The reduction of accidental injury in Hull For children and young people aged under 18 years

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1 Accident prevention in Hull For children and young people aged under 18 years

2 Accident prevention in Hull Introduction Accidental injury is a leading cause of death amongst children and young people aged Many of these injuries are preventable. It is the duty and responsibility of everyone living and working in Hull to promote the safety of children and young people through the Every Child Matters agenda. Our target is to reduce the number of emergency hospital admissions caused by accidental injuries to children and young people aged under 18 years per 10,000 of the population by 3.5% year on year until the strategy review. Effective partnership working and collaborative effort underpin this joint strategy which has been developed with the commitment from key partners to tackle a wide range of risks both inside and outside the home. Partnerships are key to the delivery of strategies aimed at preventing unintentional injury and require co operation at a local level Better safe than sorry (audit commission 2007) 2

3 National Context Around 2 million children and young people visit UK accident and emergency departments each year as a result of non fatal injury. In England unintentional injuries resulted in over 100,000 children aged 0-14 being admitted to hospital each year from (The NHS information centre) and put more children in hospital than any other cause. Many more are treated by GPs, minor injury departments, out of hours services or by parents and carers. Accidental injuries to children and young people are a leading cause of morbidity and mortality and present a significant burden to public services nationally. All children are vulnerable to injury because they live in a world in which they have little control. All children are exposed to hazards as part of their everyday lives as they play, travel around, when they are at home and when they are asleep. However some groups of children are more vulnerable to the risk of injury for example if children: Are under the age of 5 years (generally, under-5s are more vulnerable to unintentional injuries in the home) Are over the age of 11 (generally, over-11s are more vulnerable to unintentional injuries on the road) Have a disability or impairment (physical or learning) Are from some minority ethnic groups Live with a family on a low income Live in accommodation which potentially puts them more at risk (this could include multiple-occupied housing). 3

4 Local context The city of Hull has a resident population of approximately 260,000, of which 62,000 are children and young people aged 0-19 years. Hull is the 11th most deprived city in England based on the index of multiple deprivation (2007). Over one third of children and young people live in income deprived households and around 33% live in poverty. (Hull Children and Young People s Plan ) Admission to hospital of children and young people for accidental injury is a key indicator for child safety, and includes situations such as road traffic accidents, trips falls and stumbles, burns and scalds. Hull appears to have a higher than national and other comparators rate of admissions for these reasons. (Hull Children and Young People s Plan ). Poorer children are much more likely to be involved in accidents. With young people from the most deprived families 13 times more likely to die from accidents, and 37 times more likely to die in a fire than the children of professionals. (Tim Loughton speech to the Safety 2010 conference) Preventing injury Most injuries and their precipitating events are predictable and preventable (Davis R Pless B 2001) The World Health Organisation advises that by providing the right information in a timely fashion to allow families to make their own informed decisions about safety is essential in creating sustainable outcomes for children and young people. Hull Children and Young People s Plan highlights a need for children, young people and parents to understand the consequences of their health choices and are able to take responsibility for accessing the services and support they need. The Child Accident Prevention Trust shared findings from the Accident Prevention Amongst Children Review which found that partnership work is a major driver for success in reducing death and serious injury from preventable childhood accidents. They state that creative partnership projects that pool resources and share opportunities can make a real difference at a local level. This strategy has been developed with the commitment of key partners to tackle a wide range of risks both in and outside of the home. It is important to strike the right balance of allowing children the freedom that they need and to have fun while keeping them safe from harm. 4

