The first few years of a child's life are critical to their brain and body development, as well as their future health. Sadly, too many children - particularly those from poorer backgrounds - are being left behind.
Our ambition to improve health equity
To act against health inequity, Barnardo’s established the Children and Young People’s Health Equity Collaborative, a partnership with the UCL Institute of Health Equity (IHE) in 2022.
By sponsoring this programme, Barnardo’s sought to build evidence about practical ways for the health and care system to reduce inequalities among children and young people through action on the social determinants of health and to demonstrate the value of collaboration, bringing together charities, academics and integrated health and care systems.
Barnardo’s led the recruitment of three Integrated Care Systems to partner with. Following a rigorous process, NHS Birmingham and Solihull, NHS Cheshire and Merseyside and NHS South Yorkshire were recruited and the programme officially launched in February 2023.
The programme ran from 2023 until November 2025, when the findings from the evaluation of the programme were launched.
A key component of the CHEC programme was the delivery and evaluation of three pilot initiatives delivered by the three ICSs, which were designed to promote good health and wellbeing among children and young people, reduce health inequalities through action on the social determinants of health, and improve outcomes for children and young people from underserved communities.
These initiatives have provided rich learning about the opportunities and challenges to better support children and young people’s health and approaches for other Integrated Care Boards (ICBs) and their partners within the ICSs to develop and use. The learning has led the CHEC to make a number of calls to action to the health care system in our report, Born Unequal: Tackling the Root Causes of Health Inequity in Childhood.
Through our learning from the CHEC programme, we have developed a range of outputs which together provide tools and learning for other healthcare systems to meet the challenges in delivering greater health equity for children and young people.
We began by developing a Child Health Equity Framework for the drivers of health for children and young people. The framework identifies the key social determinants of health and wellbeing.
The framework can guide:
- Service and intervention development – identifying areas where the healthcare system can intervene to support better health
- Where the voice of children and young people and data are needed to identify particular issues and monitor impacts
- Advocacy – making the case that the healthcare system must recognise that health is shaped by the social determinants of health and act to improve them.
We engaged with children and young people across the three ICS regions to understand what health means to them.
More than 300 children and young people shared their lived experience and the factors which influence their lives and wellbeing. Responses from this work have allowed an understanding of the key views and priorities of children and young people involved. The findings from this engagement were incorporated into the Child Health Equity Framework to ensure children and young people’s views and lived experiences inform and are embedded in it.
What good child health equity data looks like and the child health equity monitoring framework
The CHEC data working group developed a list of priority data indicators, mapping to the different domains of the Child Health Equity Framework, that are intended to be used by local areas to monitor child health.
Drawing on our learning, we developed the What good child health data looks like and how the voluntary, community and social enterprise sector can contribute report, seeking to provide an overview of what constitutes good data on child health equity, why having good data matters and the value of the VCSE in contributing to this. This is accompanied by the Child Health Equity Monitoring Framework, developed to provide a common set of indicators and a shared language for understanding child health inequalities.
Our Child Health Equity Readiness tool and action plan
The collective learning from the CHEC programme has been used to develop a Child Health Equity Readiness tool, designed to support Integrated Care Boards (ICBs) and other ICS organisations to reflect on their readiness to:
1. Address the social determinants of health
2. Reduce health inequalities among children and young people
3. Improve child health equity
It is intended that the information you generate using this tool will support your ICB to make equity informed decisions about the health of babies, children and young people and their social determinants.
Across the programme, the three ICSs developed approaches to undertaking meaningful engagement with children and young people at a local level. Each ICS set out to embed young people’s perspectives into service design and decision-making so that local solutions would be grounded in lived experience. While these aims shaped the direction of the programme, the extent to which they were fully realised varied across contexts. What has been clear is that being part of the CHEC created a shared space where ICSs could reflect together on challenges, exchange practical strategies and build on their strengths.
At Barnardo’s, we believe that children and young people should have opportunities to have their voices heard and be taken seriously in decisions that affect them. This leads to better decision-making, which means children and young people are better off. This is why the CHEC was established with the ambition that the voice, opinions and views of children and young people would be central to its work.
We have developed the three examples of practice, setting out their journeys: where they began, how their approaches have evolved, and the legacy this work is creating. These examples have been developed to offer practical insights for other ICSs seeking to strengthen their own engagement with children and young people, and to ensure that their perspectives are integral to building more equitable health systems.
Our Children and Young People's Voice and Influence tool
We have used our learning from the CHEC programme, alongside our other voice and influence work, to develop a tool to support health and care organisations to reflect on how children and young people are involved across different levels of decision-making and settings.
Find out more about our work
If you would like to know more about Barnardo’s child health equity work, get in touch [email protected].