GOOD MANAGEMENT

Published: 06/10/2005 Volume 115 No. 5976 Page 26 27

The success of the London Olympic bid will bring a surge of investment that could benefit children in some of the most deprived parts of London. Neil Brocklehurst and colleagues explain

Whether they knew it or not, 6 July was a great day for young people in north-east London. Winning the 2012 Olympic Games bid ensures that youth and health will be at the top of the agenda for years to come in one of the most ethnically diverse, fastest-growing and socially deprived corners of Europe.

For those of us charged with implementing a swathe of new national policies, laws and strategies promoting the health and well-being of children and young people in this area, this is good news.

In England, we have one of the most comprehensive national policy programmes for children and young people in the world: the Every Child Matters green paper and the subsequent children's national service framework.

In north-east London, we are determined to make a real difference for the 400,000 or so children and young people whose future health and well-being is at stake. Life expectancy at birth is lower here (at 75 for males and 79.9 for females) than in any other London strategic health authority area, and well below the national average.

Not only that, but as a result of the Thames Gateway developments, we are expecting our population to grow by around 20 per cent by 2016.

We already have an innovation and improvement framework in place for health services across the whole of north-east London, with a vision of a world class health service for all our citizens by 2008.

It consists of a funded series of 18 priority work streams, each led by a local trust or primary care trust chief executive, and all with specific, patient-focused objectives. This approach has already made a tangible and positive difference to effective, devolved decision-making and is delivering service improvements for local people.

Importantly, children and young people's health is one of these priority work streams, giving this often neglected policy area a tremendous strategic - and financial - boost.

As a consequence, establishing a sector-wide, multi-agency programme focusing specifically on children's and young people's health and well-being has been relatively straightforward.

Not that it has been easy. In February 2005 we gathered more than 85 north-east London practitioners, managers, public health specialists, educationalists and policy-makers just across the road from the Olympic site. We agreed priorities for joint work to improve the health, well-being and services for our growing 0-19 population. By June we had established a multi-agency work programme (see chart) comprising seven sub-projects, a steering group and a dedicated recurrent development budget (£80,000 in 2005-06) to support the work.

Each project has a local lead (either NHS or local authority), a core group of members, an action plan and timetable, and one or more 'products' for the first phase of the three-year programme. Each product is aligned directly to a specific national target or policy objective for children and young people that local stakeholders have identified as urgent priorities.

The programme is managed by a senior, part-time co-ordinator who provides technical, strategic and financial support (via an SHAsponsored programme budget) to each sub-group. The groups and the co-ordinator are held accountable to a multi-agency programme steering group, which meets quarterly and receives regular updates on each sub-project. Overall responsibility for programme delivery is taken by Havering PCT chief executive Ralph McCormack.

Since June we have already achieved widespread engagement in the programme from practitioners and managers in all 14 NHS organisations, and in many of the sector's eight co-terminous local authorities. It is a testament to the level of local commitment and the relevance of the programme that several of the sub-projects are now virtually self-supporting, with minimal help needed from the coordinator. Not only that, but the programme has provided a major focal point for new developments - for example, a sector-wide performance management framework for children's services.

Our priorities for the next few months are to secure real engagement of children and young people in the programme, to build on the early local successes of collaborative working in our children's trusts and, perhaps most challenging of all, to ensure sustainability during a period of inevitable organisational turbulence arising from Commissioning a Patient-led NHS.

But we are determined to capitalise on the palpable local enthusiasm, robust overarching framework and exceptional opportunities for young people arising from the games.

We hope also, out of recent tragedies such as the death of Victoria Climbié and other children, that we can secure a happier, healthier future for north east London.

Neil Brocklehurst is an independent consultant in public health practice development, responsible for developing the north-east London programme. Trish Morris-Thompson is North East London SHA executive director of nursing and lead for children, child protection and maternity services. Ralph McCormack is chief executive of Havering PCT and north-east London NHS lead for children and young people. For more information e-mail trish. morristhompson@nelondon. nhs. uk