5 National Targets Reduce the number of emergency hospital admissions caused by unintentional and deliberate injuries to children and young people under 18 (VSC29 including NI 70) Fire and rescue National framework (04/05) Reduce the number of accidental fire related deaths in the home by 20% by PSA 3 Reduce the number of accidental fire-related deaths in the home (communities and local Government 2005) PSA 12 improve health and wellbeing of children and young people (HM Government 2008) PSA 13 Improve children and young people s safety (HM Government 2008) The Child Health Promotion Programme (2008) builds on the national service framework for children, young people and maternity services (2004) whose core standards include: Promoting health and well being, identifying needs and early intervention. National recommendations Accident prevention is a very complex area, involving many different agencies. When agencies and the community work together there is a better chance of creating a safer environment for children and young people. Prevention activities range from education and training to product or environmental modifications and enforcement (regulations, legislation). The audit commission report Better safe than sorry (2007) made the following recommendations for Primary Care Trusts and Local Councils to help them achieve targets of reducing accidents: Develop joint strategic plans and action plans aimed at preventing unintentional injury, ensuring regular review and monitoring of outcomes. These plans should ensure that resources are directed towards sustainable evidence based strategies, that avoid duplication of work and that they are directed at reducing inequalities. Regularly review and develop a clear understanding of the rates and types of unintentional injury in their local area to enable actions and resources to be directed accordingly. Determine what sources of local data are available and, where possible record and share data across the NHS and local government. Influence local strategic partnerships to strengthen the focus on unintentional injury in local communities. Use Local Children s Trust arrangements or Local Safeguarding Children Board s (LSCB s) as a vehicle to oversee and ensure delivery of prevention strategies. Familiarise themselves and local practitioners with the evidence base detailing what works and target strategies for preventing unintentional injury accordingly. The 2010 National Institute for Health and Clinical Excellence (NICE) Public Health guidance Preventing unintentional injuries among under 15 s includes national recommendations to assist local action. 5

6 The decision whether the recommendations are taken forward and how they are prioritised will be determined by government and subject to statutory regulatory and cost impact assessments. Local strategies This strategy focuses on priority areas and associated interventions that will reduce the number of emergency hospital admissions caused by accidental injuries to children and young people under 18 years of age. However it is important to note that there are a number of other local policies / strategies which contribute to the achievement of this strategy. Some examples are listed below: Hull Children and Young Peoples Plan recognises the requirements to ensure children s safety in all aspects of children s lives and this includes safety in play, leisure and communities, crime reduction, multi agency public protection arrangements and safe recruitment practices. Hull Safeguarding Children Board Guidelines and procedures (2010) Hull City Council Local Transport Plan Safer Roads and the Road Safety strategy Local policing crime and disorder reduction strategy Strategy for children and young people , the fire and rescue service Building an evidence base A better understanding of the impact and cost of unintentional injuries at all levels will be a powerful enabler in raising its priority. There is a need to build, use and share the evidence base in order to make progress on reducing unintentional injury and target local resources efficiently. (Audit commission 2007). 6

7 Children and young people s views As part of the consultation for this strategy the KEY group of children and young people were asked the following questions: What is an accident to you? Something that hurts Something accidental What type of accident do you feel most at risk from? Being run over Falling Something unusual that doesn't happen often Being burnt Heights How can adults / professionals help prevent children from having accidents? Providing protective equipment (helmets as an example) Staying with us Talk to them Teach us (to tie shoe laces etc) The children and young people of the KEY group highlighted that being burned or being run over were the areas that they were most concerned about with regard to accidents. Hospital admissions Over 1 million children under 15 years of age experience accidents in and around the home every year, for which they are taken to accident and emergency. Many more are treated by General Practitioners and by parents and carers. Most at risk from a home accident is the 0-4 age group. Falls account for the majority of non-fatal accidents whilst the highest numbers of deaths are due to fires. The information displayed in the chart below was provided by NHS Hull and describes a breakdown of the top three reasons for children under 18 years being admitted to hospital in Hull following accidental or deliberate injury for the period of 2009/2010. As can be seen from these figures, the main reason for admission to hospital for children under the age of 16 years are falls, with intentional self harm being the highest admissions In the 17 to 18 age range. Using this local information to build the Accident prevention strategy will be important in informing local services about how they need to respond in order to reduce the number of accidents and admissions in these areas. 7

