NHS England and NHS Improvement launched Core20PLUS5 in 2021, a national approach to support the reduction of health inequalities at both national and system level. This new initiative is split into two different cohorts, adults and children and young people, this particular page focusses on the latter.

CORE20PLUS5 for children and young people is made up of the following components:

• ‘Core 20’ refers to the communities living within the 20% most deprived areas in England based on the 2019 Indices of Deprivation (IMD), some areas of the East Riding are included within that group.
• ‘Plus’ refers to additional groups of people identified locally as experiencing poorer than average health access, experience or outcomes, in the East Riding this includes: Children Looked After, Young Carers, A focus on Speech and Language Therapy & Neurodiversity, Children who are overweight/obese
• ‘5’ refers to the 5 clinical areas identified by NHS England as their target services in which to reduce health inequalities: asthma, diabetes, epilepsy, oral health and mental health.

A document (see below) has been produced to show how elements of CORE20Plus5 look within the East Riding, it can also be downloaded. A number of key points have been provided in the section beneath the document.

A number of high level summary points from the document can be viewed below, divided by the main sections.

CORE 20

There are 17 LSOAs (2011 definition) within the East Riding that fall within the most deprived 20% of areas nationally. The ward of Bridlington South contained 7 of these LSOAs, South East Holderness and Bridlington Central and Old Town both contained 3 of the LSOAs, others were located in Goole South, Minster and Woodmansey and East Wolds and Coastal. Map shows LSOAs (2011) in red that fall within the most deprived 20% of LSOAs nationally

PLUS

Children Looked After (CLA)
At the end of 2022/23 there were 350 East Riding children who were looked after and as a rate of 10,000 population, the East Riding has less CLA than statistical neighbours, region and England overall. A significantly higher rate of CLA were placed in locations which were amongst the most deprived nationally.

Young Carers
As of the 2021 Census, there were 547 East Riding residents (aged 5-17) identified as a carer, which represented 1.2% of the total 15-17 population; a proportion significantly lower than the England average.

Children’s Weight
Childhood obesity, with major implications on a variety of health outcomes, is of considerable interest to public health. Evidence shows that most children who are above a healthy weight will grow up to being overweight or obese in adulthood. In 2021/22, the East Riding when compared to England, reported a significantly higher prevalence of ‘overweight’ and ‘overweight and obese combined’; whilst Year 6 children were classed as similar to England for all but one category. The underweight category was reported as being significantly lower for both reception year and year 6. The East Riding obesity and severely obese categories were lower in prevalence than both Regional and England averages (for Reception year and Year 6) but were not significantly different when compared to England. Within the East Riding there was a significantly higher prevalence of obesity within the wards of Goole South and Bridlington South.

Five

Asthma
As of 31 July 2023, there were almost 2,000 children aged 0-17 years registered with an East Riding PCN recorded as having asthma, equating to an overall NHS East Riding prevalence of 3.9%. A significantly higher proportion reside within the 2 most deprived national quintiles. Asthma emergency admissions involving East Riding residents (0-18 years) have been in decline since 2014/15 and have remained significantly lower (i.e. better) than the England average overall during this period. The rate of admissions did drastically decrease during 2020/21 but this was most likely be due to the impact of COVID-19 on secondary care. In 2020/21 the count of admissions was recorded as 15, however in the preceding 5 years the average count per year was 65 per year. By 2021/22 the count of admissions had increased again to 65. Within the East Riding there is some variation in emergency admissions, Bridlington Central and Old Town and Driffield and Rural showing significantly higher rates than the East Riding.

Diabetes
The RAIDR system states that the majority of the 68 children (under 18 years) registered with diabetes in the East Riding on 31 July 2023, were registered with Type 1 diabetes. There were less then 5 children registered with Type 2 diabetes. Goole North was the only ward with a significantly higher rate (135.3 per 100,000 population) of diabetes emergency admissions than the East Riding average (51.5 per 100,000) in the period 2020/21-22/23. When looking at deprivation quintiles, none had a significantly different rate of diabetes emergency admissions than the East Riding average.

Epilepsy
The RAIDR system is able to provide by PCN, the registered numbers of children 0-17 years with epilepsy. There were a total of 177 patients registered on 31 July 2023, with an overall prevalence for the East Riding of 0.3%. Emergency admission rates due to epilepsy, for the 3 year period 2020/21-22/23 showed that there were 2 wards with a significantly higher rate of admissions than the East Riding average (73.1 per 100,000). These were Bridlington Central and Old Town (227 per 100,000, which was 3 times higher than the East Riding average) and South West Holderness (173.5 per 100,000). Separate deprivation analysis highlighted that none of the deprivation quintiles were significantly different from one another or the East Riding overall.

Oral Health
Between April 2018 and March 2023, East Riding ward rates of hospital admissions (0-19 years) concerning a primary procedure of tooth extraction and a diagnosis of tooth decay were mostly similar to the East Riding average. The only exception was South East Holderness, which recorded a significantly higher crude rate of admissions than the East Riding average. At 94.7 per 100,000 population, the South East Holderness rate was over twice the East Riding average (44.1 per 100,000).

Multi-morbidities
In the East Riding a number of children will be registered with more than one condition. As an example, there were 2,001 East Riding patients under the age of 18 who are registered with asthma. Of these 2,001 children, 98 also have anxiety disorders, 8 have diabetes and 15 have epilepsy and so forth. This example provides detail on just 2 co-morbidities, but many children have more than 2 conditions and this might be a suitable area of investigation for partners to pursue.