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By Jo Howes, Reducing Inequalities Lead at Bradford District and Craven Health and Care Partnership.

In March 2023 the Reducing Inequalities Alliance  took a deep dive with a wide range of colleagues into the inequalities faced by families, babies and children in our district.  This was part of the Alliance’s key pillar to create opportunities for all those working in our district to shine a light on inequalities.

Where are we now?

The story of our children is well written about and those present at the deep dive were aware of the challenges our families face.  A recent report by N8 following publication of the Child of the North report revealed 90% of children aged between seven and ten in Bradford are exposed to issues affecting their wellbeing such as bullying, a lack of three meals a day, no internet access at home and constant worrying about money. The data speaks for itself and there is a wealth of it available. For example, the public health data found on OHID Fingertips or the data included in the Health intelligence dashboard for West Yorkshire Health and Care Partnership provides a benchmark against other local authorities and England as a whole.  There are many areas in which we face challenges such as the number of children in care, the numbers of pupils with Special Education Needs (SEN), and our high child mortality and poverty rates.  We can also see high obesity levels by year 6, and high levels of dental decay from the earliest years in life.  We have other areas where despite the socio-economic challenges our district faces, we are providing improved outcomes.  For example, the number of health reviews in the very early stages of life our families receive are above the national average, and child hospital admissions (including mental health) are below the average.

A recent partnership in Bradford within the work of Prevention and Early Help has culminated in a new outcome’s framework for 0-5 and soon 0–19-year-olds.  Bringing partners together Born In Bradford produced a report on the final framework including an illustrative example of the stark differences found in the need of children across the district.  The research and evaluation of the Children and Young People’s priorities from the Bradford Institute of Health Research is invaluable in understanding progress that has been and still is to be made.

A graphic of three children living in Bradford. Each child has various inequalities statistics under their names based on where they live.

What could we do better?

The national Child of the North report concludes with some helpful recommendations we would do well to use as a backbone of the work we move forward with in Bradford district and Craven:

  • Investment in early years services
  • Consider the impact of pandemic related service changes on inequalities
  • Take immediate measures to tackle child poverty
  • Support educational settings to initiate earlier interventions
  • Adopt a public mental health approach (prevention, early detection, prompt professional treatment)
  • Place-based monitoring of the longer-term impacts of COVID-19 on inequalities (via data and research)
  • Take a rights-based approach (Child Friendly)

The Bradford Schools Pandemic Recovery summit took place in March 2021 acknowledging the pandemic as being the most challenging of times for young people.  The manifesto that was produced as a result brings the insight of young people to what they would like to prioritise and provides their voice on the issue.

Where are the opportunities to improve inequalities?

The deep dive was an opportunity to cement the knowledge of this inequality’s priority reminding ourselves of the issues of greatest importance but also to discuss and raise the consciousness of some possible opportunities within our grasp and to seek support from colleagues in the actions needed.  There are several opportunities in our place now giving us direction for collective action:

The Bradford Children and Young People’s plan 2023 is in draft form with the interim plan due for renewal. This is a great opportunity for partnership working on the priorities for our Babies, Children and Young people with a chance to cement the Act as One approach for our families.

The strategic priorities reset of the Bradford District and Craven Health and Care Partnership to deliver on best possible outcomes including reducing inequalities for our communities and colleagues. This includes a children and young people priority with four pillars of focus developing quickly into clear programs of work.

How do we make the changes needed?

Using the four pillars of population health (Wider determinants of health, Integrated health and care, Health and behaviours, Places, and communities we live in and with) the deep dive allowed for discussion directly related to each of the new pillars of the children and young people’s priority of:

  • 1001 days (Conception to Aged 2)
  • Universal Prevention and Early Identification
  • Services and Pathways
  • Complex Needs

Understanding and appreciating what is being done already, what needs to be done and what purpose it will service was the context of the session.  Colleagues were generous with their contributions and each pillar was able to highlight several areas of focus for their work that are a starting point for a focus on inequalities understanding this will be an evolving picture over time:

Matrix summarising the inequalities priorities for each of the Children and Young People's board pillars across the population health pillars.

The Reducing Inequalities Alliance will continue to support the Children, Young People and Families Board with the work on addressing inequalities. It will harness the opportunities with the Core20Plus5 Children’s framework to address specific health inequalities taking a preventative approach as possible to the challenges faced by colleagues working with children and their families.

View more inequalities blogs on our Reducing Inequalities Alliance webpage. To write a blog about inequalities work you’re involved in, please email ria@bradford.nhs.uk

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