Warwickshire had seen a rise in hospital admissions for unintentional injuries in 0-14 year olds over the last few years, and concern was expressed by the authority’s Health and Wellbeing Board as the targets set out in Public Health Outcomes Framework indicator 2.7 (to reduce hospital admissions from unintentional to children and young people) were not being met.

Through a partnership with the Child Accident Prevention Trust’s [CAPT] Department of Health-funded project, Improving Capacity and Collaboration (ICC), which has a particular focus on home accidents to the under 5s, Warwickshire began by setting up a small multi-agency working  group that  included representatives from Public Health, Fire and Rescue, Health visiting, Family Nurse partnership, Warwick hospital A&E and Citizens Advice. This group under took a detailed data analysis and started to plan next steps.

Warwickshire has a strong track record of successful partnerships, and with CAPT’s support a ‘Safe Children; Together we’ve got this’ multi-agency event took place on 5 June 2018, during Child Safety Week with the aim of bringing stakeholders together in order to develop a shared understanding of the issues and concerns, and to agree a shared way forward.

Representatives attended from many different organisations including  Health, Public Health, Early Years,  Warwickshire Childrens Safeguarding Board,  Leisure services and Trading Standards, also district, borough and county council departments, and the voluntary and community sector.

Karen Higgins, Senior Project Manager (Children’s Public Health), who worked to bring the event together and ensure a successful outcome said:

‘With the excellent supporting information provided by Ian Evans from CAPT, I was able to spend time targeting child accident prevention messages to individual services explaining the relevance of the messages and how their involvement would be mutually beneficial. I was also able to visit a number of services personally to help them understand their role in the bigger picture of reducing childhood admissions for unintentional injuries.’

‘I explained that the hospital admission indicators for Warwickshire were consistently high compared with the national average which was, of course, a cause for concern.  Many of these accidents were preventable and by coming together we could make a difference. This approach really seemed to motivate people.’

The keynote speaker was Alison Morton, from Public Health England, and Karen believes that having a national speaker helped encourage people to attend. Members of Warwickshire County Council’s Insight Intelligence Team had produced a JSNA (Joint Strategic Needs Assessment) report looking at the local picture and comparing this with what was going on Nationally. Councillor Les Caborn, Portfolio Holder for Adult Social Care and Health, spoke about local concerns and attended the full event and agreed to chair the Child Accident Prevention Multi Agency Steering Group which ensures leadership and ownership at a county wide level.

After information about the local and national picture, delegates came together for table discussions on the following two questions.

• Who can make a difference?
• How can we make it happen?

These discussions generated many helpful suggestions including the need to develop a multi-agency approach for disseminating information to a variety of stakeholders, training for frontline practitioners and understanding the pathways used in clinical settings and how the data is generated for childhood admissions for unintentional injuries.

By the end of the event there was a strong consensus that the issues needed strategic leadership, to drive forward a multi-agency approach. It was agreed that Councillor Caborn would take a proposal for a way forward to Warwickshire’s Health and Wellbeing Board in September 2018, to harness strong strategic leadership and oversight for this work priority across the county.

Karen Higgins drew on Public Health England papers on reducing unintentional injuries for children under 5 to develop the proposal for the Board.  Karen also wanted to ensure that the momentum from the seminar wasn’t lost. She brought together some of the participants from the seminar to look at some of the key areas which had emerged ie–

• developing the workforce
• understanding the key injuries in Warwickshire
• strengthening partnership opportunities
• and communicating accurate information

The discussions from these working groups fed into the development of a recommendations report.

At the September, meeting of the Health and Wellbeing Board the proposal was formally adopted as a key work stream, with the endorsement of the related Child Accident Prevention Steering Group .

As the workgroups were already constituted and had begun to gather data, information and ideas it was straightforward to ratify  the groups into working sub-groups to the Child Accident Prevention steering group.

Key actions identified for the development of a three year action plan, to include:

• Workforce Development
  Using Making Every Contact Count, Warwickshire is developing specific training for frontline children and family practitioners working with the 0-5 age group, which will have child accident prevention at its core.
• Communications and Partnership work
  Research on how other areas have improved their performance and RAG rating has shown that this can often be attributed to the creation of robust, clear communication strategies and wider supportive partnerships, including community outreach. Warwickshire is looking at methods to create these and has   identified resources to invest in ensuring the messages are consistent.

Karen says: ‘We are auditing existing information with a view to coordinating shared messages. We developing a communication strategy which will focus on the areas where there are the most opportunities to affect change.’

• Better understanding of data from hospitals across Warwickshire and examination at a granular level is needed to gain a helpful picture and a clearer knowledge of unintentional child accidents, A&E attendance and admissions in the area. This will be used to increase understanding of what leads parents to take children to A&E, how these A&E attendances/admissions are processes, and how to give the best guidance to support parents in making these decisions.
• What makes it work
  Warwickshire is in the process of developing the strategies above, built on a sound foundation of multi-agency engagement.For robust partnerships to work, it’s important to have strategic leadership, good communication and someone to coordinate the work. Karen believes

‘You do need someone owning, driving and facilitating this work. Having a designated person really helps with that and having ownership at the highest level is also a significant and positive factor in the ultimate success of the programme.’