To provide an update on the progress of the implementation plan for the Health and Wellbeing Board’s strategic priority of giving our children the ‘Best Start in Life’ focusing on 0-5 years.

The report was introduced by the Public Health Principal, highlighting progress recorded in the Best Start in Life (BSiL) Implementation Plan 2023-2025 (Appendix 1 to the report) and in the Outcome Indicators Dashboard (Appendix 2).

Attention was drawn to the following red, amber, green (RAG) ratings:-

i.             Red indicators: dental decay in 5-year-olds; MMR (measles, mumps and rubella) vaccination at 5 years; DTaP and IPV (diphtheria, tetanus, acellular pertussis and inactivated poliomyelitis vaccine) booster vaccinations at 5 years; vaccination coverage of children in care; and premature births (less than 37 weeks).  The board was advised about the work being undertaken in relation to oral health and vaccinations.

ii.            Amber indicators: mother’s smoking status at time of delivery; overweight children including obesity at reception and year 6; children achieving a good level of development at age 2.5 years; and Free School Meals children reaching a good level of development at the end of reception year.  It was reported that local data suggested that ‘smoking status at time of delivery’ had reduced from 8.3% to 6.7%.  It was commented that the time lag in some national data sources highlighted the need to explore the use of uptake data and other proxy indicators at a local level to identify trends more quickly.

iii.          Green indicators included: the launch of the Healthy Schools programme, with work coming along on the Healthy Tots programme, and for further education settings; and SEND (special educational needs and disabilities) champions had been implemented within the 0-5 service and were represented in each PCN (Primary Care Network) area.  It was commented that progress had been made in terms of partnership working and in utilising data from early years settings to inform policy development.

The Public Health Lead (Children and Families) provided further details about BSiL projects and initiatives.  The key points included: over 45 schools had signed up to the Health Schools programme; the Healthy Tots programme aimed to enhance standards in early years settings, including addressing issues around unhealthy baby and toddler food products; a large proportion of schools had signed up to the supervised toothbrushing scheme; through the recommissioning of the 0-19 years Public Health Nursing Service, additional health checks had been introduced and were receiving good uptake; and work with the local maternity services included the roll-out of ‘challenging conversations’ training to midwives around healthy lifestyles.

The Chairperson emphasised the corporate parenting principles for children in care and sought further clarification on the position with vaccination coverage.  The Public Health Principal commented on the efforts to identify which vaccinations were missing, noting that a significant proportion of the children concerned were in out of county settings, and the Public Health Programme Officer (Strategy and Partnerships) outlined the work with partners and other local authorities to administer vaccinations and to improve the recording process.  The Vice-Chairperson noted that the position had improved, with coverage increasing from a baseline of 80% to 87% currently; this compared favourably to the region (83%) and England (85%).

The Chairperson questioned why action 3.2.2, ‘Co-produce a community offer that will extend children’s social experiences and support their communication skills …’ was rated amber but ‘No progress to date’ was identified.  In response, the Public Health Lead (Children and Families) explained that work was underway and, alongside organisational changes to Talk Community, action targets were being adapted.

In response to questions from board members:

1.           The Public Health Lead (Children and Families) explained that ‘Work with CVS to reach and gain the voice of children and families…’ involved a broad range of community and voluntary groups.  A board member suggested that an appendix could be included to identify the groups that the authority was working with, particularly to recognise their positive contributions.

2.           The Public Health Principal commented that action B, ‘Develop a cross-sector dashboard covering health services, social care, CVS and early years data’, had ‘limited progress to date’ partly due to hiatus in Children and Young People Partnership Board meetings.  It was reported that, in view of the information already collected by services, it should be possible to deliver this another way, and the action would be updated accordingly.

3.           The Public Health Principal noted that, whilst significant progress had been made, reducing smoking status at time of delivery should remain a priority.  It was reported that a pathway was being developed with the health visiting service to encourage mothers to abstain from smoking subsequently.  The Chairperson drew attention to the next agenda item on the Tobacco Control Plan.

Resolved:  That

a)           the board has considered the report and appendices, and notes the progress and challenges to date on the Best Start in Life priority; and

b)          future updates include an appendix to identify the involvement and contributions of voluntary and community sector groups in the projects.