We provide a template letter for each UK nation to support with influencing the design of children’s services to shape better care and outcomes locally.
England
Reducing child health inequalities is a priority for the NHS.ÌýThere will be a children’s lead responsible for championing the needs of babies, children and young people locally in your Trust - for example, they could be the CEO or Paediatric Lead.
Paediatricians have unique perspectives to feed into discussions on how to address child health inequalities and influence the design of children’s services to shape better care and outcomes locally. You can use the below template letter to write to your local children’s lead as an opportunity to establish a relationship and collaborate on reducing child health inequalities. You are invited to adapt the template and add in local data to highlight issues specific to your area, and remember to include a clear action.
- Template letter for England
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Dear [children’s lead],
As I’m sure you are aware, there are widening child health inequalities driven by child poverty in our area that are set to increase due to the current cost of living crisis. As a paediatrician I see the devastating impact of poverty on the mental and physical health of the children I care for and their families. I would therefore like to ask to meet to discuss how we can work together to address this issue Ìý
Health inequalities are the avoidable, unfair and systematic differences in health outcomes between different groups of babies, children and young people. Children living in poverty are more likely to have poorer health outcomes including low birth weight, poor physical health, and mental health problems:Ìý
- Infants in the 10% most deprived areas are twice as likely to die in infancy as those in the 10% least deprived.
- Rates of obesity in children living in the most income deprived areas are rising, while the rates are decreasing in the least income deprived areas.
- Children living in poverty are significantly more likely to require hospital admission, and were 72% more likely than other children to be diagnosed with a long-term illness.Ìý
- [National data can be substituted here with local statistics for your area found on , for example in Walsall, 25.1% of children are in absolute low income families.]Ìý
The health impacts of growing up in poverty are significant and follow children across their life. The current cost of living crisis will only exacerbate this by pushing more families into poverty. It is essential that health inequalities driven by poverty are addressed to improve child health outcomes.
As the children’s lead, you have a vital role in speaking up for children and young people’s needs and ensuring that child health inequalities driven by poverty are prioritised on the agenda to realise improved child health outcomes.
I would welcome an opportunity to meet to discuss how we can take this forward.
Kind regards,
³Ý³Ý³ÝÌý
Wales
Reducing child health inequalities is a stated priority for the Welsh Government and health services in Wales - but we know that making change will involve bringing together a range of services and sectors, not just health.
In Wales, Regional Partnership Boards (RPBs) bring together health boards, local authorities and the third sector to meet the care and support needs of people in their area.Ìý.
Paediatricians have unique perspectives to feed into discussions on how to address child health inequalities locally. You can use the below template letter to write to your local RPB and highlight the child health inequalities you see in your area, as well as the opportunities you see to address the issues and make change. Please feel free to adapt the template and add in local data to highlight issues specific to your area and specific actions you would like to see where you live and work.
- Template letter for Wales
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Dear [Regional Partnership Board Chair or Children’s Lead],
As I’m sure you are aware, there are widening child health inequalities driven by child poverty in [RPB area] and I would like to ask to meet to discuss how we can work together to address this.Ìý
Health inequalities are the avoidable, unfair and systematic differences in health outcomes between different groups of babies, children and young people.
Children living in poverty are more likely to have poorer health outcomes including low birth weight, poor physical health, and mental health problems:Ìý
- Between 2011 and 2020, the child death rate was 70% higher in the most deprived areas of Wales compared with the least deprived areas.Ìý
- Prevalence of obesity is significantly higher than the Welsh average in the areas of greatest deprivation and significantly lower in the least deprived areas – and the gap is growing.Ìý
- Children from lower socioeconomic groups are more likely to be at risk of tooth decay prevalence and severity - the leading reason that children aged five to nine require admission to hospital.Ìý
- [National data can be substituted with local statistics for your area found on XXX]Ìý
ÌýThe health impacts of growing up in poverty are significant and follow children across their life. The current cost of living crisis will only exacerbate this by pushing more families into poverty. It is essential that health inequalities driven by poverty are addressed to improve child health outcomes, as well as reduce costs to the NHS in the long term.Ìý
As a paediatrician, I see the health impact of poverty and inequality but to make meaningful change, we need health, education, social care and other services to work together. That’s why as the [Children’s Lead or Chair of RPB], you have a vital role in speaking up for children and young people’s needs at this difficult time and ensuring that child health inequalities driven by poverty are prioritised to realise improved child health outcomes.Ìý
I would welcome an opportunity to meet to discuss how we can take this forward.Ìý
Kind regards,Ìý
³Ý³Ý³ÝÌý
Scotland
Reducing child health inequalities is a priority for the Scottish Government and health services in Scotland - but we know that making change will involve bringing together a range of services and sectors.
In Scotland, we have 31 health and social care partnerships (HSCS) with the aim to deliver better health and wellbeing outcomes with a community-based approach. This health and social care integration has created a unique set of arrangements, with all partnerships becoming responsible for adult social care, adult primary health care and unscheduled adult hospital care. However, only some HSCS are responsible for children’s services. In other areas, these powers have remained with the local authority or health board.Ìý.
Paediatricians can offer their unique perspectives to feed into discussions on how to address child health inequalities locally. You can use the template letter below to write to your local HSCS / local authority or health board and highlight the child health inequalities you see in your area, as well as the opportunities you see to address the issues and make change. Please feel free to adapt the template and add in local data to highlight issues specific to your area and specific actions you would like to see where you live and work.
