Centre for Public Health

Liverpool John Moores University

Public Health Institute - Liverpool John Moores University

World Health Organization Collaborating Centre for Violence Prevention

Part of the Liverpool John Moores University

Optimising the use of NHS intelligence in local violence prevention and measuring its impact on violence

Medical teamwork

We are in the final year of a three year research project, funded by the Department of Health, which aims to identify and support the optimum use of NHS data in local violence prevention, and to identify the impacts of local NHS data sharing on levels of violence.

Project publications can be found at the bottom of this page.

Background to the study

Violence is a significant problem within the UK. Data from the Crime Survey for England and Wales (CSEW) indicates that over 2 million incidents of violence took place among those aged 16 and over in 2011/12 alone (ONS, 2013). A further half a million incidents were thought to have been experienced by those aged 10-15 years (ONS, 2012). Violent experiences have huge implications for victims, who as well as suffering physical injuries often develop subsequent emotional or mental issues (Bellis et al., 2012). However, the impacts of violence are far reaching, affecting families, communities, and society as a whole. The estimated economic and social costs of violence in England and Wales for example were £29.9 billion in 2008/09 (Bellis et al., 2012).

It is possible to prevent violence. The World Health Organization (WHO) recommends a public health approach to violence prevention, in which the routine availability and use of data on violence plays a fundamental part (Krug et al., 2002). Whilst historically, data from police-recorded violent crimes has been used to target interventions, many violent incidents are underreported (Chaplin et al., 2011). However, victims of violence often require health treatment. Research indicates that between one third (Sutherland et al., 2002) and up to 80% (Faergemann et al., 2007) of assault victims who require treatment in Emergency Departments (EDs) do not report the assault to the police. Data from health services could therefore make a valuable contribution to planning and monitoring violence prevention. Despite many areas in England developing and establishing systems to use health data in violence prevention activity, these datasets are currently underutilised. Variations exist in data collection methods and information systems, and there is also a lack of understanding of what can be shared whilst maintaining patient confidentiality (Davison et al., 2010).

The coalition government has put a strong emphasis on ED data sharing through the Coalition programme for action (Cabinet Office, 2010). Some studies have shown the benefits of the use of health data in violence prevention (Boyle et al., 2012, Florence et al., 2011, Quigg et al., 2012), however there remains a scarcity of knowledge on such work across England. This study aims to address this gap by identifying and supporting the optimum use of NHS data in violence prevention.

Study objectives

To fulfill the aim of the study, the project has three key objectives:

  1. To assess the use of NHS datasets in local violence prevention and demonstrate their utility in providing a comprehensive picture of violence.
  2. To gather detailed information on NHS data sharing pathways and data use in study sites, and to measure the impact on violence.
  3. To work with local partners in study sites to make best use of NHS data for targeting violence prevention activity and measuring its impact.

Study methods and outputs

Nine study sites across the North West of England and London are taking part in the study. These are: Bolton, Brent, Hackney, Hammersmith and Fulham, Lambeth, Preston, Westminster, Wigan and Wirral. The study sites selected are at different stages of health data sharing for violence prevention (based on a Department of Health audit on the use of emergency department data in violence prevention (The Centre for Public Innovation, 2012)).

The project involves a number of work strands:

1. Exploration of the use of health data and its impact on local levels of violence

Detailed exploration of the use of health data (from EDs, hospital admissions, ambulance services) has been conducted in the nine study sites. Researchers collected information on local violence prevention activity and the use of health data (particularly ED data) in such activity over a 12 month period (April 2013 – March 2014). Data was collected from partners on a monthly basis detailing violence prevention activity and the use of health data, including any specific interventions that had been developed or targeted through the use of health data. The impact of data sharing on local levels of violence will now be measured through a further analysis of trends in NHS and other partner data for assaults over the study period. A final research report will be completed by Summer 2015.

