of Computer Assisted Personal Interview (CAPI) and Computer

The Mental Health of Children and Young People (MHCYP) survey was conducted with 5 to 15 year olds living in Britain in 1999 and 5 to 16 year olds living in Britain in 2004. The 1999 and 2004 surveys sampled from child benefit records. For the 2017 survey a stratified multistage random probability sample of 18,029 children was drawn from NHS Patient Register in October 2016. Children and young people were eligible to take part if they were aged 2 to 19, lived in England, and were registered with a GP. Children, young people and their parents were interviewed face-to-face at home using a combination of Computer Assisted Personal Interview (CAPI) and Computer Assisted Self Interview (CASI), between January and October 2017. A short paper or online questionnaire was completed by a nominated teacher for children aged 5 to 16 years old. Data collection varied with the selected child’s age:

charities, academics, educators, the public and the media. Uses of the data include: informing and monitoring policy; monitoring the prevalence of health or illness and changes in health or health related behaviours in children and young people; informing the planning of services for this age group; and writing media articles. Universities, charities and the commercial sector use the data for health and social research. User needs have been gathered and considered at all points in the collection and publication of this information. This has been guided by a steering group consisting of representatives from NHS Digital, DHSC, PHE, DfE, NHS England, Anna Freud National Centre for Children and Families, academic leads in Child and Adolescent Mental Health, and academic leads in Contemporary Psychoanalysis and

The Mental Health of Children and Young People (MHCYP) surveywas previously conducted with 5 to 15 year olds in 1999 and 5 to 16 year olds in 2004, who were living in Britain and sampled from Child Benefit records. For the 2017 survey, a stratified multistage random probability sample of children was drawn from the NHS Patient Register in October 2016. Children and young people were eligible to take part if they were aged 2 to 19, lived in England, and were registered with a GP.

The Mental Health of Children and Young People (MHCYP) survey was conducted with 5 to 15 year olds living in Britain in 1999 and 5 to 16 year olds living in Britain in 2004. The 1999 and 2004 surveys sampled from Child Benefit records. For the 2017 survey a stratified multistage random probability sample of 18,029 children was drawn from NHS Patient Register in October 2016. Children and young people were eligible to take part if they were aged 2 to 19, lived in England, and were registered with a GP. Children, young people and their parents were interviewed face-to-face at home using a combination of Computer Assisted Personal Interview (CAPI) and Computer Assisted Self Interview (CASI), between January and October 2017. A short paper or online questionnaire was completed by a nominated teacher for children aged 5 to 16 years old. Data collection varied with the selected child’s age:

Self-esteem can have both a positive and negative impact on mental health. This survey showed that one in twenty children with a mental disorder had high self- esteem, compared to one in four children without a mental disorder. Research has shown that high self-esteem can serve as a protective buffer against the impact of negative influences (Mann et al., 2004), and that adolescents with high self-esteem suffer fewer symptoms of anxiety, depression and attention problems over time (Henriksen et al., 2017). Conversely, low self-esteem is considered to be a risk factor for mental health. Trzesniewski et al. (2006) found that adolescents with low self- esteem had more mental health problems during adulthood than those with high self-

referred to as Autism Spectrum Disorders. Symptoms include language problems; difficulty relating to other people; unusual forms of play; difficulty with changes in routine; and repetitive movements or behaviour patterns. Autism and Asperger’s syndrome are the most widely known form of PDD, and account for most cases. They are persistent, developmental conditions, often first recognised in early childhood (Landa et al., 2008), and estimated to be present in one in every hundred adults in England (Brugha et al., 2016). While ASD in adulthood is under researched, the condition is thought to have a major impact throughout the life course. For example, the higher rate of suicide in adults with ASD has started to get recognition (Pelton and Cassidy, 2017).

methods to assess for a range of different types of disorder according to International Classification of Disease (ICD-10) diagnostic criteria (WHO, 1992). Comparable data is available for 5 to 15 year olds living in England in 1999, 2004, and 2017. In keeping with broadening definitions of adolescence (Sawyer et al., 2018), the 2017 sample was the first in the series to include 17 to 19 year olds, as well as 2 to 4 year olds. Behavioural (or conduct) disorders were one of the types of child mental health conditions assessed on the survey. Information on the prevalence of behavioural disorders in 2 to 4 year olds can be found in the Preschool Children topic report. This topic report examines the:

• Although interviewing multiple participants was a strength of this survey, this was not possible in all cases. For example, information was not collected for all teachers of children aged 5 to 16, this was accounted for by applying an adjustment factor to minimise bias. Information was not collected from teachers for children aged 2 to 4 and 17 to 19 years old and should be taken into account when comparing rates across age groups. Additionally, questions which were unique to either parents or children and young people were not asked if they were not interviewed which resulted in high levels of non-response to some questions. • Findings in the individual topic reports have excluded item non-response

You have said that you were worried about your child's emotions, behaviour or concentration, and you haven't seen a specialist about your worries. There are many good reasons for not seeing specialist services about your concerns as they are often not needed, but sometimes people don't get to specialist services because there are barriers in their way.

Productive interviews (involving one or more participants in each household) were achieved for 9,117 children (1,463 2 to 4 year olds; 3,597 5 to 10 year olds; 3,121 11 to 16 year olds; 936 17 to 19 year olds), and 3,595 teachers (54% of eligible children). The survey included the detailed and comprehensive Development and Well-Being Assessment (DAWBA). This allowed the assessment of emotional, hyperactivity, behavioural and less common disorders, like autism. After interviews were complete, eleven trained clinical raters reviewed the data to reach disorder codings for each participant. Raters applied the diagnostic criteria for specific disorders set out in the tenth International Classification of Disease (ICD-10) (WHO, 1992) and the Diagnostic and Statistical Manual of Mental Disorders (DSM–5) (APA, 2013).

Young people  in England have one of the  highest incidences  of  type  1 diabetes mellitus  (T1DM) in  Europe.  At  present,  over  26,000  young  people  have  the  condition 1 ,  which  represents  the  fourth  largest  population  in  Europe  and the  fifth largest population  in the world. 2,3  More worrying  is the  fact  that young people in England have one of the worst records for glycaemic control  in Western  Europe.  Over  85%  of  young  people  with  T1DM  were  recently  identified  as  not  achieving  NICE  recommended HbA1c levels of <58mmol/mol (7.5%) and this figure has remained unchanged for the  past 7 years. 4   

The Children and Young People‟s Unit is also running lots of small discussion groups across England. Just some of the places that we will be going to include Cornwall, Blackburn, Durham, Manchester, Norfolk and London. We also want to talk to loads of different young people – including those of you who are disabled, are in or leaving care, and are from black or ethnic minority backgrounds.