8 Data Analysis Hospital admission caused by unintentional and deliberate injuries 2009/10 Age band IC10 Category No. of % of Injuries injuries Under 5's Falls % Exposures to inanimate mechanical forces 56 22% Accidental poisoning by and exposure to noxious substances 18 7% 5-11 Falls % Exposures to inanimate mechanical forces 40 17% Exposures to animate mechanical forces 24 10% Falls 73 23% Intentional self-harm 72 23% Exposure to inanimate mechanical forces 42 14% 17 Intentional self-harm 24 34% Exposure to inanimate mechanical forces 12 17% Falls 11 16% Inanimate mechanical forces - This includes being struck/contact with an object such as glass, knife, machinery etc. Animate mechanical forces - this includes contact/collision with animals or persons, for example striking against or bumped into by another person, bitten or struck by a dog etc. Local intervention The Local Authority Children s Services and their partnerships, in consultation with LSCB s need to ensure that local and national plans and strategies for children and young people s well being include a commitment to preventing unintentional injuries among them. In particular, the plans and strategies should aim to prevent unintentional injuries amongst the most vulnerable groups to reduce inequalities in health. This commitment should be part of a wider objective to keep children and young people safe. (NICE 2010) The Accident prevention workstream The Prevention of Accidents multi agency work stream under Hull Safeguarding Children Board has responsibility for overseeing this strategy and its action plans. The workstream reports both to the Hull Safeguarding Children Board and the Stay Safe Outcome Group and information is fed in and out from the Child Death Overview Panel. Each member agency has responsibility to feedback to their organisations and any groups they may sit on. (See appendix 1 for a list of member agencies). 8

9 Workstream objectives Strategic objectives: Provide a dedicated lead for the prevention of accidents that is city-wide; Provide baseline information for rail, fire, home and road safety; Improve knowledge and understanding of unintentional injuries through improved data collection and sharing; and To maintain and improve on multi agency working Operational objectives: Increase injury minimisation training Maintain home safety checks Home Safety Schemes Reduce the number and severity of unintentional injuries through data collection and analysis. Reduce of injuries in the home Reduce pedestrian injuries Reduce deaths where safe sleeping is identified as a contributory factor Fall prevention Prevention of burns and scalds Injury minimisation programme for schools (I.M.P.S) Prevention of poisoning incidents Reduce of deaths and injury due to Road Traffic Collisions (RTC) Promote the mental health care pathway Coordination of accident prevention Research recommends the appointment of an injury prevention co-ordinator to increase the profile of unintentional injury and provide a dedicated resource to effectively ensure visible, expert coordination and progress on delivery. (The priority review recommendation c1 (DH, DSCF DfT 2009). To meet this recommendation Hull has a dedicated Injury minimisation coordinator. Many local partners and agencies play important roles in improving children and young people s safety. Appendix 2 describes these services in some detail, along with their individual targets and activities to meet them. 9

10 Strategic and operational action plans Comprehensive strategic and operational action plans are described in the tables in appendix 3. Some of the recommendations based on identified local need are highlighted below. A dedicated lead for accident prevention Strengthen formalised operational partnerships Monitor data collection against current National targets Formally evaluate campaigns and services with an impact assessment. Continue to provide home safety checks and safety equipment to targeted high need areas. Continue to deliver the safe sleeping campaign Continue to deliver safety information messages to children, young people, parents carers and professionals on areas such as road safety, fire safety and rail safety Ensure the promotion of the Child and Adolescent Mental Health care pathway Performance monitoring A reduction in the number of preventable deaths caused by unintentional injuries in children and young people as recorded through the child death review panel processes. The principle of the Child Death Review process is to learn lessons and reduce the incidence of preventable child deaths in the future. Improving the quality and outcomes of accident prevention services and activities through improved knowledge and understanding of the data, better co-ordination, pooling of resources and joint funding arrangements, ensuring existing and new guidance / policies are embedded within strategy and action plans. Improving health outcomes specifically for the most disadvantaged group of children and young people at risk of accidental injury. Reducing health inequalities by targeting prevention work and resources in identified areas. Long term efficiency savings through coordinated, targeted interventions and reduction of unintentional injuries in children and young people aged under 18. Through continuing to liaise with children, young people and their families, both through user involvement groups and the young persons parliament. 10