2. Exploration of data sharing pathways between emergency departments and local partners

In each study area, semi-structured interviews were conducted with relevant partners (e.g. crime and safety partnerships, local authorities, EDs) to gain a better understanding of local data sharing pathways. The information collected from the interviews informed the development of a number of case studies regarding emergency department data sharing processes and the use of the data in violence prevention. The case studies provide detail on how data sharing processes were set up, how they work in practice, the barriers experienced, how these were overcome, and the use of the data within local violence prevention. These good practice documents highlight how different data sharing pathways can be taken in different area types. The case studies were published in December 2014. Case studies for five local authority areas in the North West and London (Hackney, Lambeth, Preston, Wigan and Wirral) are available at the bottom of this page.

3. Local violence profiles

Researchers used non-identifiable health data, including ED attendances, hospital admissions and ambulance call outs, to produce a local violence profile for each of the study sites. The profiles detail when and where violence occurs, at-risk groups and communities, and any circumstances around violence. Although the profiles are only completed for study areas, they should be of broader interest to anyone wanting to understand the types of information that can be drawn from health data and how this can help inform violence prevention. The profiles were published in December 2014.

4. Guidance on the use of health data in violence prevention

A guidance document on using health data within local violence prevention has been developed. Aimed at health professionals and other local partners involved in violence prevention, the report introduces the main health data sets and highlights how they can be analysed and used within local violence prevention. It includes a step-by-step guide to setting up local data sharing systems and discusses how to handle and manage health data safety and securely. The document includes practical examples of health data sharing and use gathered from the study sites. The guidance document was published in December 2014.

5. Workshops: providing support for local partners

Two workshops (one in Liverpool and one in London) were held in July 2014 with local and national partners, including voluntary organisations. The workshops aimed to support local partners in using health data to inform violence prevention. The workshops raised awareness of the types of NHS data available to local partners, increased understanding of how NHS data sources could be used within local violence prevention, and provided an opportunity for partners from participating areas to share experiences and knowledge on local data sharing issues.

An interim findings report is now available to download here. A final project report will be published in Summer 2015, which will include analyses of the impact that health data sharing can have on local levels of violence. Findings will be published in journals that target both practitioners and academics, and will be communicated at relevant local and national conferences. A poster presentation on the research was given at the Public Health England Annual Conference 2014 (16-17 September 2014).

Final Research Report

http://www.cph.org.uk/publication/optimising-the-use-of-nhs-intelligence-in-local-violence-prevention-and-measuring-its-impact-on-violence-project-research-findings/

Violence Profiles

http://www.cph.org.uk/publication/bolton-violence-profile/

http://www.cph.org.uk/publication/brent-violence-profile/

http://www.cph.org.uk/publication/hackney-violence-profile/

http://www.cph.org.uk/publication/hammersmith-and-fulham-violence-profile/

http://www.cph.org.uk/publication/lambeth-violence-profile/

http://www.cph.org.uk/publication/preston-violence-profile/

http://www.cph.org.uk/publication/westminster-violence-profile/

http://www.cph.org.uk/publication/wigan-violence-profile/

http://www.cph.org.uk/publication/wirral-violence-profile/

Case Studies

http://www.cph.org.uk/publication/accident-and-emergency-department-data-sharing-to-support-violence-prevention-in-hackney/

http://www.cph.org.uk/publication/accident-and-emergency-department-data-sharing-to-support-violence-prevention-in-lambeth/

http://www.cph.org.uk/publication/accident-and-emergency-department-data-sharing-to-support-violence-prevention-in-preston/

http://www.cph.org.uk/publication/accident-and-emergency-department-data-sharing-to-support-violence-prevention-in-wigan/

http://www.cph.org.uk/publication/accident-and-emergency-department-data-sharing-to-support-violence-prevention-in-wirral/

http://www.cph.org.uk/publication/a-case-study-to-demonstrate-the-use-of-health-data-in-violence-prevention-within-the-voluntary-and-community-sector-local-solutions/

