Fairness Commission Review November 2016- Children’s Health

Obesity

A higher proportion of children in RBG are overweight or obese than in London and nationally

Source: CYPP quarterly monitor

Percentage of children who are overweight or very overweight by gender

Period / Reception / Year 6
Male / Female / Male / Female
2012-13 / 28.0% / 25.2% / 39.8% / 38.5%
2013-14 / 29.8% / 27.3% / 39.8% / 41.0%
2014-15 / 27.6% / 24.9% / 39.5% / 40.2%
Source: National Child Measurement Programme 2012-15

Obesity data from the National Child Measurement Programme shows greater levels of excess weight in the Black, Asian and mixed race populations in year 6 as is the case nationally.

Percentage of children who are overweight or very overweight by ethnicity

Ethnic Group / Reception / Year 6
Asian / 23.6% / 41.2%
Black / 34.2% / 44.5%
Chinese / 23.1% / 30.8%
Mixed / 25.3% / 43.4%
Not stated / 27.6% / 35.5%
White / 23.5% / 36.1%
Any other ethnic group / 19.6% / 35.5%
Source: National Child Measurement Programme 2012-15

Emergency Admissions

Directly standardised rate of emergency admissions for children aged under 19 with lower respiratory tract infections per 100,000

RBG rate is above London and national rates

Source: CYPP quarterly monitor

Directly standardised rate of emergency admissions for children aged under 19 with lower respiratory tract infections per 100,000

Gender / 2010/11 / 2011/12 / 2012/13 / 2013/14 / 2014/15 / 2015/16
Girls / 190.7 / 164.5 / 320.5 / 359 / 310.5 / 476.1
Boys / 242.8 / 210.5 / 534.6 / 473.1 / 486.7 / 567.5
Source: CCG OIS Indicator 3.4 (NHS Digital)

Breastfeeding and smoking at time of delivery

Ethnicity data for maternities at QEH has been increasingly poor since around 2010; the percentage recorded as unknown has grown steadily. In addition, breastfeeding and smoking status was less well recorded in 2013-15, which adds to the lack of reliability of results shown here. (Recording of this has improved in the last year, but recording of ethnicity continues to be a problem.) However, the results suggest a continuing pattern of greater levels of smoking and lower levels of breastfeeding amongst White British mothers, and especially amongst young White British mothers.

Maternities at Queen Elizabeth Hospital: any breastfeeding recorded at initiation or discharge by ethnicity

Breastfeeding by ethnicity / 2007
-08 / 2008
-09 / 2009
-10 / 2010
-11 / 2011
-12 / 2012
-13 / 2013
-14 / 2014
-15 / All Years
Asian / Count Mothers / 247 / 254 / 255 / 291 / 275 / 278 / 303 / 157 / 2,060
% Breastfeeding / 94.7% / 91.7% / 92.2% / 90.4% / 92.7% / 94.6% / 92.4% / 79.6% / 91.7%
Black / Count Mothers / 1,135 / 1,080 / 956 / 983 / 873 / 823 / 749 / 398 / 6,997
% Breastfeeding / 90.9% / 93.5% / 91.9% / 91.3% / 93.2% / 94.2% / 93.2% / 90.7% / 92.4%
Mixed / Count Mothers / 110 / 110 / 113 / 100 / 106 / 68 / 97 / 45 / 749
% Breastfeeding / 82.7% / 82.7% / 89.4% / 87.0% / 86.8% / 79.4% / 89.7% / 82.2% / 85.4%
Other / Count Mothers / 341 / 391 / 352 / 349 / 374 / 427 / 381 / 234 / 2,849
% Breastfeeding / 90.0% / 90.3% / 92.6% / 91.1% / 92.2% / 91.3% / 91.6% / 85.5% / 90.8%
Unknown / Count Mothers / 112 / 103 / 160 / 337 / 564 / 647 / 681 / 618 / 3,222
% Breastfeeding / 83.0% / 84.5% / 86.3% / 86.6% / 88.7% / 90.6% / 88.5% / 81.7% / 87.0%
White / Count Mothers / 1,619 / 1,511 / 1,400 / 1,456 / 1,403 / 1,233 / 1,134 / 675 / 10,431
% Breastfeeding / 70.8% / 70.4% / 70.4% / 71.4% / 69.1% / 68.4% / 69.1% / 63.9% / 69.6%
Source: QEH

Maternities at Queen Elizabeth Hospital: mothers smoking at time of delivery by ethnicity

Mothers smoking at delivery by ethnicity / 2007
-08 / 2008
-09 / 2009
-10 / 2010
-11 / 2011
-12 / 2012
-13 / 2013
-14 / 2014
-15 / All Years
Asian / Count Mothers / 247 / 254 / 255 / 291 / 275 / 278 / 303 / 157 / 2,060
% Smoking / 2.0% / 2.4% / 2.4% / 1.7% / 1.5% / 2.5% / 1.0% / 1.9% / 1.9%
Black / Count Mothers / 1,135 / 1,080 / 956 / 983 / 873 / 823 / 749 / 398 / 6,997
% Smoking / 3.4% / 2.7% / 1.0% / 1.4% / 0.8% / 0.9% / 2.0% / 1.5% / 1.8%
Mixed / Count Mothers / 110 / 110 / 113 / 100 / 106 / 68 / 97 / 45 / 749
% Smoking / 14.5% / 11.8% / 11.5% / 8.0% / 6.6% / 7.4% / 9.3% / 6.7% / 9.9%
Other / Count Mothers / 341 / 391 / 352 / 349 / 374 / 427 / 381 / 234 / 2,849
% Smoking / 5.3% / 4.3% / 4.3% / 5.4% / 4.5% / 4.7% / 6.8% / 3.0% / 4.9%
Unknown / Count Mothers / 112 / 103 / 160 / 337 / 564 / 647 / 681 / 618 / 3,222
% Smoking / 3.6% / 11.7% / 12.5% / 9.5% / 6.9% / 6.8% / 5.7% / 5.2% / 6.9%
White / Count Mothers / 1,619 / 1,511 / 1,400 / 1,456 / 1,403 / 1,233 / 1,134 / 675 / 10,431
% Smoking / 22.6% / 24.0% / 24.1% / 22.0% / 20.5% / 22.5% / 21.1% / 19.6% / 22.3%
Source: QEH

Teenage Pregnancy

RBG rate is above London and national

Source: CYPP quarterly monitor

Teenage mothers in Greenwich are predominantly of White British ethnicity, but numbers of teenage mothers have reduced substantially across all ethnicities.

