Sajid Javid has the answer to youth knife crime if he wants it: the Cardiff model | John Poyton
In Sajid Javid’s first major speech on crime today, marking one year since the launch of the serious violence strategy, the home secretary said the government will look at using data from multiple sectors to improve understanding of the causes of serious youth violence.
This year so far 20 young people have been killed by knife assaults, and thousands of knife crime victims were treated in our hospitals in 2018. But with only half of all NHS trusts currently recording data for weapon assaults on 11- to 25-year-olds, we can’t fully diagnose the size and shape of the problem we seek to prevent.
Just as the spread of a 19th-century cholera epidemic was interrupted by mapping deaths from the outbreak, the youth violence that has engulfed our cities can be treated specifically by hospitals collecting data on serious assault injuries.
Research released by the all-party parliamentary group on knife crime – of which the youth charity Redthread is the co-secretariat – has revealed gaps in the recording of youth violence in hospitals. The 58% of NHS trusts that did respond showed that in 2018 more than 4,500 young people – 12 per day – attended an emergency department or urgent care centre following assault by a knife or other weapon.
NHS Digital, which gathers national admissions data on injuries with a knife or sharp objects, reported earlier this year that admissions had increased by nearly 30% since 2012-13, from 3,888 to 4,986 last year. However, this data only captures those who are admitted and misses out the thousands of young people who are victims of weapon assault but have their medical needs met without spending a night on a ward.
The government says it is committed to adopting a public health approach to treat violence as a disease. Evidence shows that violence spreads from person to person through witnessing violence in formative years or in their community. So we have to use the available data to diagnose the causes of youth violence, look at what works to treat the symptoms, and use the data to develop solutions.
Prof Jonathan Shepherd, who raised the question of hospital data collection during Javid’s speech, developed the Cardiff model of data sharing more than 20 years ago which helped fill gaps in police knowledge by anonymously gathering information from victims in hospitals regarding method of injury, time and location of incident. Crucially all data is anonymised, meaning it does not require NHS staff to break patient confidentiality. Hospital admissions due to violence in Cardiff halved between 2002–2013.
With the government announcing a public health duty consultation, it is crucial there is widespread adoption of this model of data collection across the NHS. A fully funded programme of robust data collection of hospital attendances for violence is needed for it be rolled out nationwide.
Similarly, the support that is available to victims of violence is a lottery. Some hospitals host charities such as Redthread, which I lead, and which runs hospital-based violence intervention programmes, providing youth work support to victims at bedside. We meet many of these young people in what we call the “teachable moment”. It’s a unique time in which young people attending due to violent injuries become more aware of their vulnerability, and are more open to conversations around change. During the decade I spent as a youth worker in south London’s hospitals and GP surgeries, I was regularly witness to this moment.
As youth violence continues to rise, professionals from all sectors must see these access points as “teachable moments” for ourselves; an insight into the lives of society’s most vulnerable, those transitioning between childhood and adulthood, and an opportunity to learn what we could be doing better to support them.
During the 1854 Broad Street cholera outbreak, John Snow identified the source of the disease as the contaminated public water pump by speaking to local people and mapping those who had died. He realised that they were mostly people whose nearest access to water was the Broad Street pump. His theory and studies of the pattern of the disease were enough to persuade the council to disable the pump. It was later discovered that the water for the pump was contaminated.
To truly adopt a public health approach, the government needs to ensure we collect the data when victims arrive in hospital, and meet and support them when they are discharged to stop them from coming back.
• John Poyton is chief executive of Redthread youth charity