Doctors are key to tackling knife violence, says expert

July 17, 2008

Every hospital emergency department should share information about violent incidents with local crime reduction agencies to tackle the problem of knife crime, says an expert in this week's BMJ.

Professor Jonathan Shepherd, Director of the Violence Research Group at Cardiff University, believes anonymous data should be collected by all emergency departments on the locations and times that violence occurs and the types of weapons used, and then shared with crime reduction partnerships, so that violence "hotspots" can be identified and targeted.

Evidence shows that increasing the perceived likelihood of being caught is more of a deterrent than the severity of sentence, and that police interventions that target "hotspots" are particularly effective, he writes.

Since 2000, violence in England and Wales has become considerably less frequent, but injuries may have become more serious, says Shepherd. Hospital statistics show that rates of hospital admission in England for violence of all types increased (from 82.7/100 000 in 2000-1 to 114.1/100 000 in 2006-7) while admissions due to knife violence also increased (from 8.5/100 000 to 11.3/100 000). However, at the same time, treatment in emergency departments after violence decreased from about 850 to 620 per 100 000.

"It is not safe to assume that the most serious violence, including knife and gun violence, will have been reported", says Shepherd. Indeed, many serious violent incidents which result in treatment are not reported to the police due to fear of reprisal or an inability to identify assailants.

Shepherd points out that evaluation of partnership work over the past 10 years shows that the 350 Crime Reduction Partnerships to which the NHS, local authorities and police all contribute has confirmed that an integrated approach and data sharing significantly reduces violence compared with the police and local authorities working alone.

He suggests that alongside measures that decrease the availability of knives, a prevention policy of hospitals sharing information with other agencies is vital to tackling knife violence.

Key to this will be emergency medicine consultants being directly involved in partnership prevention work, including attending meetings with the police and local authority representatives, he concludes.
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BMJ

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