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Multicenter Study
. 2009 Nov;59(568):819-24.
doi: 10.3399/bjgp09X472520. Epub 2009 Sep 2.

Child deaths: confidential enquiry into the role and quality of UK primary care

Anthony Harnden  1 , Richard Mayon-White, David Mant, Deirdre Kelly, Gale Pearson
Affiliations
Multicenter Study

Child deaths: confidential enquiry into the role and quality of UK primary care

Anthony Harnden et al. Br J Gen Pract. 2009 Nov.

Abstract

Background: In 2006 the Confidential Enquiry into Maternal and Perinatal Deaths was extended to pilot a collection of child deaths. This helped optimise data collection for local safeguarding children's boards, which, since April 2008, have a statutory responsibility to review all child deaths. Reviewing primary care records may highlight areas in which systems, skills, and care could be improved.

Aim: To review the role and quality of primary care in child deaths.

Design of study: Confidential enquiry into child deaths.

Setting: Five regions of the UK: North-East, South-West and West Midlands, Wales, and Northern Ireland.

Method: The confidential enquiry collected core data for all child deaths (age range 28 days to 17 years) and an age-stratified sample was assessed by multidisciplinary panels for avoidable factors. An independent detailed review was conducted of the primary care records on all children in the North-East region and all children who were reviewed by panel in the other four regions.

Results: Primary care records were reviewed for 168 child deaths. There were 25 (15%) deaths from acute infection, 22 (13%) from cancer, and 11 (7%) from asthma or epilepsy. Fifty-nine (35%) deaths were sudden: sudden unexplained death in infancy, suicides, and assaults. Of 149 with immunisation records, only 88 (59%) had been fully vaccinated on time. One or more primary care professionals were involved in the management of 90 (54%) children. Avoidable primary care factors were identified in 18 (20%) of these deaths. Avoidable primary care factors included failure in the recognition and management of serious infection, failure to vaccinate, and inadequate management of asthma and epilepsy.

Conclusion: Decisions made about diagnosis and management in primary care may affect the cause, time, and circumstances of a child's death. Maintaining skills in assessing the acutely ill child remains an essential part of good clinical practice.

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References

    1. Office for National Statistics. Mortality statistics general: review of the Registrar General on deaths in England and Wales, 2004. Series DH1 no 37. http://www.statistics.gov.uk/downloads/theme_health/Dh1_37_2004/DH1_No_3... (accessed 29 May 2009)
    1. Lewis G, editor. The Confidential Enquiry into Maternal and Child Health (CEMACH). Saving mothers' lives: reviewing maternal deaths to make motherhood safer 2003–2005. The seventh report on confidential enquiries into maternal deaths in the United Kingdom. London: CEMACH; 2007.
    1. Pearson GA, editor. Why children die: a pilot study 2006; England (South West, North East, West Midlands), Wales and Northern Ireland. London: CEMACH; 2008.
    1. Holden J, O'Donnell S, Brindley J, Miles L. Analysis of 1263 deaths in four general practices. Br J Gen Pract. 1998;48(432):1409–1412. - PMC - PubMed
    1. Rimsza ME, Schackner RA, Bowen KA, Marshall W. Can child deaths be prevented? The Arizona Child Fatality Review Program experience. Pediatrics. 2002;110(1 Pt 1):e11. - PubMed

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