1. Background
1. BACKGROUND
There is increasing recognition of the link between health and the way people live
their lives, and the opportunities available to them (Department of Health, 2004).
Patterns of health and other behaviours are established early in life and may in
later years affect people’s health, negatively or positively. In consultations for the
Department of Health’s Our Health, Our Care, Our Say White Paper, people
identified emotional health and wellbeing as being equally important as physical
health in enabling them to get the most out of life (Department of Health, 2006, p
35). The importance of addressing resiliency and emotional health alongside
physical health has been recognised, particularly for young people, with an
estimated 10%-20% of children and young people in the UK experiencing mental
health problems (Young Minds, 2006).
Life checks have been proposed for England as a personalised service providing
support and advice at key stages throughout the lifespan to help people maintain
and improve their emotional and physical health (Department of Health, 2006). A
set of transitional stages have been identified as the most appropriate stages for
life checks to take place. These include the postnatal examination, GP
registration, the teenage years, and the over 75s (Hainsworth, 2006). For young
people, the proposed key stage for a life check is the transition between primary
and secondary school at the ages 11 to 12 years. The plan is to pilot life checks at
the start of 2007 at demonstration sites around the country.
Traditionally, children and young people have been offered screening,
immunisations and physical examinations at key developmental stages of their
lives. Recently, the need for a more holistic form of support, addressing the
broader range of issues faced by children and young people, has been
recognised. The Choosing Health report describes proposals to achieve this
through its Child Health Promotion Programme:
The new programme moves on from a narrow focus on health screening and
developmental reviews to a more broad-based programme of support to
children and their families that will help address the wider determinants of
health and reduce health inequalities. (Department of Health, 2004, p 44)
The Scottish Executive has also released guidance on child health proposals,
based on recommendations made in the latest edition of the Royal College of
Paediatrics and Child Health's review of child health surveillance, Health for All
Children (Hall and Elliman, 2003). This guidance recommends a reduction in the
number of universal routine contacts and developmental checks for school age
children in order to release capacity for additional intensive support for those most
in need (Scottish Executive, 2003). The guidance recommends that primary care
workers use each contact with young people as an opportunity for health
surveillance, that teachers are tasked with identification of problems, and that a
more proactive approach by school nurses is taken in assessing and meeting
needs.
Children and young people have been identified as being particularly in need of
support during their transition into teenage years. The document Youth Matters
A scoping review of the evidence relevant to life checks for young people aged 9 to 14 years