1. Avoidable Injuries How can we monitor them effectively? Carol Williams Public Health Analyst Northamptonshire Teaching PCT

2. Why is it a priority? Part of Local Area Agreements Not part of LDP or PSA targets

3. Routine Data Sources Mortality Data Hospital Admissions A&E Attendances Ambulance Calls Other e.g. Police, Fire etc

4. Which codes to use? ICD-10 primary diagnosis in the range S00 through T98X and external cause code in the following ranges: V01-V99, W00-X59, Y40-Y84 Includes complications of medical & surgical care

5. Mortality Data Issues Falls under recording: Fractures with cause unspecified (E887 ICD9) Now coded in ICD 10 as X59 (accidental exposure to unspecified factor) East Midlands had a relatively high number Include fractures with unspecified external cause Include deaths with diag. of osteoporosis (Health Statistics Quarterly Winter 2006)

6. Levers for change? National guidance for monitoring deaths from falls NCHOD need to reflect this issue for deaths from accidental falls

7. Hospital Admission Data Lack of timely comparative data – NCHOD 2004/2005 Serious Accidental Injury (LOS > 3 days) No further breakdown by accident type Lack of specific external cause code for some hospitals

8. Avoidable Injury Admissions

9. Lack of specific codes

10. Effect on cause-specific rates

12. Levers for change? Payment by Results – probably not Coding Standards – is there any process such as Data Accreditation? Information Agreement – not enough on its own Other National Initiatives?

13. A&E attendances Not part of SUS – no global data to set quality standards A&E mds has limited use Payment by Results only gives Low, Medium, High bandings No Accident Type field (except Patient Group) No detailed Incident Location CAER codes only relate to type of injury and treatment

14. Levers for change Informing Healthier Choices SUS user group A&E data part of SUS Development of national A&E mds

15. Accident monitoring initiatives NWPHO – Trauma and Injury Intelligence Group (TIIG) – additional data such as Injury Group, Accident Location West Midlands Accident Surveillance Centre (Bgm Uni) – based on A&E mds Cardiff University – All Wales Injury Surveillance System Dr Foster – Smart Risk

16. Other initiatives Use of other data sets e.g. Ambulance (can give location of accidents) Examples of special data collections? Other?