Nottinghamshire Insight

Joint strategic needs assessment

Avoidable injuries in children and young people (2019)

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Topic title Avoidable injuries in children and young people (2019)
Topic owner Nottingham and Nottinghamshire Children’s Avoidable Injuries Strategy Group
Topic author(s) Stephanie Morrissey, Glyn Smith, Catherine O’Byrne & John Wilcox
Topic quality reviewed December 2018
Topic endorsed by Nottingham and Nottinghamshire Children’s Avoidable Injuries Strategy Group
Topic approved by Health and Wellbeing Board March 2019
Current version March 2019
Linked JSNA topics

Executive summary

An infographic depicting key avoidable injury statistics for Nottinghamshire. This can be downloaded as an accessible PDF from this same page.


Download an accessible version of this infographic


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

Recommendation Lead(s)

Ensure there is a mechanism for strategic leadership and coordination between agencies with responsibilities that contribute to preventing avoidable injuries in children in the home, on the roads and in leisure time.

Strategic group members

The approach to commissioning future avoidable injuries intervention must consider reducing inequalities.

Local Authority and NHS Commissioners

The approach to the commissioning and delivery of future interventions must consider a range or combination of interventions e.g. education, engineering, enforcement and empowerment 

Local Authority and NHS Commissioners

Consider how best to incorporate local views in future strategies

Strategic group members

In the home

Exploration of funding to continue the delivery of home safety equipment scheme in Nottinghamshire beyond 2020.

Nottinghamshire County Public Health

When commissioning home equipment safety schemes, standardised home safety advice should be provided to families alongside the home safety equipment.

Local Authority and NHS Commissioners

Implement evidence based, standardised, age appropriate home safety messages across the system. 

Strategic group members

Re-establishment of home safety sub group of the Children’s Avoidable Injury Strategic Group

  • to support delivery of and learning from the home safety equipment scheme. 
  • Establish governance, process and accountability
  • Identify Chair and lead

Nottinghamshire County Public Health and identified Strategic group members

Partners to explore ways to improve ability to recognise risk and improve secondary prevention

Strategic group members

On the road

Continue the programme of casualty reduction schemes on Nottinghamshire’s roads

Nottinghamshire Road Safety


Continue the provision and maintenance of safety cameras on Nottinghamshire’s roads

Nottinghamshire Road Safety Partnership

There should be consideration of the allocation of resources to reduce cyclist road casualties which are significantly higher in Nottinghamshire than the national average.

Nottinghamshire Road Safety


Continue to support the delivery of the evidence based, data led road safety education programme

· Ensure delivery on ages/areas with greatest evidence for need, for example children ages 11-15 years

· There should be a focus on geographical areas with higher rates of children aged 0-15 years killed or seriously injured on the roads

Nottinghamshire Road Safety Partnership

Leisure Activities

The development of a Leisure Safety Action plan pulling together established and newly formed working groups including Nottinghamshire Safety Education Partnership (including Rail Safety) and the Nottinghamshire Water Safety Partnership.

Members of Strategic group and members of working groups

Key contacts

This is an online synopsis of the topic which shows the executive summary and key contacts sections. To view the full document, please download it.

Full report »