RoSPA has recently launched its new campaign, Safer Lives, Stronger Nation: Our Call for a National Accident Prevention Strategy. We talked to RoSPA’s Research Manager, Dr James Broun, about the data behind the campaign and how you can get involved.

Dr James Broun joined RoSPA in February this year and embarked on over six months of intense research to create a detailed picture of the UK’s accident data. The resulting report reveals the shocking toll that accidents are having on people’s lives and on the wider economy.

So why did we decide to embark on this research now?

James explains: “Although RoSPA had examined data on accidents in 2019, a lot has changed since then – such as the pandemic, the effects of austerity and the recent economic turbulence that we've had.
 
“Because we've been a devolved country for the last nearly 25 years now, data recording between the four nations has been carried out separately and there haven't been many attempts to stitch it together and build up a picture of what the whole of the UK looks like, but also what the four nations look like in comparison with each other.”

“In addition, we knew that we had a good oversight of data in some areas – for instance in road safety, but there are other big areas like home safety where there's a lot that we didn't know and as a consequence we felt we needed to have a holistic view of what accidents looked like.”

How did you go about doing that research and how difficult was it?

“There's a lot of published data out there. It's about finding it and knowing where to look, but it's also about understanding the strengths and weaknesses of each of the different datasets. Some countries do things one way and some another and not everywhere publishes the same data, so finding out what each country has was the first step. So that was the start, and I was able to lean on a lot of the expertise we've got both inside and outside of RoSPA to find the right information.
 
“The main source we used was government data, so for instance, we look at mortality data and cause of death that is given. Ultimately the causal chain will lead back to the accident and that's recorded on the death certificate. And what the Government do is tally all of those up across all the different causes. They publish them and all four countries do that. So that is a good example there of where we have pretty good data because everybody who dies has a death certificate and if they die due to an accident, there's typically an inquest or a postmortem, so there is usually reasonably good data on what that looks like, and therefore that tends to be the most comprehensive and robust data we have.
 
“But obviously the challenge with that is that it is also the most extreme outcome of an accident. Most people don't die when they have an accident. The vast majority of us get minor injuries. Some of us unfortunately get more serious injuries, so to try and capture those we looked at NHS-published hospital admissions data as it breaks down admissions by the reason for somebody being admitted. There are strengths and weaknesses around that. Data recording can be a little buried, but because the numbers are so much bigger, over 700,000 people were admitted to hospital due to accidents last year in England alone for example, that gives you a really big pool of data.
 
“Other sources include transport data, which is reported by the police through STATS19, data from the fire service, and then of course, WAID, which is the water safety database which RoSPA administers.”

What were the main findings of the research?

“The core finding is that the accident rate in the UK has gone up quite substantially over the last 10 years. The rate of accidental deaths has risen, but also over the last couple of decades, we've seen hospitalisations go up quite starkly as well.
 
“What's concerning is that in all adult age groups, the rate of accidental deaths has gone up. We tend to associate accidents and accidental deaths, in particular, with the very elderly and with the youngest in our society, because they tend to be most vulnerable. However, while accidents are far higher in the elderly, the rate of change has been highest amongst the middle-aged, who are of course also our working-age population, so there are quite serious economic effects there: the cost to businesses from people having to take time off work, as well as the costs to the NHS.
 
“We reckon that accidents in the UK cost at least £12 billion annually. That's massive: it’s nearly the size of the foreign aid budget in the UK for instance. We have seen in the recent Autumn Statement how Rachel Reeves has had to increase a range of taxes to balance the books. Those rises could have been a lot lower if the cost of accidents hadn’t been so high.
 
“As well as rising accident rates and extremely high costs, the research revealed that the home is where most accidents happen. We've not really been able to quantify that for a very long time because of the way data is collected but we can now. We think about our homes as the safest spaces in our lives but actually they’re the places where we're most likely to have a very serious accident.”

What surprised you the most from your findings?

“The fact that over 50% of accidents actually happen at home was shocking to me. But what surprised me the most as somebody who hasn't previously worked in the sector is just how big the scale of the accident problem is.
 