11 Conclusions There are a range of front line services and staff engaged in reducing accidents and many examples of good practice as outlined in Appendix 2. Some local partnership arrangements are well developed and do contribute to reducing accidents but this is still dependent on the commitment of individuals rather than formal arrangements. There is a need to review existing services and their impact on the prevention of accidents. There is a need to think long term when it comes to accident prevention particularly in creating sustainable outcomes for children and young people. Cooperation is key. Acknowledgements Specialist Nurse Practitioner for Child Death Review and Injury Minimisation - Hull Teaching Primary Care Trust Hull Safeguarding Children Board Young people (members of the KEY group) Humberside Fire and Rescue Service City Safe Network Rail Hull City Council Road Safety (Street Scene) NHS Hull Public Health Nursing Children s Centres I.M.P.S City Health Care Partnership Designated Nurse Hull PCT Children s Social Care Voluntary and Community sector Humberside Police Hull City Council Play Development Healthy Schools Partnership Members of the Child Death Overview Panel Accident and Emergency Minor Injuries Units 11

12 References Accidents are not unpredictable. Davis R Pless B (2001) BMJ bans Accidents. BMJ 322:1320. Better safe than sorry preventing unintentional injury to children audit commission (2007) Getting serious about safety child injury prevention strategy summary Bradford Safeguarding Children Board Humberside Fire Authority annual performance report 2009/2010 Local Transport Plan ( ) Hull City Council NICE (2010) preventing unintentional injuries among under 15 s North Tyneside young people s accident prevention strategy Our Children and Young Peoples Plan () Hull Children s Trust Safe Network preventing avoidable accidents mini guidance Working Together A guide to inter-agency working to safeguard and promote the welfare of children (DCSF 2010) 12

13 Appendix 1 Membership of the Prevention of accidents workstream Child Death Overview Panel Children s Centres Children and Young Peoples Services Children s Social Care Health promotion / City Safe Healthy Schools Hull City Council Hull Safeguarding Children Board Humberside Fire and Rescue Service Humberside Police I.M.P.S City Health Care Partnership Key group Learning, Participation and Skills Network Rail NHS hull Play Development (Hull City Council) Public Health Nursing Road safety Specialist practitioner for child deaths 13

14 Appendix 2 Hull initiatives Many local partners and agencies in Hull play important roles in improving the safety of children and young people. There is a raft of activity in the field of accident prevention carried out by a wide range of agencies and organisations in partnership. This includes the work through the Child Death Overview Panel process. Below are described some of the initiatives in hull that aim to contribute to meeting the aim and objectives of the Accident prevention strategy. Education and training for children and young people Injury Minimisation Programme for Schools (IMPS) This service aims to provide Year 6 children with the skills and knowledge that enables them to minimise injury, provide basic life support and reduce environmental risk factors. The lead organisation of the IMPS programme is City Health Care Partnership and between April 2009 and March children from 51 primary schools have participated. The programme is now well established within schools with many rebooking for the following year. Over 17,500 children have been trained through I.M.P.S since it was first launched in Participating schools are provided with free support and materials and pupils have a tour of the accident and emergency department at Hull Royal Infirmary. They also learn the principles of first aid via an interactive DVD and resuscitation skills on manikins. The I.M.P.S team also deliver sessions within the school setting. Feedback from both children and teachers continues to be positive, pupils enjoying the hands on nature of the sessions. The children thoroughly enjoyed the morning, all the activities were relevant and interesting and the children learned a huge amount - thank you Hull primary school A very well presented and informative session enjoyed by all. Thank you very much. More aware of danger and consequences. More confident to deal with an emergency situation. We will link the activities to our PHSE lessons Hull Primary school City Health Care Partnership additionally work with other agencies in promoting safety education to school pupils, parents and the local community in conjunction with such agencies as Hull City Council s Road Safety department, Humberside Fire and Rescue Service and HM coastguards. 14

