NHS Wiltshire

October 2011

Prioritising accident prevention across a children’s partnership trust

Strong relationships between partner organisations helped Alison Bell, public health consultant at NHS Wiltshire, to secure child accident prevention as a strategic priority for the Wiltshire Children & Young People’s Trust Stakeholder Partnership.

The starting point for the partnership’s commitment to child accident prevention was the Healthy Lives, Healthy People draft public health outcomes framework, which was published in December 2010.

“We’re a large group of around 40 organisations and in a group of that size it’s very easy for each representative to feel they have to fight a battle to get support for their own agenda,” explains Alison explains. “I saw the public health outcomes framework as an opportunity to get an outside steer on the priorities we should be tackling and the outcomes we should be aiming for.”

The approach

Identifying priorities

The partners shared Alison’s view that the public health outcomes framework would be a helpful tool for identifying areas where the group should concentrate their efforts. Childhood accidents have a prominent place in the framework. Alison’s colleague Liz Norris, a public health specialist, had developed good local data which helped the partners to agree childhood accident prevention as a priority area.

Between September 2009 and October 2010 more than 32,000 under-19s attended A&E each year following accidents. The most common known causes of accidents were foreign bodies, burns and scalds, and poisoning. Where an accident resulted in admission to hospital, the most common causes were falls and transport (ranging from road-traffic accidents to cycling injuries).

The partnership’s strategic plan for 2012-15 incorporates child accident prevention into two strategic areas: prevention and early intervention, and promoting access to healthy lifestyles. “Our overarching aim for child accident prevention is to achieve greater multi-agency working at a strategic level,” comments Alison. “We’re still at an early stage of planning our work, but we’re particularly keen to find ways of working together to give parents the skills and confidence they need to respond to minor accidents without attending A&E.”

Ongoing relationship-building

Alison says that the group of partners have strong relationships, developed through working together over a long period of time. However, several partners ¬– including the primary care trust and the local authority – have recently gone through major organisational changes. “These kinds of structural changes mean that relationships can’t be taken for granted. You have to meet with new teams and individuals and engage them in your work early on. Trust is really critical – it’s often difficult for people to find time for strategic planning, but if there’s trust then they’ll be more willing to commit time to the partnership.”

In 2011 the group decided to reduce the frequency of their meetings to three a year. Rather than aiming to cover all of the partnership’s areas of work in each meeting, each meeting now focuses on one area, such as childhood accidents. “Trying to cover everything just wasn’t an efficient use of our time – you’d get a very brief overview of work but no real discussion or progress. Concentrating on one area gives us time to develop a proper understanding of the evidence, share activities that are going on and make things happen.”

Outcomes

Developing messages

One of the first activities that the partnership is working on is a set of messages on effective approaches to preventing childhood accidents. The messages will cover accidents that are common in different age groups and give examples of local prevention programmes that have worked well. The messages will be used in leaflets and other materials for people working with children and young people in children’s centres, schools and other settings, to help them implement their own accident prevention programmes.

“Our partnership has a broad membership which includes school governors and colleagues from the acute hospital trust, which helps us to get messages and information out to a very wide audience,” says Alison. “When people hear about what has worked well in one setting, it gets them thinking about approaches they could take themselves.”

Focusing on free and low-cost changes

Liz Norris recently held focus groups with children’s centre staff to find out their views on child accident prevention, based on their experiences of working directly with families. “One thing that emerged was that in today’s economic climate, cost can hold people back from doing all they can to make the home and other environments safer,” comments Liz. “But you can usually make free or low-cost changes which will reduce the risk of accidents. Often it’s down to behavioural changes which cost nothing.”

What we can learn

  • Using an external policy framework, such as the public health outcomes framework or NICE guidance, can help steer a large group of partners towards a shared view of priorities and outcomes.
  • Building strong relationships with partners requires ongoing effort, to understand roles and responsibilities and establish trust. This is especially important in times of organisational change and uncertainty.
  • Keep partnership meetings focused and productive by exploring a different theme each time. This provides more opportunity for discussion about activities, evidence and how each organisation can get involved.
  • Remember that there are lots of free and low-cost steps that people can take to reduce the risk of accidents. Think about how you can help parents develop the skills and confidence to manage minor accidents without attending A&E.

Further information

For more information about the work of the partnership:

You can also email Alison Bell at alison.bell@wiltshire.nhs.uk or Liz Norris at liz.norris@wiltshire.nhs.uk or phone either of them on 01380 736044.

Updated February 2014