Percentage of births to Greenwich residents aged less than 19 at Queen Elizabeth Hospital by ethnicity

Ethnicity / 2007-10 / 2008-11 / 2009-12 / 2010-13 / 2011-14 / 2012-15
Asian / 1.0% / 1.4% / 1.6% / 1.3% / 1.4% / 1.1%
Black / 11.3% / 7.7% / 5.5% / 2.5% / 1.9% / 2.2%
Mixed / 4.5% / 5.6% / 5.5% / 4.7% / 3.9% / 3.3%
Other / 8.7% / 8.8% / 8.7% / 9.7% / 12.6% / 14.4%
Unknown / 2.6% / 6.3% / 12.2% / 16.9% / 17.4% / 16.0%
White / 71.8% / 70.2% / 66.5% / 64.8% / 62.8% / 63.0%
Total / 100% / 100% / 100% / 100% / 100% / 100%
Source: QEH

Immunisations

No breakdown ofdata is available beyond the headline the measures in the quarterly monitor, across which performance remains good. The table below reflects that health checks and up to date immunisation performance when focusing on children in care is also strong; this performance extends to the disabled cohort within the wider CLA cohort.

Health checks and immunisations of Children Looked After (inc. disabled children looked after)
REF / DEFINITION / 2014/15 Outturn / 2015/16 Outturn / London / NAT / 2016/17 Performance
Q1 / Q2
3.4.01 / A) looked after children (1+yrs) who had their teeth checked by a dentist and/or had an annual health assessment. NB: quarterly data are cumulative. / 92.5%
(343/371) / 93.7%
(355/379) / 89.9%
(14/15) / 87.7%
(14/15) / 18.0%
(73/405) / 34.9%*
(135/387)
B) Disabled looked after children (1+yrs) who had their teeth checked by a dentist and/or had an annual health assessment. / 91.7%
(33/36) / 97.2%
(35/36) / N/A / N/A / 14.0%
(7/50) / 30.6%*
(15/49)
3.4.02 / A) looked after children (1+yrs) who had their teeth checked by a dentist. NB: quarterly data are cumulative. / 91.6%
(340/371) / 88.9%
(337/379) / 89.2%
(14/15) / 85.8%
(14/15) / 19.0%
(77/405) / 31.3%*
(121/387)
B) Disabled looked after children (1+yrs) who had their teeth checked by a dentist. / 88.9%
(32/36) / 94.4%
(34/36) / N/A / N/A / 12.0%
(6/50) / 22.4%*
(11/49)
3.4.03 / A) looked after children (1+yrs) who had an annual health assessment. / 93.3%
(346/371) / 98.4%
(373/379) / 90.5%
(14/15) / 89.7%
(14/15) / 16.8%
(68/405) / 38.2%*
(148/387)
B) Disabled looked after children (1+yrs) who had an annual health assessment. / 94.4%
(34/36) / 100%
(36/36) / N/A / N/A / 16.0%
(8/50) / 38.8%*
(19/49)
3.4.04 / A) looked after children with immunisations up-to-date (reported annually). / 90.3%
(335/371) / 89.4%
(339/379) / 85.3%
(14/15) / 87.8%
(14/15) / Avail. Q4
B) Disabled looked after children with immunisations up-to-date / 88.9%
(32/36) / 97.2%
(35/36) / N/A / N/A / Avail. Q4

Source: CYPP quarterly monitor (data from LAC health team)

CAMHS caseload

  • More boys in 5-14 caseload, more girls in 15-19 caseload
  • Black children are under-represented aad White British over - represented

Source: Oxleas CAMHS Commissioner report Q2

1 / 2 / 3 / 4 / 5 / 6 / 7 / 8 / 9 / 10 / 11
Caseload Snap shot by Age and Gender
0-4 / 5-9 / 10-14 / 15-19
Q1 / Q2 / Q3 / Q4 / Q1 / Q2 / Q3 / Q4 / Q1 / Q2 / Q3 / Q4 / Q1 / Q2 / Q3 / Q4
Female / 5 / 8 / 44 / 44 / 169 / 164 / 206 / 189
Male / 8 / 5 / 123 / 117 / 223 / 228 / 105 / 107
Total / 13 / 13 / 167 / 161 / 392 / 392 / 311 / 296
Breakdown of Caseload by Ethnicity / Q1 / Q2 / Q3 / Q4 / Qtr / % Total / % Pop / Diff
White British / 394 / 406 / 406 / 56% / 43% / 13%
White (Other + Irish) / 43 / 38 / 38 / 5% / 7% / -2%
Black / 82 / 87 / 87 / 12% / 27% / -15%
Asian / 18 / 20 / 20 / 3% / 9% / -6%
Mixed / 65 / 69 / 69 / 10% / 10% / 0%
Other / 21 / 20 / 20 / 3% / 3% / 0%
Not Known / 83 / 69 / 69 / 10% / 0% / 10%
Not Stated / 18 / 14 / 14 / 2% / 0% / 2%