Injury prevention – addressing health inequalities Wendy Harris Public Health Specialist Child Health Improvement Team Wiltshire Council

Activity Look at your items and discuss 1.What are the main risks to a baby or young child? 2.What could you do to prevent a serious injury or a death? 5 minutes then feedback 3.If you had IP as your PH role, who could you work in partnership with? 10 mins Join with another group discuss and come up with 3 key points to develop an active partnership. 10 mins Think widely and creatively! Feedback

PHE Injury Prevention Priorities – Under 5’s Choking, suffocation and strangulation Falls Poisoning Burns & scalds Drowning ’

Inequalities and injury Strong links between unintentional injury and health inequality Admissions 45% higher in more deprived areas compared to the least deprived Children from most disadvantaged families are 13 times more likely to die in an accident Three times more likely to be admitted to hospital with more severe injuries Source - CAPT 2012, PHE 2014

Consequences of serious injury to a family Life changing injuries to a child, affecting the whole family Regular hospital appointments and regular health and social care support Increased caring responsibility for parent/s (particularly women) Emotional, social, educational, environmental and financial issues can cause strain on family life

Health & Social Care Costs NHS spends £146 million a year on childhood visits to A & E and £131 million on emergency admissions Costs of a serious injury of a child 0 -4 years is estimated at £33,000 Long term treatments are even higher - Children with serious bath water scalds generate lifetime treatment costs of £6.7 million Source – PHE 2014, CAPT 2012

New guidance for Injury Prevention in 2014 Public Health England Reducing injury among under 5’s at home Keeping Children Safe at Home. Injury Prevention Briefing, UWE & Nottingham Universities (5 year study) ROSPA & CAPT have supported these reports NICE Guidelines 2010 have informed this work All agree the way forward!

Key facts from Public Health England report 2014 An average of 60 children under 5, die each year due to an unintentional injury Unintentional injuries lead to around 40,000 emergency hospital admissions each year Around 450,000 attendances A & E Falls are the main cause of admissions Choking, strangulation and suffocation cause the most deaths

PHE Priorities ‘Five for the under 5’s’ Choking, suffocation and strangulation Falls Poisoning Burns & scalds Drowning

Injury Prevention Briefing 5 year research project, focuses on effective interventions Developed through collaboration with practitioners and parents in 30 children’s centres Target audience aimed at practitioners who provide support to families pdf version available free at

Parents say –We want more information on child development Learning about stages of child development is a key part of injury prevention work with parents and they are asking for this. It will help parents Predict and Prevent an injury

And…. Home fire safety checks, smoke alarms and family escape plans from Fire Service are helpful Home safety checks - with advice from trusted sources i.e. HV’s, Children Centre outreach staff Child Safety Equipment Schemes for most vulnerable families All are evidenced based ways of reducing injuries in the home among under 5’s

Map of Wiltshire, showing LSOA’s in 2015

PHOF Indicator 2.07i (2013/14) Hospital Admissions Caused by Unintentional and Deliberate Injuries in Children Aged 0-4 Years: Benchmark Comparisons

How are we tackling the issue to reduce injury in Wiltshire? Focus on 3 key action areas recommended by PHE Providing leadership and mobilising existing services 2.Training and development of early years workforce to strengthen and support it’s central role 3.Focus on the 5 types of injury for under 5’s And: - 4.Respond to recommendations from our Child Death Review Panel at local level, as recommended by NICE 2010 guidelines 5.Target our work in deprived areas, engaging families and communities to reduce health inequalities, as advocated in Marmot Review.

What have we done in Wiltshire 2015/16 Wiltshire Young and Safe -multi agency injury prevention group to improve joint working and produced first action plan together. Workforce development – training and support on key injury prevention issues with children centre providers, across county, using latest evidence – 53 senior staff trained, cascading training through workforce. Campaign work i.e. button batteries, water safety, Halloween costumes, Christmas home safety Targeted Paediatric First Aid with vulnerable families in 15 LSOA’s, promoting latest 5 national injury prevention messages at sessions

What have we done in Wiltshire 2015/16 cont… Regular e updates on IP, to promote messages and resources with different networks WYS group members collective responsibility to promoting uptake of fire service, home fire safety checks Medical student – Falls literature review Raising profile of injury prevention with different services in LA e.g. Housing Gaining IP resources – limited budget

The future - Wiltshire Young and Safe Action Plan - work together to raise awareness and target our work better Increase workforce development with others Improve our targeted work in deprived areas Improve our access to unintentional injury data Raise the profile of unintentional injury prevention in Wiltshire

Thank you for listening. Any Questions? Wendy Harris Public Health Specialist Child Health Improvement