Sharing emergency department data with police could reduce violenceBMJ 2006; 333 doi: http://dx.doi.org/10.1136/bmj.333.7574.877 (Published 26 October 2006) Cite this as: BMJ 2006;333:877
Emergency departments should collect information on assaults and share it with police and local authorities in an effort to control violence, the Academy of Medical Sciences said last week.
The call came at a meeting in London on the science of violence, after members heard research findings from Jonathan Shepherd of Cardiff University showing that hospitals record many attacks that are never reported to police.
“About three quarters of the violence related injuries treated in emergency departments come from assaults that were never reported to the police,” Professor Shepherd told the BMJ. “Pooling anonymised hospital data with police intelligence can give a better picture of the true level of violence and help police target resources on hot spots.”
The 1998 Crime and Disorder Act calls on NHS trusts to work with police to perform local crime audits and to develop crime reduction strategies. Little was done before this year, but a scheme piloted by Professor Shepherd in Cardiff is now being adopted by 34 emergency departments in southeast England.
In the scheme patients presenting to emergency departments with injuries resulting from assault are asked to provide details at registration, including the location of the attack and the name of any drinking establishment involved. The data are anonymised and regularly shared with police.
The Cardiff trial of the scheme, which was reported in the Emergency Medicine Journal (2006; 23:12-7), focused on identifying pubs and clubs that were prone to violence. Interventions were then targeted at these venues, involving the police and emergency department consultants.
As a result of information provided by the emergency department, said Professor Shepherd, “police resources were brought in from the suburbs, where there was less violence; patrol routes [were] changed to include the hot spots; the main thoroughfare was pedestrianised; door staff [were] regulated; and a number of fast food outlets [were] closed.”
Consultants from the emergency department visited two high risk licensed premises and confronted managers with graphic accounts of the injuries sustained by their customers and the numbers of assaults perpetrated against them, said Professor Shepherd.
“We also told them we were auditing injuries sustained on their premises and would be publishing the results in the local press in six months.”
The study found a sharp reduction in violence at the two premises visited by hospital consultants and a more modest reduction at “hot spot” establishments that were identified in the hospital data but were visited only by police.
“A&E [accident and emergency] consultants can have a direct impact by going to meetings and advocating violence prevention,” said Professor Shepherd. He also called for more scientific evaluation of measures aimed at reducing violence.
“Randomised and controlled experiments are just as applicable to violence prevention interventions such as CCTV or toughened glasses in nightclubs as they are to testing new drugs and medical treatments,” he said.