Why Unintentional Injuries to Children Matter?

1. Child Injury Prevention Strategy 2011-2014Preventing Unintentional Injury to Children in the Bradford District

2. Why Unintentional Injuries to Children Matter? • Unintentional injury is a leading cause of death, disability and serious injury to children. • In 2010 172 children died in England and Wales. • Children in the Bradford District are 17% more likely to be admitted to hospital with a serious injury than the national average. (YHPHO 2010) • Children from disadvantaged backgrounds are more likely to suffer unintentional injury.

3. National Context Rising up national agenda • Healthy Lives, Healthy People 2011:strategy for public health. Target to reduce unintentional and deliberate injuries to children. • Suite of NICE guidance published 2010: Preventing Unintentional Injuries among under 15’s. • Lessons from Serious Case Reviews (2008 – 2009) found neglect to be a factor in some cases of serious accidental injury to children. • Strategic Framework for Road Safety, 2011. • Fire and Rescue National Framework, 2010.

4. Regional Death Rates

5. Reduction in Regional Death Rates

6. Cost of Unintentional Injury Human costs Death, disability, trauma, PTSD Financial and social costs Millions of pounds NHS annually treating preventable injuries Audit commission estimate cost of childhood A and E visits alone = £146 million Family costs Time of work, feelings of guilt/ depression, time to care

7. Counting the Cost Locally The Child Accident Prevention Trust (2004) estimated the cost of unintentional child injury to the Bradford District as a whole = £136 million. A 5 % reduction would therefore save around £15 million.

10. Unintentional Injury and Safeguarding • Of 173 SCR’s completed, 58 were due to accidents and adverse events and other external causes (incl drowning and fire). This is 33.5%. • Common characteristics of the families included drug and alcohol misuse, DV, mental health problems and or LD. • The report mentions frequent A and E attendance as a possible cry for help by families which was often overlooked

11. Local Responsibility • BSCB has responsibility for reducing child injuries and deaths due to ‘accidents on the road, in the home and in public spaces’ . The Government has placed this issue in the Safeguarding Arena. • Post of Children’s Accident Prevention Coordinator • Inclusion within JSNA • Target within the Child Poverty Strategy • Development of 2nd Child Injury Prevention Strategy

12. Mission statement ….The overarching aim of the strategy is to reduce deaths and unintentional injuries to children which occur on the roads, in the home and in public spaces and reduce the associated health inequalities. The target the strategy is working towards is to reduce by 5% the rate of children killed and seriously injured due to unintentional injury in the Bradford District by 2014 from the 2011 baseline (rolling 3 year death rate and admission to hospital > 3 days)…..

13. Progress The previous strategy document detailed a reduction of 5 % from the 2005 -2007 baseline when compared to 2009 -2011. The trend data for deaths and serious injury (admissions >3days) in the Bradford District show reductions of 18.7 % for deaths and 6.2% for admissions for these dates. The 2010 road safety target of no more than 35 children KSI was met. The data is limited due to coding issues, differences in interpretation, different data sets. These are, however, national issues and are not peculiar to Bradford.

14. What the Local Data Tells Us • Death rates due to unintentional injury (0-18 years) are reducing • Hospital admission rate due to unintentional injury (0-18 years) stay >3 days are reducing • Hospital admission rate due to unintentional injury with any length of stay are fluctuating • Hospital admissions due to unintentional injury are concentrated in areas of high deprivation • Leading types of unintentional injury include: falls, transport, caught or crushed and accidental poisoning

15. Emergency admission rates for injury by 5yr age band, 2006/07 – 2010/11

16. Gaps in the Data • We know the rates of injuries but not what is causing the changes in the rates (hotspots, types of injuries rising/falling and where). • We know leading causes of injury but not how or where they occurred. • A and E statistics, coding has been poor, new system provides new opportunity for deeper analysis.

17. Priorities for Action • The overarching aim of the strategy is to ‘Reduce the number of deaths and unintentional injuries to children in the Bradford District which occur on the road, in the home and in public spaces’ with a focus on the reduction of the associated health inequalities • 3 Strategic objectives and 3 operational objectives have been set : data collection, injury prevention training, multiagency collaboration, reducing inequalities, reducing road traffic collisions, reducing home and leisure injuries

18. Baseline Data and Monitoring • Target reduction for the strategy is to reduce the number of children killed and seriously injured due to unintentional injury by 2014 by 5% from 2011 baseline. • The 2011 baseline will be taken as a rate of death rolling three year time period, per 10,000+ rate of serious injury (hospital admission > 3 days) rolling three year time period per 10,000. Aged 0-18 and unintentional injuries only. • Governance and monitoring of this strategy will be through the BSCB, the BSCB Universal Safeguarding Sub Group and through the Health and Wellbeing Board.

19. What Works in Preventing Unintentional Injuries • Provision and installation of home safety equipment. • Targeted fire safety and prevention activity on high risk groups. • Fitting child car seats which are appropriate for child's age, height and weight. • Pedestrian Training schemes. • Injury Minimisation Programme for Schools.

20. Action Plan • There are a number of actions under each objective • Each action is the responsibility of a named individual or group • The Child Injury Prevention Practitioners group monitor and work to the actions within the action plan • The strategy has been signed off by Bradford Safeguarding Children Board and is available to view on the BSCB website: http://www.bradford-scb.org.uk

21. What are we doing locally? • Road Safety Week 19th – 23rd November • Local campaigns (nappy sacks, safe sleep, hot drinks burn) • E learning for practitioners – Accidental Injury, Basic Child Protection and Safe Sleep • IMPS • Community First Aid for Parents/Carers • Pedestrian Training Skills • Car seat checking • Cycle Training • Developing a business case for Equipment Scheme • Piloting a home safety checklist • Regular newsletters and trading standards recall notices

22. Sum up • Many child injuries are preventable • Pass on simple messages (i.e. burns first aid, supervise young children when in bath etc) • Everyone’s responsibility, not an add on when everything else completed • As Marmot said ‘Doing nothing is not an option’!

23. Further Information • CAPT (2004), Coming of Age, winning recognition and shared strategic commitment to reduce children’s accidents in Bradford. • CAPT (2011). Advocating Child safety: A networking resource to support the development of local partnerships for injury prevention in England. • NICE (2010) Preventing Unintentional Injuries Among Under 15’s. NICE public Health guidance 29,30 and 31 at www.nice.org.uk/guidance/PH29, www.nice.org.uk/guidance/PH30, www.nice.org.uk/guidance/PH31. • www.capt.org.uk • www.dft.gov.uk Davina Hartley: davina.hartley@bradford.gov.uk