Agenda item

Report of the Director of Public Health and Chair of the County Durham and Darlington Child Death Overview Panel.

The Board considered a report of the Director of Public Health, who presented the 2021-23 County Durham and Darlington Child Death Overview Panel (CDOP) Annual Report (for copy see file of Minutes).

The Director of Public Health explained that during 2022-23 there had been 38 deaths notified to CDOP, fewer than the 47 notified the previous year.  She reminded the Board of modifiable factors, some of which were HWB priorities.  In reference to ‘making smoking history’, it was noted that addressing smoking during pregnancy, and within the household, and the management of high-risk pregnancies was an area of focus.  She added that enabling healthy weight for all was another area of focus, which could help address maternal obesity during pregnancy and again, the management of high-risk pregnancies.

Councillor R Bell referred to Table 2 within the report, which gave a breakdown of the age of the child at the time of notification of death.  He noted the largest group was for 0-27 days, the next largest being 28 days to one year old and asked how those two age ranges differed.  The Director of Public Health noted that the CDOP had a range of agencies involved, including health partners.  She added that those deaths within 0-27 days often were very complex with multiple morbidities and in some cases were expected despite positive care.  She noted that information was fed back to services and departments accordingly.  A Petty noted that a number of years ago, the HWB had wrote to the Clinical Board and the Integrated Care Board (ICB) as regards issues, such as Junior Doctors being able to escalate issues to their Seniors.  She asked as regards whether that had been flagged with the Care Quality Commission (CQC) or had been resolved.  The Director of Public Health noted it was not flagged with the Panel, however, it was noted that there were escalation processes in place.  It was added that there were themed reviews, with governance via the ICB and their sub-committees.

The Corporate Director of Children and Young People, John Pearce noted that while numbers were thankfully very small, he asked how statistically significant they were in terms of the ICB or wider footprint in terms of learning.  The Director of Public Health noted that discussions with the ICB included as regards quality of safeguarding, with some issues noted such as co-sleeping.  Dr J Carlton noted that these were the most devastating outcomes and he asked as regards how the HWB could take assurance in terms of previous recommendations.  The Director of Public Health noted it was for the HWB to take assurance from the report, or challenge, if they felt appropriate.  She gave smoking during pregnancy as an example, with the HWB knowing the issue and also knowing that it was a modifiable factor and therefore it was an area of work for partners and Trust colleagues.  She noted the HWB were kept informed, with those areas flagged as complete and those themes going forward.  Dr J Carlton noted as regards evidence of health interventions that should be taking place, adding that for modifiable factors, campaigns should help reduce numbers further.  The Director of Public Health noted that work and actions would begin as soon as they were understood, and not wait until reports were fed back to various boards, such as the HWB.

Resolved: That the Board;

(i)       Note the content of this report and the associated CDOP Annual Report as assurance CDOP is fulfilling its responsibilities as a sub-group of the Durham Safeguarding Children Partnership (DSCP).

(ii)      Note the modifiable risk factors aligned to the HWB priorities and consider any additional actions required to mitigate against them.

(iii)         Continue to promote a ‘call to action’ and continue to take forward the recommendations from the Tobacco Control update report presented in March 2024.