15 KID alert KID alert is an annual two week programme targeted for year 6 children from all Hull primary schools and is designed to teach them about safe behaviour. The event is now in its 15th year and is run by the Hull accident prevention group with multi-agency input from: Hull City Council Environmental health, Health and Safety Section, Trading Standards, Road Safety, Dog Wardens Community Anti-Bullying Project Humberside Fire and Rescue I.M.P.S City Health Care Partnership St. John Ambulance HM Coastguards Northern Gas Networks In June 2010, 1300 children attended sessions over a two week period. The children took part in 10-minute interactive scenarios that are designed to highlight the link between behaviour and keeping safe. City Safe training City Safe advertise their wide ranging services to schools in order that they can deliver presentations. These include: Anti Social Behaviour Noise Environmental crime Humberside Fire and Rescue Service and Humberside Police Humberside Fire and Rescue Service and Humberside Police provide bespoke training packages both jointly and individually to both primary and secondary schools in Hull dependent upon need. Also education and training for workers, parents and carers NICE guidelines (2010) recommend that access to appropriate education and training is provided in how to prevent unintentional injuries for everyone who works with (or cares for or supports) children, young people and their families. 15

16 Children s centres Hull Children s Centres are community resources that provide a range of services to local families. A function of Children s Centres is to provide access for families to affordable education and training about accident prevention. Recent courses offered by Children s Centres include: Parenting and family support including managing children s behaviour Home safety advice Health advice for you and your child First aid courses Paediatric training Children s Centres are responsive to local community need and each area may run a different selection of courses based on this. The Healthy Child Programme The Healthy Child Programme provides preventative services tailored to the individual needs of children and families, acting as a best practice guide for Children s Services. The Programme helps to meet the vital requirements on prevention of accidental injury. Frontline staff including midwives, health visitors, GPS, school nurses, early years and schools who actively promote and provide advice and support in relation to accident prevention as part of their core work. This includes signposting to targeted interventions and specialist services. 16

17 Safe sleeping The Child Death Overview Panel for Hull and East Riding identified that locally co sleeping was an issue which needs to be addressed. The Safe Sleeping Scheme was jointly funded by East Riding and Hull Safeguarding Children Boards through the Child Death Review process and is designed to raise awareness of the risk factors associated with sharing a bed, sofa or chair to sleep with a baby. The key messages to parents are: The safest place for your baby to sleep is in a crib or a cot in a room with you for the first 6 months of their life. All parents are given a leaflet titled Reducing the risk of cot death by a midwife in the post natal period. This is explained by an interpreter to parents who are not fluent in the English language yand guidance/dh_ New birth packs from Health Visitors will contain the FISD leaflet detailing the safest place for a baby to sleep Identifying and targeting high risk groups increases the effectiveness of the project, reduces the overall costs and ensures the efficient use of provider services. High risk groups include parents who are smoking, drinking alcohol, taking medication or drugs which can cause drowsiness, or if the baby has low birth weight or was premature. 17

