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J Pediatr. 2016 Oct;177S:S217-S242. doi: 10.1016/j.jpeds.2016.04.058. Epub 2016 Sep 22.

Child Health Systems in the United Kingdom (England).

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King's College London, Department of Public Health Sciences and Primary Care, Evelina London Children's Hospital, London, United Kingdom.
University of Oxford, Oxford, United Kingdom.
London School of Pediatrics, London, United Kingdom.
Emeritus Pediatrician, Bath, United Kingdom.


Child health in the United Kingdom has improved markedly over recent decades but has failed to match health gains and reductions in mortality achieved by other European countries. Child poverty and inequalities are rising in the United Kingdom. The National Health Service (NHS) is a universally accessible health service, funded by taxation and is free at the point of use. The NHS is undergoing substantial reform, aiming to improve care quality and experience, meet rising demands, and contain costs. The NHS is struggling to balance access with expertise for urgent and unscheduled care. There is increasing use of urgent and emergency care, and there are unexplained variations in outcomes. Quality of care for children and young people with chronic and long-term conditions, including transition services, is variable and sometimes poor. Many determinants of noncommunicable conditions are worsening. Key achievements include a universal service free at the point of use, providing generally accessible, and equitable care. Key challenges include increasing fragmentation of services, insufficient emphasis on preventive care, achieving an effective balance between access and expertise of care for children, and improving child health and well-being outcomes despite generally high quality inputs and high levels of spending.


children services; economics; public health care

[Indexed for MEDLINE]

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