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Derby City and Derbyshire County Child Death Overview Panel Annual Report 2017-2018

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Derby City and Derbyshire County Child Death Overview Panel Annual Report 2017-2018 Derby City and Derbyshire County Child Death Overview Panel Annual Report 2017-2018 Alex Hawley (Acting Consultant in Public Health, Derby City Council and Chair of CDOP) Sereena Raju (Information Analyst, Public Health, Derby City Council) 1 2 CDOP Annual report April 2017 – March 2018 Contents Preface ................................................................................................................................................... 4 The year in retrospect .......................................................................................................................... 6 The panel’s meetings April 2017 to March 2018 ......................................................................... 6 Confidentiality ................................................................................................................................... 9 Safe sleeping .................................................................................................................................... 9 Sudden neonatal deaths in hospital ............................................................................................ 11 Maternal obesity ............................................................................................................................. 12 Smoking in pregnancy ................................................................................................................... 13 Update on nappy sacks ................................................................................................................. 14 Update on consanguinity ............................................................................................................... 15 Taking stock .................................................................................................................................... 15 Looking forward .................................................................................................................................. 16 Analysis of Case Data ....................................................................................................................... 18 1.0 2017/18 data ........................................................................................................................... 18 1.1 Modifiability .......................................................................................................................... 23 2.0 2013/14 – 2017/18 data ........................................................................................................ 24 2.1 Trends over the five year period ...................................................................................... 24 2.2 Cumulative patterns ........................................................................................................... 27 2.3 Modifiability .......................................................................................................................... 40 3 Preface I am pleased to present our Child Death Overview Panel (CDOP) annual report for 2017- 2018. As always, the panel has gone about its work with great diligence and dedication, always adopting an objective but sensitive approach to such emotionally and professionally challenging subject matter, with undiminished zeal for learning and applying important lessons, to benefit and protect other (and future) Derbyshire children. It is worth restating Ofsted’s judgement of the work of the panel from its inspection of the Derby Safeguarding Children Board in early Spring of 2017, in which it found that the panel was doing “all that it can to ensure that awareness is raised in the local community in the hope of preventing further deaths.” I certainly would like to take the opportunity I have in writing this preface to offer my personal thanks to everyone who has attended CDOP panels during the year, or who has contributed behind the scenes. I feel extremely privileged to have been the Chair of this panel for nearly two years, given the high calibre and dedication of all its members from across a wide range of disciplines. Thanks to everyone who has contributed Form Bs, compiled agendas, presented cases, taken minutes, followed up actions, engaged in discussion, or represented CDOP at other meetings. During the year, some long-serving stalwarts of the panel have moved on, and I would therefore particularly like to register huge thanks and best wishes to DCI Malcolm Bibbings, Dr Helen Jacques, Sue Rucklidge, and Kathy Webster. I am very confident that Juanita Murray, Kathy Webster’s successor as Designated Safeguarding Nurse in the north, and also my successor as incoming Chair, will benefit from the same level of commitment and support from her CDOP colleagues that I have enjoyed, and will successfully take the work of the panel forward. I would also like to extend my thanks to Michelina Racioppi, who will shortly be stepping down as Vice-Chair, and I am very grateful to Anne Hayes for stepping up to take on that role and so ensure that Public Health continues to have a strong voice in the work of the panel. It is clear that there are some important challenges in the year ahead, as national guidance and local governance changes come into force. At the time of writing, we are still awaiting the publication of the final Child Death Review statutory guidance (updating the consultation version that was published in October 2017). In the meantime, however, July saw the publication of the new ‘Working Together’ guidance, which means that the clock is already ticking for agreeing our revised local safeguarding arrangements, including CDOP and other processes of child death review. 4 We also now know that the long-awaited and keenly anticipated National Child Mortality Database (NCMD) is now in development. NHS England has commissioned the University of Bristol, in collaboration with University of Oxford, UCL Partners and QES to develop the NCMD, to which all CDOPs will eventually submit data for central analysis, with the expectation of deeper understanding of patterns and trends. The project is funded for four years from April 2018, with these key milestones expected: Year 1: Develop and pilot the IT systems required to support data capture and create the central database structure Year 2: Commence national data collection and publish the outcomes from the pilot Year 3: Annual and Thematic Reports Year 4: Annual and Thematic Reports To better enable such national analysis, it seems inevitable that this project will require some further standardisation across CDOPs in the way that components of reviews are currently interpreted. In the meantime, we always endeavour to achieve thoroughness and consistency in the decisions we make in the panel and the way that this is recorded and coded, and to be constantly vigilant for any emerging local themes or trends, so that we can respond accordingly. A key component of that is the analysis we carry out every year and present in this report. I hope that you find it both informative and interesting, notwithstanding the grim nature of the topic . If this report raises any further questions or you would like to make any comments please do not hesitate to contact Rachel Turley for additional information via [email protected] I am indebted to Sereena Raju, Information Analyst in the Public Health Department at Derby City Council, for carrying out the analysis of CDOP data for this report, and setting this out so clearly not only for the last financial year (2017/18), and also for the last five years (2013/14 to 2017/18). Given the number of historic cases that have come to panel this year, I was keen to include this look-back analysis, and I am very grateful to Sereena for agreeing to take on this extra work. Her analysis begins on page 17. Finally, I would like to offer one final personal vote of thanks to Rachel Turley. It has been a pleasure and a privilege to work closely with Rachel, and I am very grateful for her constant good humour and personal support at all times. Alex Hawley, Acting Consultant in Public Health, Chair of Derby City and Derbyshire County Child Death Overview Panel 5 The year in retrospect The panel’s meetings April 2017 to March 2018 The number of cases presented at each panel sitting are set out below, along with the number of representatives present at each meeting. Note that the August meeting was cancelled due to availability, and March was used as an additional neonatal panel meeting (neonatal panels shaded in blue, full CDOP panels in green), rather than a development session. In November, there were no Lead presenters available, meaning no cases could be presented, but the meeting went ahead as a development and communication session, with a focus on the consultation on ‘Working Together’, which concluded in December. Cases Number presented attending April 5 8 May 2 19 June 4 15 July 10 10 August Cancelled September 6 17 October 12 10 November 15 December 6 20 January 13 16 February 5 19 March 14 16 Overall, the number of cases presented (not all were closed) to each neonatal panel tends to be larger, but usually with a slightly smaller attendance, owing to the greater medical focus of issues of concern, and perceived reduced need for wider partnership discussion. In total, 54 cases were presented to five neonatal panel sittings, while 23 cases were presented to five full CDOP panels. All the panel sessions last between three and three and a half hours, and also include sign-off of minutes, follow-up of actions,
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