18 Home safety For the purpose of this strategy home refers to the home, garden and boundaries of a property. Over 1 million children under 15 experience accidents in and around the home every year, for which they are taken to Accident and Emergency. Many more are treated by General Practitioners or by parents and carers. Most at risk from a home accident is the 0-4 age group. Falls account for the majority of non-fatal accidents whilst the highest numbers of deaths are due to fires. The Hull home safety scheme is delivered by local Children s Centres in partnership with a range of statutory and voluntary organisations providing advice, information, training, home safety assessments and home safety equipment to families with children under 5 years. On 20 February 2009 the Department for Children Schools and Families (DCSF) launched Safe at Home: The National Home Safety Equipment scheme. Safe at Home is being delivered by the Royal Society for the Prevention of Accidents (RoSPA), which works with local partners to provide home safety equipment and practical home safety to the most disadvantaged families in the 141 areas with the highest accident rates. The Hull home safety scheme has worked alongside this government initiative in targeting the most disadvantaged families, providing staff training and fitting 1254 home safety equipment packs during RoSPA recognised and praised Hull at a recent Accident Prevention Conference for being one of the best delivered schemes in the country, and the only scheme where no complaints have been made by members of the public. A home safety assessment can be defined as The process of systematically identifying potential hazards in the home, evaluating the risks and providing information or advice on how to reduce them. (NICE 2010) Home safety equipment is any device used to prevent injury in the home. This includes door guards, cupboard locks, safety gates and barriers, blind cleats, smoke and carbon monoxide alarms. 18

19 Humberside Fire and Rescue Service Although falls account for the majority of non-fatal accidents, the highest numbers of deaths are due to fires Strategic Plan - on a page The table below provides an overview of our strategy and the ways we will achieve our objectives Strategic Objectives Outcomes Outcomes Measure Delivery Priorities Community Preventing loss of life and injuries from emergency incidents Reducing risk in our communities Fewer deaths Fewer injuries Fewer accidental fires Fewer deliberate fires Number of deaths Number of injuries Number of accidental fires Number of deliberate fires Integrated Risk Mangement Plan Responding quickly and effectively to emergencies when requested Always respond quickly and effectively Performance against response standards Level of public satisfaction Enablers Resource Processs Making the best use of the resources we have Increasing new ways of working Establishing new ways of working Value for money Efficiencies target Service Improvement Plans Learning and Growth Continuing to develop a committed, flexible, skilled and safe workforce A committed, skilled, flexible and safe work force FRS Equality Framework achievement RoSPA QSA System FRS equality & diversity targets Personal and Organisational Develpment Strategy Medium Term Financial Plan 19

20 As can be seen from the this table, during 2009/10 the Humberside Fire and Rescue Service has continued to exceed its 2004/07 baseline targets for reducing injuries from fires and the number of fires occurring. We are also below the national average with regard to fire related fatalities although during 2009/10 there were nine deaths within the Service area, the same as our 2004/07 baseline. The Service has also made a positive contribution in driving down the number of people killed or seriously injured on the roads. Performance measures Reducing the number of primary fires by 15% against our 2004/07 baseline average of 3391 fires/year. Reducing preventable fire deaths by 25% against our 2004/07 baseline average of 5 deaths/year. Reducing fire related injuries by 10% against our 2004/07 baseline average of 122 injuries/year. Reducing arson by 15% against our 2004/07 baseline average of 6888 arson incidents/year. People killed or seriously injured in road accidents. 40% reduction against Humber Road Safety Partnership baseline of 820 average KSI/year. Children killed or seriously injured in Road Traffic Collisions 50% reduction against the Humber Road Safety Partnership baseline of 139 average KSI/year. 2009/10 actual %+/- t 36% 3 s 44% 7 t 55% 3 t 45% 3 t 43% 3 t 33% 3 Humberside Fire Authority prevention and protection Minimising risk is the core aim behind all of our community safety activities. We engage with the people who live in our communities 365 days of the year but this shouldn t only be when they dial 999 and require our assistance. We believe strongly in prevention and we work very hard utilising the excellent relationships we have established with our partner organisations to achieve our service delivery priorities. In 2009/2010 we almost doubled the number of Home Fire Safety Checks and smoke alarms fitted from the previous year. Home fire safety checks are free to residents but are carried out on a risk level basis which means the most vulnerable people are prioritised first. 20

