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Issue Date:- 17 February 2009

PCTs fall short on baby hip examinations

NATIONAL charity STEPS has revealed an alarming number of Primary Care Trusts (PCTs) in England have no formal policy in place for infant hip examinations.  The charity provides support and information for all lower limb conditions in children and young adults. On 24 February, during Baby Hip Health Awareness Week, STEPS supporter Dave Anderson MP will table a cross-party Early Day Motion in the Commons to urge government action to overcome shortcomings.

Research carried out by STEPS asked Acute Trusts and PCTs in England to submit existing guidelines and formal policy on baby hip checks. Of those who responded, it was revealed 57% of PCTs and 10% of Acute Trusts have no formal policy in place, despite a national screening policy being introduced in the UK in 1969.

The aim of the screening programme is to identify and treat infants with a hip abnormality at an early stage, with a post-birth hospital check and again at 6 to 8 weeks.  Up to 2000 children a year are diagnosed with development dysplasia of the hip (DDH) which requires treatment involving splints and plaster body casts. Late diagnosis can lead to complex surgery and lifelong problems, often impacting on psychological development.

STEPS also conducted a survey of parents with children affected by lower limb conditions. While many praised the care received during treatment for DDH, the majority of parents felt they weren't informed about the condition and it wasn't clearly explained to them.

Theresa Quinn from Haywards Heath in West Sussex has a daughter, Harriet, who was diagnosed with DDH aged 10 months:-
"A health visitor came to check on Harriet, who was developing very quickly and gave us no cause for concern. She noticed, on further examination, when Harriet put both legs together lying down, her right leg appeared to be half a centimetre shorter.

When she suggested we should visit our GP it sent me into a blind panic - I felt like I'd failed my daughter in not finding it sooner. My GP didn't even touch Harriet during the check and was extremely dismissive.

After months of waiting and chasing the GP for diagnosis, Harriet was admitted for treatment in hospital and had her 2nd spica cast on 11 December. We will be going back to hospital again this month to review her case. It really is a waiting game and an emotional rollercoaster. We can't fault the care Harriet has received in hospital but I can't believe there is such a lack of information out there for parents."

Radio presenter, Sara Cox, is getting behind the cause and was personally affected by DDH as a young child:- "I obviously can't remember the trips to hospital, the corrective cast I had to wear or my parents telling my siblings I was a special baby. I'm sure my parents would've been grateful for an organisation like STEPS.  I think it's really important families have information to hand and a good support network to help them through what can be a very emotional experience. Organisations like STEPS are invaluable and offer advice, a friendly ear and access to people in the same situation who understand exactly what you're going through."

Dave Anderson, MP for Blaydon, said:- "I am very proud to support the important work of the STEPS charity and to highlight it in Parliament. I am impressed by their work in showing that the national screening programme needs to be backed by proper procedures and policies which can then prevent needless suffering as well as spending. I hope that the Minister will meet STEPS to see how current shortcomings in the screening programme can be overcome."

Sue Banton, founder and director of STEPS, added:- "Our research highlights a staggering gap in health policy which, if correctly followed, could detect lower limb conditions at an early age and save both parents and children from years of pain and emotional distress.  It's frightening so many PCTs are refusing to take responsibility for checking babies' hips, leaving it to GPs and creating massive inconsistency in procedure."

Andreas Roposch, orthopaedic surgeon and epidemiologist at Great Ormond Street Hospital, said:- "The failure to diagnose hip dysplasia in a timely manner is very disconcerting to families with children affected but screening is a complex issue with mixed results world-wide. Suffice it to say that the hips should be checked in all newborns in routine examinations performed by well-trained health professionals, especially in those with known risk factors.

Specialist referral is essential in any uncertain cases, and treatment should be commenced early on if needed!"

£6.4 million investment in Liverpool’s public transport network

LIVERPOOL'S public transport network is set to benefit from an investment of over £6 million from the Northwest European Regional Development Fund (ERDF).

The funding is being allocated for 6 projects, to be taken forward by Merseytravel, which aim to improve the provision and accessibility of public transport into the city centre. The projects include:

City Centre Underground Stations – This project has been allocated £417,000 of ERDF funding to enhance the welcome, attractiveness and accessibility of the gateway underground stations to Liverpool city centre. The scheme involves the refurbishment of the station’s entrances, new signage, and improving accessibility.

James Street Underground Station – This project, which will receive an ERDF grant of £680,000, will enhance the gateway station to Liverpool’s waterfront and the western areas of the city centre, including Liverpool One. The scheme includes the creation of a new station entrance/exit, the extension of the concourse area allowing incorporation of extra automatic ticket gates, the introduction of a landmark canopy outside the station entrance and new lighting and signage.

In addition, 4 individual projects which will upgrade significant bus corridors to improve access into the city centre have also been approved. These include:

City Centre Bus Corridor (A59) (£1.4 million ERDF) – Connecting Liverpool city centre with St Helens. It will create improved transport routes in and around the city centre to connect with the radial routes on the major corridors including Brownlow Hill, Pembroke Place, London Road, Lime Street and Upper Parliament Street.

Integrated Corridor B Gateway (A57) (£911,000 ERDF) – Connecting Liverpool city centre and Bootle with Walton, Fazakerley, Old Roan, Maghull and Kirkby.

Integrated Corridor D Gateway (A561) (£1.4 million ERDF) – Connecting the city centre with Kensington, Old Swan, Dovecot, Page Moss, Huyton, Prescot, Whiston, Rainhill, Widnes and St Helens.

Integrated Corridor F Gateway (£1.7 million ERDF) – Connecting Liverpool city centre with Allerton, Aigburth, Speke and Liverpool John Lennon Airport.

Work will include improving bus stops, creating new and upgraded bus lanes, upgrading traffic signals to enhance bus movements and upgrading pedestrian crossings. The projects aim to reduce the variability of bus journey times, make it easier for the local community to access public transport and ensure that Liverpool’s bus service provides a real alternative to car use.

Steven Broomhead, Chief Executive of the NWDA, said:- “These investments will significantly improve access into Liverpool city centre and encourage greater use of public transport, which will both help to ease congestion in the city centre and support the Agency’s commitment to tackling the climate change agenda. Through driving up the quality, accessibility and frequency of public transport, I hope that these schemes will help to provide a real, affordable and convenient alternative to car use for local residents.”

Councillor Mark Dowd, Chair of Merseytravel, said:- “Around 200 million journeys are made by bus or train every year on Merseyside. Public transport is a vital part of people’s day to day lives and we are constantly looking at ways to deliver better, more reliable, more accessible facilities for them along with our partners in the district councils.  Improving our transport network is also essential to the region’s economic success and prosperity. Partnerships and investment are the cornerstone of delivering this so I’m delighted that this money is being invested here.”

The schemes are part of Merseyside’s Local Transport Plan, which runs until 2011 and is a £230m delivery programme of transport investment and service improvements.  It aims to give Merseyside a safer, sustainable, efficient and integrated transport network, accessible to all.

A separate investment from the Northwest Regional Development Agency (NWDA) will be allocated for the Liverpool Transport Model project, which will receive £250,000 Agency funding to create a computer based modelling facility that will enable the transport needs and impact of new developments to be planned for. The creation of a Liverpool Transport Model, which will be led by Liverpool City Council and Liverpool Vision, will enable partners to undertake detailed road network and junction simulation when planning new developments, helping to reduce the potential impacts on congestion that new developments may create.

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