“We've got loads of great work going on by practitioners, healthcare workers, people at RoSPA and other partners that we have across the health and safety sector but fundamentally government, in my view, seems to be massively overlooking this problem. And when you see the size and scale of it, it feels like in most other sectors this would be headline news. More would be being done if we saw the rates of, for instance, a very serious illness like cancer rising as sharply as we've seen accident rates are rising. I think there would be a lot more alarm. We need to put the case to government that this should be treated like any other public health problem - as a really serious issue.”

And why do you think it has been such a neglected issue?

“Partly, it comes back to data, partly it’s about how government operates its policy environment. On the one hand, the data is collected in a fragmented way so the Government doesn’t get a full picture of the problem. But also, there's no government ownership of the issue in one place. So if we think of an area where health and safety works really well, it's in the workplace and part of the reason for that is because there is one act of Parliament that dominates (the Health and Safety at Work etc Act 1974), there is one regulator (the Health and Safety Executive), and there is one government department that owns all of that (the Department for Work and Pensions). They've got a long-running, stable, really well-crafted piece of legislation with more detailed regulation sat behind it with clear ownership, really clear direction, a lot of expertise, a lot of data recording. And as a consequence, we've seen accident rates at work fall across all industries.
 
“I think that points to the fact that you can have success in this sector if you have very clear leadership, clear ownership and a long-term plan. But, right now, the reality is when you look at accident prevention outside of work, I could count on both hands the number of government departments alone who each hold responsibility for bits of it, without thinking about agencies and the many local authorities who provide frontline prevention services. And as a result, understandably there's not been a really clear direction set in reducing accidents, and not everyone is working in the same direction.”

What were your main conclusions and recommendations coming from the report?

“The main conclusion, as I've said, is that this is a serious public health problem that's getting worse and it's very costly. Our recommendation is essentially that government needs to do something at a very top level to deal with this, it needs to set a strategic vision for how we get out of this crisis and reverse the trend that we're in.

“One of the ways I think we can do that is by setting up the national accident prevention strategy that we're calling for, It has to have clearer ownership, ideally from a single minister who has responsibility for this, ideally at a cabinet level (a minister without portfolio for instance). This would be fantastic because it would mean that accident prevention could be raised across different departments. And when you set a strategy that then brings together different government departments, it allows policy to trickle down so that we can then start having a more detailed intervention but with all the parts moving together in the right direction.

“In the report, we set out quite a large number of individual policy recommendations that have come out of the analysis we've done, not necessarily as any one headline piece for this report, but to highlight the sorts of things to government that should be in the strategy that they introduce.”

How is RoSPA going to achieve our aim of getting a national accident prevention strategy?

“We launched our report this week, but we very much see it as the start - bringing updated data, new recommendations and a new way of framing the problem with the backing of a long-running campaign. We don't want to just launch this and then forget about it. We want to launch it and be reminding government of it, be pushing it and be using the things that are in it to engage with individual ministers and departments and start talking about this issue in a more holistic way.

“It's always an uphill struggle when you're asking for change, particularly change that is as ambitious as this, although I would argue that it's actually common sense to do this. If it were a business that had a problem, it would have a strategy. So, we have to put the case forward, really firm and hard. And we have to keep going with it.”

How can people get involved?

“There are lots of ways people can help us. We are asking people firstly to share our campaign and findings on their social media platforms and in their professional networks and to show public support for it. Because ultimately these things are successful when they get really great reach and when we get traction, we can get influence over public discourse.

“We encourage people to publicly back us, and that can mean giving us permission, for instance, to put their logo on our campaign webpage as a supporter and to go public with an endorsement of what we're doing. This isn't something we feel we can do just on our own. We need other people, whether they're RoSPA members, external stakeholders or members of the public to back what we're doing.
 
“And finally, it's also about political support. This is ultimately a political campaign and writing to MPs, highlighting the issue and endorsing our strategy document and our report is going to be really helpful as well in getting the message out. The more people out there saying the same thing, the more likely people are to start listening.”
 
Find out more about our campaign and read the report at: https://www.rospa.com/national-accident-prevention-strategy