21 Road safety The NHS spends an estimated 131 million per year on emergency hospital admissions because of childhood accidents. Just a small amount of money invested in injury prevention can save many times that amount further down the line. When making an argument for preventing road accidents it is worth highlighting not just the financial implications but the emotional impact they can have on children and families. For example serious accidents can often leave children disabled or disfigured long term or with Post Traumatic Stress. Children who are admitted to hospital can often miss out on days, weeks or even months of education. Lost education having a serious impact on a child s future. One of the aims of the Hull City Council Street Scene Service is to reduce the number and severity of road crash casualties in Hull. National and Local Targets Tomorrows Roads Safer for Everyone (2000) set out national casualty reduction targets to be met by 2010, measured against the average: A 40% reduction in the number of people killed or seriously injured in road accidents A 50% reduction in the number of children killed or seriously injured A 10% reduction in the number of slight casualties New national targets are expected to be recommended in the National Institute of Clinical Excellence Guidelines, due to be published in November These recommendations will be considered within the next Local Transport Plan which will cover the period Action to meet targets Hull s first transport plan has resulted in safer roads. The new transport plan runs to Target There have been significant steps taken to increase safety such as 20mph speed restrictions, cycle proficiency training in schools and designated cycle routes. (Children and Young People s Plan ). Accident reduction aims and objectives in Hull are: Education Training and Publicity Enforcement and Encouragement In practical terms these actions include such programmes as: Engineering Measures Cycle training for Year 5/6 children 21

22 Be safe be seen Nominated Year 6 pupils acting as road safety officers in schools icar training experience Year 10/11 Child car seat training Ante natal /Year 6 continuing through Secondary Schools Practical pedestrian training for year 3 pupils in the most deprived wards Each year around 3500 pupils participate in road safety training in Hull. Good egg guide to in car child safety is a national campaign and supported in Hull by Hull City Council Road safety scheme alongside partner agencies providing leaflets and local safety checks. This booklet is a guide that highlights areas where we could all improve on incar child safety; it offers good sound practical advice about buying, choosing and fitting a car seat. It is a must for all parents, grandparents and great grandparents. Other agencies who contribute to reducing the number and severity of road accidents casualties include: Humberside Police Network Rail I.M.P.S (City Health Care Partnership) Humberside Fire and Rescue Service Children s Centres Schools There is a dedicated road safety casualty reduction officer Humberside police who supports the delivery of the following initiatives: Choices is jointly run by the Police and the Youth Justice Service and is an awareness course for young offenders which is part of the court process as a last chance before custodial sentence is considered. Referral schemes such as - Speed awareness, 1st gear (moped riders 16+) Driver Improvement scheme, Considerate drivers (this is a new scheme presently on a 6 month trial & evaluation but incorporates endorsable traffic offences) Ride scheme (motor Cycles). The emphasis is now more on education rather than prosecution. Casualties on Hull s roads, assuming that they are measured against Average have reduced by an average of 11.1% per annum: The number killed or seriously injured in road accidents has reduced by 54.6% The number of children killed or seriously injured in road accidents has reduced by 46.9% The number of slight casualties has been reduced by 67.5% (target achieved) Rail safety Network Rail owns and operates Britain s rail infrastructure. They run, maintain and develop Britain s 22,000 miles of tracks, signalling system, rail bridges, tunnels, level crossings, 22

