Everyone wants to see fewer road accidents. NHS staff will be more aware than most people of the terrible damage suffered by many road casualties, including long-term disablement.
Further reductions in road accidents would be a direct benefit to the health service. Serious casualties, in particular, add to the pressure on services such as ambulances, accident and emergency, intensive care and rehabilitation. At least 25,000 people were seriously injured in England in 2005, each costing the NHS an estimated £12,800 on average for treatment and aftercare.
Programmes to improve the health of children in deprived areas need to address road accidents, and child pedestrian accidents in particular. Child pedestrians are at greater risk in deprived areas, and Department of Health reports on health inequalities show little, if any, progress in closing this gap.
The biggest challenges in reducing road accidents are around changing road users' attitudes and behaviour. Engineering improvements continue to make the road infrastructure safer, but accidents will still happen as long as road users take risks or fail to concentrate.
How the NHS could do more to help
So what can the NHS contribute to changing people's attitudes and behaviour on the roads?
- Some NHS staff (like health visitors) have opportunities to work directly with people who are at high risk of road accidents.
- Staff in ambulance services, emergency hospital departments and rehabilitation services all may have insights that can help to reduce road accidents or improve the outcome for casualties.
- NHS information managers can summarise the data that they hold on road casualties. This could help other agencies, especially councils and the police, to target their resources where they can have the greatest impact.
- And that means working in partnership with other local organisations. Public health directors and senior managers can help promote this.
One weakness is that often it is isolated enthusiasts who are carrying forward initiatives like these. A good strategy would enable the work to be supported and, if successful, spread to other areas. Better Safe than Sorry, a joint report by the Audit Commission and the Healthcare Commission on preventing unintentional injury to children, also explores the importance of strategies.
Improvement questions
Anyone working in the NHS (or other areas of care such as children's centres), who wants to improve road safety, should use these questions:
- to review how their own organisation contributes to road safety work
- to generate ideas for doing so more effectively
The questions do not cover technical aspects of road safety. The Audit Commission report Changing lanes contains case studies and other material to stimulate this discussion.
Note: The questions below have no relation to any audit work by the Audit Commission.
Strategies
- How important is road safety to your organisation? What references to reducing road casualties are there in any corporate documents?
- Has anyone estimated the impact of road casualties on local health finances or resources? (One way of making a case for preventive work is to use the Department for Transport's figures for the worth of reducing accidents.
- Who champions accident prevention (including road safety) within the primary care trust or public health sections? How do they help to build links with potential partners outside the health service?
- What formal partnerships is your organisation involved in (for example, the local strategic partnership, the crime and disorder reduction partnership)? Who attends these on behalf of NHS bodies? Could your representatives use these partnerships to contribute to road safety issues?
- Are patients able to gain access to your services by different forms of transport safely? Is there a travel plan for hospitals and health centres that might address these questions? Who is responsible for dealing with safety risks on any unadopted roads and car parks that are accessible to the public in hospitals and health centres?
Preventive activities by health service staff…
- Which groups of people locally are at highest risk of road accidents? Are people from deprived areas, from minority groups, or with specific disabilities among those at high risk? (If you don't know, your local council road safety section should be able to help.)
- Could health service staff (particularly those visiting patients at home, but other staff too) help to communicate safety messages to any of these groups?
- Are any staff doing this already? What support (resources, funding, information updates) do they need, and do they get it? Is there enough monitoring information to enable the approach to be assessed and/or improved?
- Is there promotional material on road safety available at:
- reception and waiting areas in NHS buildings
- promotional events
- the website
- Who is it targeted at (and why)? Is the material really attractive to them?
- Does your organisation act as any good employer, ensuring as a minimum that all employees who travel in the course of their duty are aware of road safety issues?
Providing insights and information
- If staff began to notice a pattern in road-injured patients being treated, or an idea for preventing them, who would they discuss this with? Is there a forum for discussing such issues? Is it accessible to staff in the ambulance service, in accident and emergency, in hospital departments and in rehabilitative services?
- What arrangements are in place to enable health staff to discuss road safety issues with other organisations? How effective and timely are these arrangements and how can they be improved?
- Do you share aggregated data on road traffic casualties with local councils or the police? (Data on individual patients is of course subject to confidentiality protection.)