Thermostatic mixing valves learning nuggets

November 2013

Sefton Council is working with local partners to supply and fit free thermostatic mixing valves (TMVs) in the homes of families with children under five years old. 

Koon Lan Chan, Public Health Development Manager for Sefton explains how the TMV initiative was informed by an analysis of local data. "Hospital admissions data showed us that burns and scalds are one of the more frequent causes of childhood injuries in the Sefton area, but our child injury prevention scheme didn’t include any specific interventions for burns and scalds.

"When we dug deeper into the data, we saw that injuries caused by contact with hot water were a particular area of concern. Children under five years old made up around 80% of hospital admissions for hot water scalds – which are most often caused by bath water. Although the number of children affected was quite small, we could see that the severity, impact and cost of the injuries could be very high."

Developing the intervention

Koon Lan worked with colleagues and local partner organisations, including the NHS and property management company Sovini, to develop an intervention which would help to reduce bath water scalds. The intervention involved supplying and fitting free thermostatic mixing valves (TMVs) in households that included children under the age of five.

"We developed a business case for the project and presented this to the primary care trust (PCT) board. We highlighted the costs of treating a serious bath water scald, which starts at around £41,000 but rises to twice that for a very serious scald that requires intensive care," comments Koon Lan.

"We demonstrated the links with the Public Health Outcomes Framework indicator on hospital admissions caused by unintentional and deliberate injuries among under 18s, as well as the NICE public health guidance on reducing unintentional injuries. We also highlighted published research into the effectiveness of TMVs in reducing bath water scalds and the cost-effectiveness of TMV installation schemes."

Launching the scheme

The PCT approved the funding and the scheme was launched in April 2012. In the first three months, the valves were offered to families which included a disabled child under five years old. The decision to focus on children with disabilities was influenced by a 2010 evaluation of Sefton’s injury prevention scheme, which found that existing interventions did not do enough to meet the needs of children with additional needs. From July 2012 the scheme was opened up to any family with a child under the age of five.

The team created leaflets and posters to promote the scheme and displayed them in children’s centres, GP surgeries, midwife clinics, emergency departments, the council’s ‘one-stop shop’ and local parent groups. Local newspapers also covered the launch of the scheme. 

Responding to challenges

In the first six months of the scheme, 30 local families expressed an interest in having TMVs installed in their homes. Koon Lan says that initial interest was lower than expected, despite the widespread availability of promotional materials. "I decided to go to a children’s centre to talk to parents and find out what they knew about what we were offering. I found that the posters and leaflets weren’t doing enough to raise awareness, which was actually pretty low."

The team learnt from this experience and planned a re-launch of the scheme in September 2013, with a wider range of activities to raise awareness among families and professionals who work with them. They linked up with the local home safety equipment scheme so that TMVs could be requested along with other safety items and they partnered with social housing providers so that they can promote the scheme to tenants whose homes are being refurbished.

One ongoing challenge is how to make sure that people keep their installation appointments. "Sometimes the installers have to make several visits to a property before they gain access and are able to fit the valve. We’re looking at ways to encourage people to stick to their agreed appointment time."

What we can learn

  • Using a variety of communication channels will help you to reinforce your messages and give you the best chance of reaching your target audience. You can’t just assume people will read and respond to leaflets and posters. Try to think creatively about different places and ways to promote your scheme, to give families lots of chances to engage with it.
  • It’s important to engage professionals who work directly with families, such as health visitors and children’s centre staff, so that they can mention the scheme in face-to-face conversations with parents.
  • Campaign materials should address common misconceptions about TMVs, for example that having one fitted will stop you from having hot baths.
  • ‘Piggy-backing’ on another local initiative can be an effective way to reach the families you want to target. Potential partners include initiatives that provide home safety equipment or smoke alarm installation, or social housing refurbishment programmes.
Updated February 2014