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Long-term conditions in childhood

This chapter focusses on common long-term conditions in childhood (0-19 years) with particular attention paid to asthma, epilepsy and diabetes.

  • Long-term conditions affect not only a child's health, but the quality of life and wellbeing of them and their family.
  • Also, their school attendance, engagement and future prospects.

A national survey of school-aged children in 2010 found that 31% of those with a long-term condition or disability said:

  • " ... their condition was affecting their school attendance" (Brooks et al., 2011).

People with long-term conditions and their carers, are more likely to also suffer from:

  • Mental health problems.
  • Functional impairment.
  • Reduced life expectancy.

They are also disproportionately greater users of primary and secondary care services and this increases with age (NHS Confederation, 2012).

In general, 1 in 7 young people aged 11-15 years has a long-term medical illness (Brooks et al., 2011).

The local picture

Exact numbers of children and young people living in Calderdale with long-term conditions including: asthma, epilepsy and diabetes are unknown. This is because local prevalence data is limited.

In 2015, 1 in 4 (23%) Calderdale school pupils in Years 7 and 10 reported having one or more common illnesses:

This represents a reduction on the 2013 figure.

In 2014, around one in seven pupils in Years 7, 10 and 12 reported that they had asthma. Around 1% reported having diabetes and a further 1% reported having epilepsy. However, the school survey from which these figures are drawn does not include pupils in special schools. Where, children with more complex disabilities and potentially one of these condition as a co-morbidity, might attend. A review of General Practitioner (GP) prescribing data suggests that 70 (around 0.2%) under 18s received insulin in 2012/13. This suggests Type 1 diabetes, while 134 (around 0.3%) had anti-epileptic drugs. (Though some such drugs may be used in conditions other than epilepsy).

Emergency admissions for long-terms conditions in under 19s in Calderdale CCG area are summarised below. (Visit: National Child and Maternal Health Intelligence Network (CHIMAT): Improving services toolkits - information tools, 2013/14).

Table 1: Emergency hospital admissions, 0-19 year olds

  Admission rate per 100,000, 2013/14 Compared to all Clinical Commissioning Groups in the North of England Compared to England
Asthma 247.4 Similar Significantly worse
Diabetes 66.9 Similar Similar
Epilepsy 83.1 Similar Similar

Figure 1: Trends in under 19s asthma admissions 2010/11 to 2013/14

Trends in under 19s asthma admissions 2010/11 to 2013/14

Figure 2: Trends in under 19s emergency epilepsy admissions 2010/11 to 2013/14

Trends in under 19s emergency epilepsy admissions 2010/11 to 2013/14

Figure 3: Trends in under 19s emergency diabetes admissions 2010/11 to 2013/14

Trends in under 19s emergency diabetes admissions 2010/11 to 2013/14

Locally, 7% of secondary school pupils surveyed in 2014 worry about missing school because of poor health. Also, 4% worry about not being able to do the job they want because of it.

Current provision

In 2015, a school nurse role was commissioned. This focuses on supporting children and young people with common long-term conditions in the school setting.

The service aims to:

  • reduce hospital admissions for LTCs;
  • and improve school attainment due to better care and improved understanding in school settings.

User views

The views of children and young people with long-term conditions have not recently been collected.

In 2016/17 we will be able to feedback specifically regarding the School Nursing Service role in managing long-term conditions. At the moment, it is too early to understand the impact.

Unmet needs

Hospital admissions data shows that Calderdale has higher than average admissions for respiratory problems for children and young people.

The reasons for this are unclear and require further analysis.

Projected future need

In recent years the number of people with asthma has risen. 1 in 11 people in the UK now have asthma. This includes 1.1 million children and their chance of good outcomes have plateaued and on some measures declined (Asthma UK). The majority of deaths from asthma are entirely preventable.

Nationally, Type 2 diabetes, which is associated with excess weight, is increasingly found in children and young people. Local prevalence of childhood overweight and obesity are in line with national trends. Thus, type 2 diabetes in children may become a local concern.

Key considerations linked to the known evidence base (what works?)

There is significant evidence regarding what works with regards to asthma, diabetes and epilepsy care.

For more about this from the National Institute for Health and Care Excellence (NICE), visit:

Since September 2014 schools are required to have a Medical Conditions Policy for children with asthma in place. This includes children having individual health plans, if it is felt to be needed.

Schools are now legally allowed to keep an emergency spare reliever inhaler and can purchase these from pharmacists without prescription.

The Department of Health has produced a comprehensive guide on how schools can implement this change in the law. For more about this, visit: Emergency asthma inhalers for use in schools.

References and further information


  • Brooks, F., et al., HBSC England National Report. Findings from the 2010 HBSC study for England (2011): Hatfield.
  • Calderdale Council: electronic Health Needs Assessment (eHNA) survey: key findings, for primary, secondary and post 16 ages.
  • NHS Confederation, Investing in emotional and psychological wellbeing for patients with long-term conditions. 2012, NHS Confederation's Mental Health Network: London.
  • Linda Haines, Kay Chong Wan, Richard Lynn, Timothy G. Barrett and Julian P.H. Shield, Rising Incidence of Type 2 Diabetes in Children in the UK (2007).
  • B Purcell et al, Epilepsy Prevalence and Prescribing Patterns in England and Wales. Office for National Statistics, Institute of Neurology, University College London (2002).

Further information

For more on children and young people, see: Further resources.

For more details on long-term conditions considered here, visit:

For more on indicators of child health, visit: Health and Social Care Information Centre HSCIC indicator portal.


  • Children and Young People's Programme Manager, Public Health, Calderdale Council.
  • Edited by Public Health Intelligence Officer, Public Health, Calderdale Council (February 2016).

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