What are the key inequalities?

Children are particularly vulnerable to injury when they play, travel and sleep. The risk of injury, however, disproportionately affects some children more than others. Great variations occur in injury, mortality and morbidity which reflect a child’s age, gender socio-economic group, address and cultural ethnic group.

What are the key gaps in knowledge/services?

Knowledge:

• Although data relating to house fires and burns and scalds are available, the data is not sufficiently specific to assess the cause of some accidents. 
• Data is not available for accidental injuries presented at GP surgeries or walk in centres.
• Data is not available for serious injuries, including drowning, poisoning, further work is required to develop an appropriate tool to collect these data 
• It is difficult to acertain trends in some of the data due to small numbers (e.g. deaths)
• Investigate more thoroughly people’s perceptions about childhood accidents and what parents feel would support them

Services:

Road accidents – need for more:

• 20 mph speed limits in areas of higher pedestrian activity
• Local child pedestrian training schemes and safe travel plans
• Systematic road safety intervention in inner city areas
• Child restraint loans scheme
• Increase the number of children who undertake cycling training
• Double yellow lines for cycle lanes
• Links between road safety teams and public health

Play and recreation – need to:

• Provision of advice around falls prevention (e.g. health visitors, school nurses, voluntary sector staff)
• Develop local guidelines for safety in children’s sports based on work done by sports associations (e.g. the Football Association) 
• Strengthen risk and safety education in schools
• Increase from 2 to 4 years the age for which home safety equipment is provided

Dwelling fires – need for:

• Home risk assessment, safety checks and escape plans
• Target deprived groups, particularly with older children in privately rented and temporary accommodation; and households in which people smoke. Ascertain whether data is available from the fire service regarding the numbers of smoke alarms fitted as part of their home risk assessment.

What are the risks of not delivering our targets?

Injury levels

Children will continue to be injured, seriously injured or die unnecessarily

Cost

The health equity audit carried out by Newcastle PCT estimates that the cost of treating children’s accidents as outpatients and inpatients has been estimated at over £200 million a year and that it can cost as much as £250,000 to treat one severe bath water scald. This figure does not reflect the long-term costs of prolonged treatment and rehabilitation or the cost of pain suffering to the patient. Nor does it reflect the lifetime disfigurement or disability and the financial loss to the patient and family or work hours lost caring for an injured child. 

Is what we are doing working?

• Newcastle upon Tyne was ranked 20th in the Index of Multiple Deprivation (IMD) 2004, compared with 37th in 2007, suggesting the City has become relatively less deprived compared with other local authorities. Data from the Newcastle Neighbourhood Information Service (NNIS), measuring the vitality of neighbourhoods, shows that the improvement in our most deprived areas has made up some ground against city averages. But there remains a wide gap to the most affluent areas
• Accident levels have decreased overall across Newcastle upon Tyne. However, the rate and number of serious accidental injury relating to hospital admissions are higher than national figures. 
• Increased introduction of 20mph traffic zones has had a positive outcome on RTAs

What is coming on the horizon?

• Strategic lead by Newcastle Safeguarding Children Board
• Resurrection of Child Accident Prevention Strategy Group and the Child Accident Prevention Forum
• Implementation of Child Death Overview Panel (Working Together, 2006)
• Baseline set of hospital admissions caused by unintentional and deliberate injuries to children and young people. However, there is concern that figures for unintentional and deliberate injuries are being mixed and that each set of data should be considered separately.

What should we be doing next?

1. A specific strategic plan that implements the Accidental Injury Task Force’s recommendations for:

• ­ Priority areas (identified examples of inequality)
• ­ Headline Interventions
• ­ Child Accident Prevention Co-Ordinator

2. Further development of Local Strategic Partnerships involving PCTs, Councils and Local Organisations, coordinated by Public Health, to ensure that sustainable funding is provided and monitored so that projects can deliver the projects at key times throughout the year, Child Safety Week for example.
3. Further work to accurately document the incidence and trends in unintentional injuries for children and young people, including play and recreation injury
4. Support and monitor the work of the Child Accident Prevention Forum to ensure that universal and targeted projects are delivered that link with the Strategic Plan and engage with front line services.
5. Review the Home Safety Equipment Scheme and consider issues relating to the delivery of the service, future funding and how it links with the strategic group.