- Template letter for Scotland
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Dear [Health and Social Care Partnership Chief Officer / ÌýLocal Authority / Health Board],
As I am sure you are aware, there are widening child health inequalities driven by child poverty in [local area] and I would like to ask to meet to discuss how we can work together to address this. 
Health inequalities are the avoidable, unfair and systematic differences in health outcomes between different groups of babies, children and young people. Children living in poverty are more likely to have poorer health outcomes including low birth weight, poor physical health, and mental health problems: Ìý
- Among children living in the most deprived areas there was an 8.4 percentage point increase between 2019/20 and 2020/21, to 35.7% at risk of overweight or obesity, compared to a 3.6 percentage point increase, to 20.8%, in the least deprived areas.
- More than one in four of Scotland’s children are official recognised as living in poverty (2019/20).Ìý
- Some studies suggest that children living in low-income households are nearly three times as likely to suffer mental health problems than their more affluent peers.Ìý
The health impacts of growing up in poverty are significant and follow children across their life course. The current cost of living crisis will only exacerbate this by pushing more families into poverty. It is essential that health inequalities driven by poverty are addressed, in order to improve child health outcomes, as well as reduce costs to the NHS in the long term.
As a paediatrician, I see the health impact of poverty and inequality, but to make meaningful change we need health, education, social care, and other services to work together. That is why, as the [Chief Officer of the HSCS / Local Authority / Health Board], you have a vital role in speaking up for children and young people’s needs at this difficult time. You can help ensure that child health inequalities driven by poverty are prioritised and the lives of those living in poverty are improved. 
I would welcome an opportunity to meet to discuss how we can take this forward. 
Kind regards,Ìý
³Ý³Ý³ÝÌý
Northern Ireland
Reducing child health inequalities has been a priority for the Northern Ireland Executive and health services in NI for some time - but given our political landscape, it has not been paid the credence it should. Nonetheless, we know that making change will involve engaging across the silos of our departmental structure and to those who commission services.
We currently have five Health and Social Care Trusts (HSC Trusts), a Local Commissioning Group (LCG) covered the same geographical area as their respective HSC Trust. LCGs were responsible for the commissioning of health and social care by addressing the care needs of their local population with children’s services supported by the Public Health Agency. We have a unique set of circumstances, ie the Health & Social Care Act (Northern Ireland) 2022 and subsequent commencement order made provision for the retention of LCGs until Area Integrated Partnership Boards could be established by Regulation. Responsibility for all the existing functions moved to the Department of Health on 1 April 2022; functions are currently undertaken by the Strategic Planning and Performance Group within the Department for Health. Staff are hosted by the BSO.
Paediatricians can offer their unique perspectives to feed into discussions on how to address child health inequalities locally. You can use the template letter below to write to the Strategic Planning and Performance Group and highlight the child health inequalities you see in your area, as well as the opportunities you see to address the issues and make change. Please feel free to adapt the template and add in local data to highlight issues specific to your area and specific actions you would like to see where you live and work.
- Template letter for Northern Ireland
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Dear [Strategic Planning and Performance Group (Chair is Peter May, Permanent Secretary for the Department of Health)],
As I am sure you are aware, there are widening child health inequalities driven by child poverty [across Northern Ireland] and I would like to ask to meet to discuss how we can work together to address this. 
Health inequalities are the avoidable, unfair and systematic differences in health outcomes between different groups of babies, children and young people. Children living in poverty are more likely to have poorer health outcomes including low birth weight, poor physical health, and mental health problems:
- Among children living in the most deprived areas there was a 3 percentage point variation between the most and least deprived with 7.7% of primary 1 age children in deprived areas reported as being obese compared to 4.7% in the least deprived according to the latest Health Inequalities Annual Report.
- The same report showed a stark difference in infant mortality rates with 5.2% occurring within the most disadvantaged areas and 3.7% within the least deprived over the period analysed.Ìý
- Twenty-three percent of children - almost oneÌýin four childrenÌý- are living in povertyÌýaccording to various sources, including the NI Children’s Commissioner.Ìý
The health impacts of growing up in poverty are significant and follow children across their life course. The current cost of living crisis will only exacerbate this by pushing more families into poverty. It is essential that health inequalities driven by poverty are addressed, in order to improve child health outcomes, as well as reduce costs to the HSCNI in the long term.
As a paediatrician, I see the health impact of poverty and inequality, but to make meaningful change we need health, education, social care, and other services to work together. That is why, as the [Chair of the Strategic Planning and Performance Group], you and your colleagues have a vital role in speaking up for children and young people’s needs within the Department of Health and in conjunction with the PHA as the structures change. You can help ensure that child health inequalities driven by poverty are prioritised and the lives of those living in poverty are improved. 
I would welcome an opportunity to meet to discuss how we can take this forward. 
Kind regards,Ìý
³Ý³Ý³ÝÌý
Add our letter from childrenÌý
Everyone is entitled to be healthy, happy and well, to be loved, to be looked after. Everyone deserves the world.
RCPCH &Us spoke to 500 children and young people across the UK about what might prevent them being healthy, happy and well. We've pulled some of their responses into an illustrated letter - why not send this with yours?
- "Everyone deserves the world" letter
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