Unintentional Injury Briefing 14th October 2022

Question:

North Yorkshire has 15.3% higher admissions caused by deliberate or unintentional injuries in children than the England average.  It was agreed that the reasons behind this would be explored further and fed back to the committee. 

Background:

Rates of hospital admissions caused by unintentional and deliberate injuries in children, both 0-4s and 0-14s remain significantly higher than Yorkshire and Humber rates and England rates and has done so over a number of years.

Overall rates of 0-14s show to be decreasing and getting better in recent years:

There has been no significant change in rates for our 0-4 population:

 

Source: Public Health Outcomes Framework PHOF data (based on Hospital Episode statistics).

 

Our Strategy & Performance Team report quarterly on trends to the North Yorkshire Children’s Safeguarding Partnership (NYSCP).  The team has recently presented a paper to NYSCP to summarise analysis of inpatient admissions data, supplied by the NHS Humber and North Yorkshire Integrated Care Board (ICB), relating to accidental and deliberate injuries in children in 2021/22. Analysis has been undertaken by age, reason for admission and home location. This data did not include Craven admissions, as this lies outside the ICB boundary, and is a snapshot in time. 

Summary of Data:

·         Scarborough district had the highest rate of admissions in the 0-5 age group, and at 491 per 10,000 population the rate was significantly higher than the North Yorkshire CCG average (370 per 10k)

·         Across North Yorkshire (excluding Craven) the most common reasons for admission was poisoning (484 admissions, 49.7 admissions per 10k) and injuries to the head (433 admissions, 44.4 per 10k)

·         Across the CCG the 0-4 age group had the highest number of admissions and highest rate of admission per 10,000 population (804 admissions, 308 per 10k population)

·         Among this age group head injuries were the most common reason for admission, accounting for 36% of admissions in this age group, followed by poisoning (13%) and foreign bodies (11%). This would be consistent with falls-related injuries or being hit or struck by an object or force, as well as being a result of the inquisitive nature of children under five years of age which puts them most at risk of poisoning/ foreign bodies.

·         In the 5-9 age group, the most common reasons for admissions were injuries to the arms, hands and wrists, which accounted for half of all admissions, followed by head injuries.  These reasons for admission would be consistent with falls-related injuries

·         In the 10-14 and 15-19 age groups poisoning was the most common reason for admission.

·         There are a number of MSOA where the overall rate of admission is significantly higher than the CCG average. These areas are focused on the coast and the upper dales.

Types of injury by age group are consistent across the Districts and most injuries by age group reflect the type of injury we would expect to see in that demographic.

 

What are we currently doing in North Yorkshire to reduce unintentional injuries in the home?

 

HEAT (Home Environment Assessment Tool)

 

Currently being used by the Healthy Child Programme universally, by 6-8weeks after birth, and, after any significant changes to family circumstances. Designed to help practitioners provide key preventative messages and identify families where there may be early signs of neglect so that prompt action can be taken to address and support families to improve home conditions and safety for their children.

 

Day or Night, Sleep Right

 

Practice Guidance and Multi-agency training. Raising awareness of the importance of safe sleeping environments for infants to reduce the risks of Sudden Unexpected Deaths in Infancy (SUDI) with a particular focus on families with increased vulnerabilities.

 

ICON, Babies Cry, You Can Cope

 

Preventing Abusive Head Trauma. ICON is discussed at several “touch-points” throughout the antenatal and postnatal journey by midwives and health visitors, and a leaflet reinforcing the key messages discussed and sources of support is left with families.

 

Take Action Today, Put Them Away Campaign

 

Increasing families understanding of the dangers of poisoning and the importance of maintaining a clear accident prevention strategy within their home, enabling them to take the precautions necessary to improve the safety of their children and reduce hospital admissions due to poisoning.  Health Visitors undertaking the risk assessment and distributing resources to all families at their new birth visit and 2year old development check.

 

Unintentional Injuries One Minute Guide

 

Aim to improve wider CYPS workforce understanding of the issues in North Yorkshire and what they can do in their roles to reduce UIs. This was rolled out in March 2019 following feedback from team managers at Early Help Manager development sessions.

 

Healthy Child Programme Text Messaging Service

Aim to Increase parent knowledge and awareness of potential hazards, and parent receptiveness to information and influence parent behaviour. 14 delivered across key stages of development 0-2s. Soon to be transferred into the new App being developed by HDFT.

 

 

Next Steps:

The Unintentional Injury Task Group will be relaunched to bring together partners and stakeholders together to improve awareness and work together to reduce the incidence of unintentional injuries in children and young people.

The work of this group will include:

·         Reviewing workforce development needs. Including supporting wider workforce (e.g. NYFRS crib sheet for fire crews)

·         Reviewing recent data provided by P&O team alongside Public Health Outcomes Framework to determine priorities.

·         Evaluation of the impacts of the ROSPA Take Action Today Campaign in North Yorkshire.

·         Communications, exploring development of seasonal multi-agency communication plan.