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Introduction

Avoidable injuries refer to injury that occurs as a result of ‘accidents’, whereby the injury is not deliberately caused and could have been avoided. Avoidable injuries tend to occur either in the home, on the roads, or during leisure activities. In children and young people (CYP), avoidable injuries are a serious public health issue and a leading cause of death and hospital admission in the United Kingdom¹

Avoidable injuries in the home for under 5’s are most commonly:

• Choking, suffocation and strangling
• Falls
• Poisoning
• Burns and scalds
• Drowning

These 5 causes account for 90% of unintentional injury hospital admissions.¹  In England and Wales avoidable injuries are the second most common cause of childhood death (age 1–4) after cancer ² and results in substantial long term disability.

The impact and consequences of avoidable injuries are major contributors to health inequalities amongst children from the most disadvantaged backgrounds. These children are at significantly increased risk.

The long term effect of an injury can be significant, both physically and emotionally, for children. They may experience:

• Disability or impairment (short or long term)
• Scarring or disfigurement
• Ongoing appointments and operations.

There are long-term impacts associated with avoidable injuries, with data suggesting that those who have suffered injury in childhood are at greater risk of physical disability, psychological morbidity, cognitive or social impairment, lower educational achievement and poorer employment prospects.³

Avoidable childhood injuries carry significant costs to the economy, the NHS and children and families. The Department of Health (DH) calculated the average cost of A&E attendances for under 5’s to be £124 per admission equating to a total cost of £140m per year, with the cost to society being £7.4 billion.⁴ To the individual, avoidable injuries that occur in under 5s incur a short-term healthcare costs of £2494⁵ and the long-term costs can be much greater. Families may also lose significant percentages of their income through childhood injuries.¹

Most injuries are preventable and strategies to prevent injuries are usually relatively inexpensive to implement and are shown to have a beneficial return on investment.¹

Unmet service needs and knowledge gaps

• Data regarding children who are treated at home, in primary care and walk in centres are currently unavailable and therefore the full extent to injuries in the home is not known.
• There is a lack of knowledge concerning the healthcare costs associated with drowning incidents, sports injuries or injuries obtained in playgrounds.
• Near misses – water safety
• NHS Digital has identified a data quality issue affecting HES data for Nottingham University Hospitals Trust (NUH) in 2016/17. Over 30% of records from this trust did not have a valid geography of residence assigned. Therefore PHE have not published values for indicators including children’s avoidable injuries admissions based on HES data for areas that had more than 20% of patients from that area treated at NUH in the previous year (2015/16). Areas where 10%-20% of the previous year’s patients were treated at NUH have been flagged and should be treated with caution. Therefore 2015/16 data is used in this JSNA chapter.

Recommendations for consideration by commissioners

Stephanie Morrissey (Public Health and Commissioning Manager)

Catherine O’Byrne (Public Health and Commissioning Manager)

John Wilcox (Senior Public Health and Commissioning Manager)