23 viaducts and 18 key stations. They strive to provide Britain with a safe, reliable and efficient railway fit for the 21st century. The Community Safety team for Network Rail work are responsible for the hard to tackle issue of railway crime. As a socially responsible company they have a moral and ethical, as well as strong business reason for trying to reduce crime and improve safety. If Network Rail can successfully address the problems of youth crime and infrastructure misuse the task of providing a safe, reliable railway is more achievable. Reducing levels of trespass and vandalism in key communities and improving performance by reducing delay minutes and costs are the building blocks of a world class railway and a world class safety education programme. It is estimated that railway crime costs the industry 250m a year. Trespassing, vandalism, graffiti, placing objects on the line, interfering with the infrastructure and throwing missiles, are the most common of the route crime offences. Every day on average, there is a fatality on the railway whether it is a deliberate act or accident, with over 250 last year. The majority of near misses, missile throwing and placing objects on the line incidents involve young people. Graffiti has been the fastest growing crime over the last five years and the age group involved in the most accidental fatalities are 8 17 year olds. Over 95% of accidents are from human error and misuse; less than 5% caused by hardware failure. The average number of fatal incidents, collisions, and suicides, have all risen between Pedestrian and vehicular fatalities have increased to a total of 40 during this period. There have been 78 suicides at level crossing and 64 train collisions also for this period. Key national targets: Reduce number of Suicides on Britain s railways over the next five years by 20% Reduce number of incidents at Level Crossings. Reduce crime and delay minutes to the business to improve safety and reduce serious injuries and fatalities. Reduce number of incidents of trespass and vandalism within the worst identified 100 locations on the railway and improve safety by raising awareness of the dangers of misusing the railway 23

24 Local Targets: Promote positive behaviour and engage young people in constructive activities To build the reputation of Network Rail as a key community partner and what they are trying to achieve in their community programme Improve community cohesion and tolerance Reduce crime and anti social behaviour within the identified locations for the North East. Reduce number of level crossing misuses within the community The strategic objectives of the Network Rail community safety team is to reduce the number of incidents of crime and anti social behaviour, improve performance and safety of the railway and to build the company reputation and community partnerships within the top 100 locations for crime Hull data Number of Cause Description Incidents 10 Trespass Trespassing onto railway property 4 Vandalism 2 x stone throwing 1 x train vandalised 1 Malicious Act Lineside fire 1 x train window smashed 3 Cable Theft Stealing or attempting to steal cable 7 Level Crossing Misuse Pedestrians / car drivers misusing crossings 1 Suicide Total: 26 incidents Hull data Number of Cause Description Incidents 5 Trespass Trespassing onto railway property 5 Vandalism Graffiti 3 Cable Theft Stealing or attempting to steal cable Total : 13 incidents 24

25 As can been seen from the above information, incidents have been reduced by half, this means that Hull has now fallen out of the national worst 100 locations for railway crime. However, Network Rail are not complacent and continue work in this area to prevent a resurgance in crime numbers. Network Rail has a website called No Messin directed at young people and focussing on safety on the railways; there is also a Network Rail Teaching Zone. The Teaching Zone contains access to free educational resources including lesson plans, factsheets, posters, videos and classroom activities as well as media files that can be downloaded for use by pupils or with school white boards. Outdoor play and leisure Children and young people learn, develop and mature when playing and taking part in activities that challenge them. Their participation in regular physical activity and outdoor play and leisure is important to their growth, development and general health and well being- in both short and long term. (e.g. obesity and cardiovascular disease) Types of hazards encountered during outdoor activity will vary for different age groups and according to where they take place Currently under development by Hull City Council s Play Development Service is the Play Strategy for Hull which is being designed to raise the profile of play and embed it in every agency s practice. Deliberate self harm pathway The CAMHS deliberate self harm pathway was launched in The pathway states that young people who present at Hull Royal Infirmary following an episode of deliberate self harm will be assessed by the team at the Department of Psychological Medicine. This service will offer a 7 day follow-up appointment. Although the Department of Psychological Medicine work evenings and weekends they are not a 24 hour service so young people who present out of hours will be assessed by the Duty Registrar who will then pass on to the Department of Psychological Medicine for them to arrange the 7 day follow-up. If it is felt that a referral to Child and Adolescent Mental Health Service (CAMHS) is appropriate the Department of Psychological Medicine or the Duty registrar can refer to the CAMHS service. If a young person presents at Hull Royal Infirmary and is already receiving a service from CAMHS then the team will assess and pass to CAMHS for follow-up. 25