Cornwall and Isles of Scilly PCT

December 2011

Formalising a multi-agency approach to child accident prevention is helping Cornwall and Isles of Scilly Primary Care Trust (PCT) to reduce emergency hospital admissions among children.

Supporting QIPP by reducing emergency hospital admissions

Kirsty Edlin is senior commissioning manager for children and maternity services at Cornwall and Isles of Scilly PCT. As part of the PCT’s Quality, Innovation, Productivity and Prevention (QIPP) programme, she has been tasked with undertaking work to reduce emergency hospital admissions among children and young people.

“Reducing emergency admissions is a fundamental part of our QIPP programme,” says Kirsty. “There are obviously many reasons why children are admitted to hospital, but we were keen to identify if there was anything we could do to reduce unnecessary admissions or possibly reduce the likelihood of emergency admissions. This is where accident prevention has a key role to play.”

The approach

Interrogating the data

The first task for the PCT’s accident prevention co-ordinator Beth Beynon was to look for themes and trends in local data. Every three months, Beth joins staff from the minor injuries unit and A&E at a meeting of the local paediatric emergency care network. The meetings give Beth a chance to hear at first-hand about the types of accidents that emergency practitioners are dealing with.

“The insights shared at these meetings directly inform our programmes of work,” says Beth. “For example, when A&E staff told us they were seeing rising numbers of injuries caused through trampolining accidents, we developed a safe trampolining campaign.” The safe trampolining campaign took place during early summer 2011. It involved giving safety information leaflets to parents when they bought a new trampoline and providing 800 free trampolining taster sessions to local children between the ages of 5 and 11.

Read more about Cornwall and Isles of Scilly's campaign on the main CAPT site.

Improving data collection

One of Beth’s priorities within the PCT is to obtain more robust data on childhood accidents, in order to identify particular areas of concern and develop targeted responses. In December 2009 she led a two-month data collection pilot within A&E departments and minor injuries units. Beth explains: “We devised a simple form to gather information on the circumstances of accidents. Patients or their parents or carers filled in the basic facts while waiting in reception, then duty staff added specific details after the examination.” The average age of attendance for boys was 10 years and for girls 9 years, with peaks at the pre-school and secondary school stages. Over a third of accidents happened in the home (39% but rising to 45% for those under five years old).

Beth says that good working relationships and effective communication is essential if you are to improve the availability and reliability of data. “Our data leads are inundated with requests for information, so you need to help them see why the work you’re doing is important,” she explains. “I always aim to show people what we’ve been able to achieve with the information they’ve given us.”

Formalising links with the local safeguarding children board

To make sure accident prevention was owned by all agencies, Kirsty set out to get accident prevention confirmed as a priority issue for the Local Safeguarding Children Board (LSCB). When the LSCB underwent a restructure in 2011, she proposed that accident prevention should be a key area of focus for the early identification and intervention sub-group. Kirsty and Beth successfully made the case for the group to have a clear accident prevention remit, by demonstrating the impact you can achieve through a co-ordinated approach.

“At the PCT we’d run a successful nappy sacks campaign and we used this as a good example of how a co-ordinated approach can deliver significant impact with minimal resources,” says Beth. “We’d found out about the sad deaths of two local babies through an LSCB alert and decided to developed a campaign to educate people about the dangers posed by nappy sacks. Our safety warning went to every household in Cornwall and the Isles of Scilly with a child under two and is now included in the ‘red book’ child health record.”

Beth is now a member of the group, along with representatives from children’s services, the local police and fire services, health organisations, Connexions and voluntary sector partners.

Using data to inform activities

Within the PCT, Beth is developing two education projects that have clear links to the QIPP goal of reducing emergency admissions among children. The education projects focus on the pre-school and secondary school audiences that the A&E data collection pilot had confirmed were high-risk groups. For secondary schools, she is exploring ways that teachers can use an NHS teaching resource that explains how A&E isn’t the only option if someone’s been injured. “The resource was sent to all secondary schools, but teachers told me they didn’t have the time or health expertise to use it properly,” comments Beth. “I’m working with our healthy schools team to understand what support teachers need to start using the resource and how we can help them.”

For the early years audience, Beth is leading on the development of a learning resource that uses games and role-play to explain when and where to seek help when someone’s involved in an accident or is feeling unwell. The resource is based on one already developed by the local fire service to teach under-fives about fire safety.

What we can learn

  • When making the case for a co-ordinated approach to accident prevention, focus on demonstrating the impact you’ve achieved with recent programmes. Accident prevention co-ordinators should always consider relevance to QIPP when developing or prioritising activities.
  • Provide regular feedback to people who provide you with data, to show them the impact of their work. If you’re asking busy frontline staff to complete questionnaires about accidental injuries, consider whether patients or their parents or carers can provide some of the details themselves.
  • When developing educational resources, see whether other organisations have already produced materials which you can use or adapt for your own purposes. Teachers may even have access to the right kind of resources, but need support to use them effectively.

Further information

For more information about the work discussed in this case study, please contact Beth Beynon on beth.beynon@cornwall.nhs.uk

Related links

Updated February 2014