Children S Partnership (CP)

Children’s Partnership (CP)

Distribution: CP plus Chair of CYPFWP Board

1. Welcome and apologies

• CR welcomed the group and introductions were invited.

1. Minutes and matters arising not on the agenda

• The minutes were accepted as an accurate representation of the last meeting, with the following amendment:

• Page 1: Attendance and Apologies - CR was in attendance, JGa was not.

• LP led the group through the handout which summarised the main points. CR thanked LP for herwork in pulling the main issues together.

• It is more common to refer to this issue as unintentional injuries rather than accidents;
• AWISS (All Wales Injury Surveillance System)collects A&E data and although it is yet to cover all of Wales, it does cover five areas. However, not all people use A&E if they have an accident and so this AWISS data will not provide the whole picture of unintentional injuries in the 0-4s;
• The group was reminded that there are data limitations e.g. those living in rural areas find it more difficult to access services and also minor injuries are either self-treated or treated by a health practitioner away from A&E. Therefore, the data will not include those less likely to access services or those that will self treat. It was advised that the smaller the data sample, the less reliable are the results drawn from the data;
• The issue of obtaining data by postcode was discussed. LW advised that this data may not be as reliable as large area data due to migration etc and also there may be difficulties in obtaining it due to the possibility of identifying individuals;
• PEDW (Patient Episode Database for Wales) is managed by Health Solutions Wales;
• General Practice Datais not consistent between practices as there are different ways of collecting and recording data across practices. The need for more consistent data has been recognised as only the ten most chronic cases are currently recorded;
• Emergency Department Data – The importance of collecting data consistently across A&E departments has been recognised and the funded project will develop this through the non-voluntary system where all A&Es must send in data. Wrexham Accident and Emergency (A&E) department has submitted all of their AWISS data and it is hoped that this dataset will link in with GP practices in future so that data can be analysed consistently;
• Children 0-4 Years: Not much data is available and so we must rely on the all Wales national picture. Wrexham has a high percentage of 0-4 year olds in the population and as 0-4s tend to have high numbers of injuries and hospital attendances, from a Wales Public Health perspective unintentional injuries in the 0-4s is an issue that requires investigation;
• Of children aged 0-19 in Wrexham, those aged 0-4 account for the highest number of unintentional injury related hospital admissions (over 5 years);
• The big difference between the 0-4 age range and other age groups is that the most common unintentional injury to affect this age group is poisoning/overdose, followed by thermal injuries such as burns and scalds;
• Most unintentional injuries (particularly in the 0-4 age range) happen in the home. LW reported that there are often simple actions that can be done to prevent injuries and so the focus of our attention should be home safety.

• Unintentional injuryis the most common cause of death in the under 1’s;
• The very old and very young are most vulnerable in the home;
• Unintentional injuries are more likely to occur in poorer and overcrowded houses due to the lack of safe places to play;
• The largest number of unintentional injuries take place in the living and dining rooms;
• The most serious unintentional injuries take place in the kitchen and on the stairs;
• For the greatest impact we should target the 0-4age range in deprived areas and through multi-agency working and through complementing existing schemes we should use evidence based interventions to target the home environment;
• We need to ensure that a robust monitoring and evaluation process is in place to assess whether the schemes are impacting on numbers;
• We should review current practice to examine whether it is effective;
• We should focus on poisonings, heat related injuries, falls from a height and burns and scalds.

• In response to the question of why some people in Wrexham do not think that accidents are an issue in Wrexham, LW speculated that it is possible that people’s perceptions are that “children will have accidents” or that the 0-4 age group are masked by the 0-25s in the data. However, 90% of accidents are preventable.
• LW stated that it is important to remember that there are pockets of deprivation in more affluent areas.
• JHJ asked the group if they wished to pursue the topic of reducing unintentional injuries in the 0-4s (KT 53) and all agreed that they did.
• CR stated that this is something that this group can make a positive impact on and an age specific issue that would benefit from attention due to the high number of 0-4s in the Wrexham population.

• JHJ explained the background behind this process and how WAG is interested in the approach.
• JHJ informed that “Population Accountability” is the whole population and “Performance Accountability” is the population of people in receipt of a specific service.
• It is unrealistic to expect that services/projects/agencies alone can achieve whole population results/outcomes by themselves, yet they can contribute towards the outcome but not held solely accountable.
• JHJ gave a presentation on results based accountability and as a group we discussed the outcomes and results which lie within the CYPP.

• The group discussed the success criteria for the unintentional injuries task. In addition to the success criteria outlined within the CYPP the group felt that effective success criteria would be a reduction in attendance at Accident and Emergencies (A&Es) and GP practices. LW informed that this could be a problem as the data is not currently available.
• MB warned against overprotectingchildren and removing all risk as this can lose sight of important childhood experiences.
• LW informed that the group should not solely rely on A&E data.
• LW stated that we must use evidence based and good practice approaches as well as robust monitoring and evaluation systems.
• LP informed that Carmarthenshire want to give parents literature on home safety as soon as possible so that they are fully informed and know they type of equipment they will need at the various stages of childhood.
• LW informed the group that evidence based interventions have been researched and this information should be used when planning how to tackle this issue.

• LW advised thatresearch shows thatjust handing out leaflets to parents is not effective as these only educate the educated and do not reach all. Some people require personal support as well as information/leaflets and also require information to be provided to them on more than one occasion in order to digest the information and act upon it.

• Not discussed at this meeting. It was agreed that JHJ, LW, LP and LH would meet to progress this work.

• LP led the group through the handout which summarised the main areas of work undertaken in Carmarthenshire with regard to home safety and reducing unintentional injuries in the 0-4s.
• LP will circulate the Carmarthenshirefull report to the group.

• Not discussed at this meeting due to time constraints. However, JHJ stated that the group needs to find out about the services currently in place to reduce unintentional injuries in the 0-4s. A mapping exercise therefore needs to be carried out so that all departments can discuss and map what they are currently doing in this area and what additional work is required to impact further on numbers.
• Additional departments to be involved in the work of the CP were discussed and it was agreed that the audit of current provision would be circulated widely rather than inviting additional members to the next meeting.

• JHJ stated that if the work of this group makes a positive impact, we should see A&E numbers come down over the next three-years.

• LP signposted members to the suggested list provided by Karen McFarlane from Children in Wales and the CP discussed the current representation and which additional members should be involved.
• JHJ suggested that she could talk to WPPA.
• JHJ suggested that a representative from Housing could prove useful (MW). JHJ also suggested that Chris Bean (as well as his replacement) could inform the group aboutinequalities.
• LW stated that Health Challenge Wrexham could be involved and to contact Gillian Cowan as Team Manager or Linda Mullock for advice and information.

• Non required

• None at this meeting

1