{
  "abstract": "Background Concern was raised that two routine data indicators show the catchment local authorities (LA) of Northumbria Healthcare NHS Foundation Trust (NHCT) to be national outliers for admissions for alcohol-specific conditions in under 18s and self-harm inchildren and young people (CYP). A working group investigated this which included experts from public health, child health, mental health and data and intelligence.Methods The working group approached this public health question by: appraising the indicators using public health data interpretation skills; and contemporaneously examining and quality assuring pathways of care for CYP attending the NHCT emergency department (ED) for these reasons.Results Appraisal of both indicators highlighted an upward trend after a new specialist emergency care hospital opened, suggesting underlying processes, including recording, could be artificially increasing admission rates. Further interrogation of the data showed that around one third of CYP admitted for these reasons are taken to the short stay unit and soon discharged, raising the question as to whether they are a true admission. Examination of the care pathways identified a gap for CYP of transition age (16-17), including in receiving enhanced support. A quality improvement project was undertaken in partnership with ED and each LA commissioned alcohol service to develop a robust referral pathway for under 18s presenting with alcohol intoxication from both LAs, including updating safeguarding referral processes.Conclusion This public health question brought the importance of public health data interpretation and appraisal skills to the fore. Work is planned to further investigate the indicators including benchmarking with other trusts. NHCT can be assured that pathways of care for CYP are safe, high quality, and robust. Clinical teams involved in caring for CYP have provided feedback that there is now a clear process, increased awareness of external services and support, and available resources in ED.",
  "authors": [
    {
      "affiliations": [
        "Public Health Team, Northumbria Healthcare NHS Foundation Trust, Newcastle upon Tyne, UK"
      ],
      "name": "Robert Taggart"
    },
    {
      "affiliations": [
        "Public Health Team, Northumbria Healthcare NHS Foundation Trust, Newcastle upon Tyne, UK"
      ],
      "name": "Lisa Nevens"
    },
    {
      "affiliations": [
        "Public Health Team, Northumbria Healthcare NHS Foundation Trust, Newcastle upon Tyne, UK"
      ],
      "name": "Carla Anderson"
    },
    {
      "affiliations": [
        "Public Health Team, Northumbria Healthcare NHS Foundation Trust, Newcastle upon Tyne, UK"
      ],
      "name": "Laura Keast"
    },
    {
      "affiliations": [
        "Child Health, Northumbria Healthcare NHS Foundation Trust, Newcastle upon Tyne, UK"
      ],
      "name": "Julie Owens"
    },
    {
      "affiliations": [
        "Child Health, Northumbria Healthcare NHS Foundation Trust, Newcastle upon Tyne, UK"
      ],
      "name": "Claire Studholme"
    },
    {
      "affiliations": [
        "Emergency Care, Northumbria Healthcare NHS Foundation Trust, Newcastle upon Tyne, UK"
      ],
      "name": "Lara Black"
    },
    {
      "affiliations": [
        "Emergency Care, Northumbria Healthcare NHS Foundation Trust, Newcastle upon Tyne, UK"
      ],
      "name": "Jack Hardcastle"
    },
    {
      "affiliations": [
        "Public Health Team, Northumbria Healthcare NHS Foundation Trust, Newcastle upon Tyne, UK"
      ],
      "name": "Jill Harland"
    }
  ],
  "title": "P10-1 Understanding high admission rates for alcohol use and self-harm in children and young people and pathway of care quality assurance: case report",
  "uid": "5cb75f9f-d96f-5cfe-80ec-7220439d4419"
}