Guides

http://www.cph.org.uk/publication/a-guide-to-using-health-data-to-inform-local-violence-prevention/

http://www.cph.org.uk/publication/a-short-guide-to-using-health-data-to-inform-local-violence-prevention/

If you would like any further details on the project please contact the research leads:

Kat Ford (Researcher)

k.j.ford@ljmu.ac.uk 0151 231 4148

Zara Quigg (Project Manager/Lead researcher)

z.a.quigg@ljmu.ac.uk 0151 231 4513

Sara Wood (Senior Researcher)

S.K.Wood@ljmu.ac.uk 0151 231 4359

Prof Karen Hughes (Principal Investigator)

k.e.hughes@ljmu.ac.uk 0151 231 4510

This report is independent research commissioned and funded by the Department of Health Policy Research Programme (Optimising the Use of NHS Intelligence in Local Violence Prevention and Measuring its Impact on Violence, 115/0002). The views expressed in this publication are those of the author(s) and not necessarily those of the Department of Health.

References

BELLIS, M., A., HUGHES, K., PERKINS, C. & BENNETT, A. 2012. Protecting people, Promoting health: A public health approach to violence prevention for England. Liverpool: Department of Health, .

BOYLE, A., SHEPHERD, J. & SHEEHAN, D. 2009. Guideline for information sharing to reduce community violence In: THE COLLEGE OF EMERGENCY MEDICINE (ed.). Clinical Effectiveness Committee.

BOYLE, A. A., SNELLING, K., WHITE, L., ARIEL, B. & ASHELFORD, L. 2012. External validation of the Cardiff model of information sharing to reduce community violence: natural experiment. Emergency medicine journal : EMJ.

CABINET OFFICE 2010. The Coalition: our programme for Government. London: Cabinet Office.

CHAPLIN, R., FLATLEY, J. & SMITH, K. 2011. Crime in England and Wales 2010/11. Findings from the British Crime Survey and police recorded crime. Second ed. London: Home Office.

DAVISON, T., STADEN, L. V. & NICHOLAS, S. 2010. Process evaluation of data sharing between emergency departments and Community Safety Partnerships in the South East London: Home Office.

FAERGEMANN, C., LAURITSEN, J.M., BRINK O, SKOV, O. 2007. Trends in deliberate interpersonal violence in the Odense Municipality, Denmark 1991–2002. The Odense study on deliberate interpersonal violence. Journal of Forensic and Legal Medicine, 14:20–26.

FLORENCE, C., SHEPHERD, J., BRENNAN, I. & SIMON, T. 2011. Effectiveness of anonymised information sharing and use in health service, police, and local government partnership for preventing violence related injury: experimental study and time series analysis. BMJ, 342.

KRUG, E., G, DAHLBERG, L. L., MERCY, J., A, ZWI, A. B. & LOZANO, R. 2002. World report on violence and health. Geneva: World Health Organization.

ONS 2012. Crime in England and Wales, quarterly first release to March 2012., London, Office for National Statistics.

ONS 2013. Focus on: violent crime and sexual offences, 2011/12 – Appendix tables (Online).

QUIGG, Z., HUGHES, K. & BELLIS, M. A. 2012. Data sharing for prevention: a case study in the development of a comprehensive emergency department injury surveillance system and its use in preventing violence and alcohol-related harms. Injury Prevention, 18, 315-320.

SUTHERLAND, I.V., SIVARAJASINGAM, V., SHEPHERD J. 2002. Recording of community violence by medical and police services. Injury Prevention, 8:246-247.

THE CENTRE FOR PUBLIC INNOVATION 2012. Information Sharing to tackle violence. Audit of progress on delivering the Coalition Commitment 2012.

UPTON, V., BELLIS, M. & PERKINS, C. 2012. Violence Related Accident and Emergency Attendances by English local Authority Area. In: THE CENTRE FOR PUBLIC HEALTH (ed.). Liverpool: North West Public Health Observatory.