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Better safe than sorry

A more coherent approach is overdue at a local level to help prevent accidental injuries to children. This is the conclusion of a new joint report published today by the Audit Commission and the Healthcare Commission.

Better Safe Than Sorry: Preventing Unintentional Injury to Children says that each year there are approximately two million attendances by children at hospital A&E departments as the result of accidents. Many of these accidents could be prevented.

The accidents cost the NHS approximately £146m per year, and accidental injuries kill three children in every 100,000 each year - a similar rate to cancer.

Injuries such as those caused by burns, falling down stairs at home, slipping on railway embankments and poisoning, are a leading cause of death and illness in children aged 1 to 14, and account for approximately 120,000 admissions to hospital a year.

Although the overall number of deaths has fallen, the report shows that there are persistent and widening differences between socioeconomic groups. Children of parents who have never worked, or who have been unemployed for a long time, are 13 times more likely to die from unintentional injury than children of parents in higher managerial and professional occupations.

There are many ad-hoc local initiatives to help prevent children's accidents, but they are often poorly coordinated. There is also an absence of evaluative data on the success of local prevention initiatives.

In Burnley, Pendle and Rossendale, strong relationships between the primary care trust's (PCT's) accident prevention team and the A&E department resulted in targeted campaigns on reducing accidents and reduced hospital attendances for the under-fives. Measures included free installation of safety equipment in areas of deprivation and the overall estimated saving to the local economy was £1.9m.

Better Safe Than Sorry recommends that:

  • The Department of Health and other central departments of government should together state more clearly what is required locally to prevent accidents and give more information on what works.
  • Councils, PCTs and their partners need to know how and where accidents occur by pooling their information.
  • Together, councils, PCTs and their partners need to apply evidence of what works and evaluate the impact at the local level and sustain their actions.

Professor Sir Ian Kennedy, Chairman of the Healthcare Commission, said: "The right of all children to be protected from avoidable accidents and injuries must be embedded in the work of those who provide public services. Health services need to collect robust data on the types and causes of injuries that they see in the children whom they treat. Collecting and analysing this information is crucial to ensure that the right strategies for prevention are put in place and lives are saved. Success will depend on partnerships across the NHS, local government and others."

The report sets out how successful prevention requires a more rigorous approach locally, based on the proper assessment of children's needs, good and well-collated data, agencies working together, a clear strategy and an approach based on evidence of what works.

There are also recommendations in the report for the NHS PCTs, local councils and the Healthcare Commission. The full report is available at or at