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NCMD Child Mortality and Social Deprivation Report

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NCMD Child Mortality and Social Deprivation Report Child Mortality and Social Deprivation National Child Mortality Database Programme Thematic Report Data from April 2019 to March 2020 Published May 2021 Over a fifth of all child deaths might be avoided if children living in the most deprived areas had the same mortality risk as those living in the least deprived www.ncmd.info Authors Acknowledgements • David Odd1,2 • Stephanie Davern7 The National Child Mortality Database (NCMD) Programme is commissioned by the Healthcare Quality Sylvia Stoianova1 Rachel Rimmer8 • • Improvement Partnership (HQIP) as part of the National • Vicky Sleap1 • Judith Gault9 Clinical Audit and Patient Outcomes Programme • Tom Williams1 • Jennifer J Kurinczuk5 (NCAPOP). HQIP is led by a consortium of the Academy of Medical Royal Colleges, the Royal College of Nursing, • Nick Cook1 • Ingrid Wolfe3,4 and National Voices. Its aim is to promote quality • Louisa McGeehan6 • Karen Luyt1 improvement in patient outcomes. HQIP holds the contract to commission, manage and develop the National Clinical 6 • Alison Garnham Audit and Patient Outcomes Programme (NCAPOP), 1. National Child Mortality Database, Bristol Medical School, comprising around 40 projects covering care provided to University of Bristol, UK people with a wide range of medical, surgical and mental 2. School of Medicine, Division of Population Medicine, health conditions. NCAPOP is funded by NHS England, University of Cardiff, UK 3. School of Life Course Sciences, Department of Women and Children’s the Welsh Government and, with some individual projects, Health, King’s College London, London, UK other devolved administrations and crown dependencies 4. Evelina London Children’s Hospital, London, UK www.hqip.org.uk/national-programmes. 5. National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, UK Supported by: Kate Hayter, Lacia Ashman and 6. Child Poverty Action Group, London, UK Ben Wreyford from the NCMD team. 7. Manchester Child Death Overview Panel, Manchester Safeguarding Partnership, UK 8. Blackburn with Darwen, Blackpool and Lancashire Child Death Overview With thanks to: Panel, Blackburn with Darwen, Blackpool and Lancashire Children’s Manchester Child Death Overview Panel (CDOP) and Safeguarding Assurance Partnership, UK Blackburn with Darwen, Blackpool and Lancashire CDOP 9. Children and Family Wellbeing Service, Lancashire County Council, UK for providing information on exemplar case studies. The NCMD Professional Advisory Group (PAG) for their Partners contributions to section 7 of the report: • Peter Fleming, NCMD PAG Chair, University of Bristol • Janice Allister, Royal College of General Practitioners • Helen Duncan, Public Health England • Luke Geoghegan, British Association of Social Workers • Marilena Korkodilos, Public Health England • Wendy Tyler, British Association of Perinatal Medicine • Ingrid Wolfe, Royal College of Paediatrics and Child Health Russell Viner, President of the Royal College of Paediatrics and Child Health, for contributions to section 7 of the report. The members of the NCMD Steering Group and the NCMD partner charity organisations: The Lullaby Trust, Sands and Child Bereavement UK for their review and contributions to the final draft. Lara Cross from West of England CDOP, Victoria Newcombe from Southwest Peninsula CDOP, Nicola Contact us Mundy from the Surrey Child Death Review Partnership and Mike Leaf, Independent CDOP Chair and Pan- Lancashire CDOP Chair for their support and helpful National Child Mortality Database (NCMD) discussions on the topic of this report. Level D, St Michael’s Hospital, All Child Death Overview Panels (CDOPs) and Child Death Southwell Street, Bristol BS2 8EG Review Professionals for providing information to NCMD on Email: [email protected] children who have died. Website: www.ncmd.info Photographs of internal scenes by Katie Wilson for Twitter: @NCMD_England The Childhood Trust’s Bedroom of London Exhibition. www.ncmd.info © 2021 Healthcare Quality Improvement Partnership (HQIP) Contents Foreword.......................................................................................................................................................................................................2 Executive summary ....................................................................................................................................................................................3 1. Why was this work undertaken? ........................................................................................................................................................5 2. Quantitative analysis of NCMD data ..................................................................................................................................................7 2.1. How to read this section ................................................................................................................................................................. 7 2.2. How we carried out this work ......................................................................................................................................................... 7 2.3. What we found .................................................................................................................................................................................. 9 2.4. Summary of this section ................................................................................................................................................................ 14 3. Qualitative, thematic analysis of completed child death reviews ...........................................................................................15 3.1. How we carried out this work ....................................................................................................................................................... 15 3.2. What we found ................................................................................................................................................................................ 16 3.3. Limitations ...................................................................................................................................................................................... 16 4. Exemplar case studies from Child Death Overview Panels ......................................................................................................17 4.1. Reducing infant mortality – Manchester CDOP ......................................................................................................................... 17 4.2. Safer Sleep for Baby Campaign – Blackburn with Darwen, Blackpool and Lancashire CDOP ........................................ 20 5. Conclusions ..........................................................................................................................................................................................21 6. Recommendation .................................................................................................................................................................................21 7. Potential interventions to reduce inequalities ............................................................................................................................22 7.1. The social factors of health .......................................................................................................................................................... 23 7.2. Health and wellbeing .................................................................................................................................................................... 26 7.3. Health care services ..................................................................................................................................................................... 27 7.4. Data sharing .................................................................................................................................................................................... 28 8. Next steps: Enhanced child death review data collection and national analyses ...............................................................29 9. Glossary of terms .................................................................................................................................................................................30 10. References ..........................................................................................................................................................................................31 www.ncmd.info 1 Foreword Every child death is a tragedy. If unavoidable it can, depending A different way of assessing avoidability of infant and child on beliefs, be put down to bad luck, fate, the universe out of deaths is to examine the relation with deprivation. Here, the kilter, God’s will. But if avoidable, there is a different sense. It relation is strong. In one of the analyses, the report shows should not have happened. “They” should have been able to that for each decile of deprivation, going from least to most do something about it. Perhaps “they” should be turned into deprived, on average, the mortality risk is relatively 10% “we”. We, organised public health, the health care system, higher. It means the rate is over twice as high in the most a well-functioning society should have been able to do deprived decile
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