“Don’t Stop Believing”

Ethna M. DillonManager, Vulnerable Baby Service

Summit for Preventing Infant Death LSE

15th June 2011

Greater Manchester

Manchester4th in Index of Multiple Deprivation

England (2010)

Population 483,830 (2009)24% aged 0-19 years

35% primary school children: English a 2nd language (2010)

13,285 births in M/C hospitals(2010)7,552 births to residents

IMR 6.3 per 1000 births (2006-08, Nat av 4.8)

Increased Vulnerability and Hard to Reach

Exposure to nicotinePremature babiesAlcohol UsersDrug UsersMobile FamiliesVictims of violence and abuseTeenagers

Why?

Environmental factors that cause stress to either the baby or their carer are potential risks ie.

Fear

WorryLack of sleep

Lack of alertness

Change in routine

Resistant to change

Relationship problems

Bonding issues

Poor concentration

Who are the babies with increased risk of SUDI in Manchester?

Analysis of deaths in Manchester shows that there were environmental factors which could have influenced the outcome for these babies;

Eg. Alcohol/Substance misuse,

Violent criminal history against child or partner,

A previous child not living with parent,

Late booking for ante natal care,

Homelessness with mental health issues/domestic

Abuse/probation. Hearing impaired parents

Referral Criteria

Targeted Specialist Case Planning led and chaired by Vulnerable Baby Service

-Family offered opportunity to have a meeting with agencies who can help them to address their needs-Referrals from health or muti- agency partners to VBS if family meet criteria. -Multi agency case planning meeting arranged, chaired and minuted by VBS -Since 2004, 983 families have been referred to VBS (1 of those babies has been SUDI; moved out of area before meeting took pace)

Early Intervention is a national strategy

Graham Allen and Eileen Munro

Meeting eg.

Midwife

Health Visitor

Chair

Social WorkerEducatio

n

Mental Health Worker

Police

Parents

ReferrerSure Start

Multi agency Partners

Housing

Universal Services

Connexions

Voluntary Services

Sure Start

Drug Services

Community Alcohol

Team

Probation

Police

Children’s Social

Care

Family

Population approach

Safe Sleeping Practice Guidance

- Every family is given consistent advice by all agencies

- All multi agency partners are stakeholders in embedding

practice

“The attitudes and behaviour of individual practitioners have a major effect on whether families engage”

Safeguarding Knowledge Review 2010

Centre for Excellence and Outcomes in Children and Young People’s Services (C4EO)

Target Staff Groups

Specialist Services, often involved with high risk families ; Foster parents and social workersHousing staff; refuges ,temporary accommodation, prisonsProbationConnexionsCommunity Alcohol TeamDrug ServicesPolice

Health

Midwives

Neonatal teams

Health Visitors

GPs

Obstetricians

Paediatricians Appoint a champion to lead in each group

Campaigns; targeted message to the population

Evaluation Reasons for co sleeping in Manchester

Midwife opinion:Breastfeeding (46%)

TirednessTo settle baby

CulturalConvenience

No cotAccidental

Public opinion:I get more sleep (53%)

I like to sleep with my babyHelps when illWon’t go in cot

No space for cot in bedroomBreastfeeding (12%)

Mum didI don’t have a cot

Learning led to 3 point process 1. Verbal explanation, reduce the risk advice

2. The wrong picture test

3. Given bib

Graph to show comparative rate of unexpected deaths of infants in United Kingdom, and Manchester (Birth - 1 year)

UK figures are from the Foundation for the Study of Infant Deaths where data include deaths that remain unexplained after post mortem examination and may be registered as sudden infant death syndrome, SIDS, sudden infant death, sudden unexpected death in infancy, unascertained or cot death. Manchester figures are locally collected unexplained deaths.

Rate of Sudden Unexpected Death in Infants

0

0.2

0.4

0.6

0.8

1

1.2

1.4

1.6

1.8

2

2002 2003 2004 2005 2006 2007 2008 2009 2010

Year

Rate

(p

er1

000 liv

e b

irth

s)

Manchester

UK

Summary- Know your demographic, analyse the local SUDI, speak to front line staff- Safe Sleep Practice Guidance - Evaluate, keep looking for gaps or themes and address them- Staff change, training and updates are a way of life- Target specialist staff groups- Keep safety of baby the priority- There is no quick fix, but there is always more that can be done

Don’t Stop BelievingThat you can make a difference

Vulnerable Baby ServiceSafeguarding Children’s TeamWalmer StreetRusholmeManchesterM14 4NB

Ethna.dillon@cmft.nhs.uk