Action needed to prevent accidents to children

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


A joint report published by the Audit Commission and the Healthcare Commission.

A more coherent approach is overdue at a local level to help prevent accidental injuries to children, according to 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 accident and emergency (A&E) departments as the result of accidents that might have been prevented.

This costs the NHS approximately £146 million per year and the most recent figures show that 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 1-14, and account for approximately 120,000 admissions to hospital a year.

However, understanding of the underlying causes of children’s injury is patchy and the actual number of injuries each year is unknown.

Although the overall number of deaths has fallen, the report shows that there are persistent and widening differences between socio-economic 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 and rely on committed individuals who frequently work in isolation and sometimes duplicate what others have done. There is also an absence of evaluative data on the success of local prevention initiatives.

However, there were notable exceptions. In Burnley, Pendle and Rossendale, strong relationships between the primary care trust’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 £1.9 million.

The report 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, primary care trusts and their partners need to know how and where accidents occur by pooling their information; and
  • together, councils, primary care trusts 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:
‘For too long, this issue has been pushed down the agenda. We have been prepared to rely on the dedication and enthusiasm of individuals. No single agency or body has taken a clear lead. Primary Care Trusts and local authorities are responsible for doing something about it, but they can’t do so without a more coordinated strategic approach.

‘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.’

Michael O’Higgins, Chairman of the Audit Commission, said:
‘Each year there are approximately two million attendances at A&E departments by children as a result of accidental injury. This causes considerable stress and anxiety for children and their families and carers. Few of us can imagine the heartache caused by the loss of a child, but the most recent figures showed that 230 children died in one year from accidents that might have been prevented.

‘The inequalities between different socio-economic groups are also shocking. For example, children of parents who have never worked or are long-term unemployed are 13 times more likely to die following an accident than children of parents in professional occupations. To tackle this, local bodies must apply concerted and rigorous action but, individually, much of what is needed is common sense.’

The report recommends that central government must support local action better by being clearer about the roles and responsibilities of the various bodies, co-ordinating the work of individual Departments in making the information they have available, and developing a fuller understanding on how to prevent unintentional injury.

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 primary care trusts, local councils and the Healthcare Commission. The full report is available at the link below or at


Better Safe Than Sorry: Preventing Unintentional Injury to Children (pdf 645kb)

Notes to Editors

1. This report covers accidental injuries, but does not deal with road accidents. This will be the subject of a forthcoming Audit Commission report.

Audit Commission

1. The Audit Commission is an independent body responsible for ensuring that public money is spent economically, efficiently and effectively, to achieve high-quality local services for the public. Our remit covers around 11,000 bodies in England, which between them spend more than £180 billion of public money each year. Our work covers local government, health, housing, community safety and fire and rescue services.

2. As an independent watchdog, we provide important information on the quality of public services. As a driving force for improvement in those services, we provide practical recommendations and spread best practice. As an independent auditor, we ensure that public services are good value for money and that public money is properly spent.

3. For further information about the Audit Commission, visit our website at

For further information from the Audit Commission, please contact:
Nigel Watts, Senior External Communications Officer
Tel: 020 7166 2129
Fax: 0845 052 2617
Mob: 07813 315 538

Healthcare Commission

1. The Healthcare Commission is the health watchdog in England.  It keeps check on health services to ensure they are meeting standards in a range of areas.  The Commission also promotes improvements in the quality of healthcare and public health in England through independent, authoritative, patient-centred assessments of those who provide services. 

2. Responsibility for inspection and investigation of NHS bodies and the independent sector in Wales rests with Healthcare Inspectorate Wales (HIW).  The Healthcare Commission has certain statutory functions in Wales which include producing an annual report on the state of healthcare in England and Wales, national  improvement reviews in England and Wales, and working with HIW to ensure that relevant cross border issues are managed effectively.

3. The Healthcare Commission does not cover Scotland as it has its own body, NHS Quality Improvement Scotland.  The  Regulation and Quality Improvement Agency (RQIA) undertakes regular reviews of the quality of services in Northern Ireland.

For further information from the Healthcare Commission, please contact:
Creina Lilburne, Senior Press Officer
Tel: 020 7448 9439

Janine Maher, Press Officer
Tel: 020 7448 9429

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins


Already registered?

Sign in

Follow Us: