Prevention is better than cure

Better accident prevention measures can help reduce the number of people who visit our hospitals and A&E departments in the first place. Adam Grinsell explains how RoSPA’s national accident reduction strategy aims to address the major dangers faced by people across their life course

RoSPA has been working for over 100 years to change both legislation and attitudes towards accidents, and while there have been such positive changes in this time, there is still much to do to not only to deal with the issues we face with accidents, but to educate the wider population on accident prevention.
Secretary of State for Health Matt Hancock recently revealed a document titled “Prevention is better than the cure”, which aims to stop health problems from arising in the first place and support people to manage their health problems when they do arise.
This is a huge step in the right direction, and we are very much of the hope that this ethos will be extended to the arena of unintentional injury.
Treatments and cures have always been the core focus for our health services, yet we know that evidence-based preventative interventions work, and help to drive down the number of people who visit our hospitals and A&E departments in the first place.

Despite the huge reductions in workplace and on-road accidents through the 20th century, these reductions have now stalled. Coupled with rises in home and leisure accidents, we now face a reality in which the overall number of fatalities from accidents – and particularly from falls and accidental poisoning – rose
in England in 2013-2016.     
Hospital admissions are also increasing, with an increase in the number of falls being the most significant contributory factor.

Preventing falls
Injury prevention programmes aimed at falls among over-65s are critical to reducing harm, A&E attendances and hospital admissions. Falls and fragility fractures can result in loss of independence, injury and death, and in health service terms they are high volume and costly.
A&E departments treat a disproportionate number of unintentional injuries among older people, and particularly those aged over 70, with accidents in the home (predominantly falls) accounting for the greatest proportion of these injuries.
For those whose injuries are particularly serious, there are 255,000 falls-related emergency hospital admissions in England per year among people aged over 65.
More than 4,500 people in England over the age of 65 were recorded as having died as a result of a fall in 2015.
At the other end of the age spectrum, accidental poisoning is the cause of many thousands of children ending up in hospital each year. Due to their inquisitive nature, children under five-years-old are most at risk, with the peak for these type of incidents being at two to three years of age; in fact, poisoning is number three in the five largest causes of accident-related hospital admissions for children under the age of five.
On average, 15 under-fives are admitted to hospital each day due to suspected poisoning, with children from the poorest families being three times more likely to be admitted to hospital due to an accident, including accidental poisoning.

Safe and active
We know that accidents like falls and poisoning can be prevented. During 2016-2018, RoSPA, together with many partners, worked on a project to produce a national strategy for England, to serve as a call to action for a step-change in the delivery of accident prevention programmes across the country.
The document, entitled Safe and active at all ages: a national strategy to prevent serious accidental injuries in England, which was launched in October 2018, quantifies and addresses the different safety challenges faced across the whole life course. The strategy advocates a public health approach to accident prevention and shows how action by a wide range of local and national players could deliver reductions in accident rates and the associated injury burden. Importantly, it recognises the links between accident prevention and other issues on the public health agenda and highlights how programmes that seek to reduce accidental injury can also support healthy activity and other indicators of wellbeing.

Its aim is to “achieve a step-change in the delivery of evidence-based accident prevention programmes across England, promoting safe and active lives and reducing the burden of serious accidental injury on society”, and its objective is “to secure local and national commitment by a range of stakeholders to implement evidence-based approaches to accident prevention that will reduce the costly burden of accidents on individuals, families, businesses and the health and social care system”.
The strategy’s 25 recommendations for action address the major dangers faced by people across their life course, from birth to older age, and wherever they may find themselves – in their own homes, at work, in education, on the road, or during leisure pursuits  – and highlight the links between accident prevention and other issues on the public health agenda.

A respect for life
We live in a time where hospital emergency departments are having to cope with unprecedented levels of demand, so it is vital that we as a nation recognise the contribution that accident prevention can make to ease the situation. Practitioners must be supported if they are to develop evidence-based interventions that will save lives. They need access to good quality data that will allow them to identify and monitor injury trends to target resource where it is needed most, and importantly data must be shared among practitioners for the setting of relevant interventions.
This is why we hope that Mr Hancock’s announcement of a new focus on prevention extends to unintentional injury. Quite often, it is a subject ignored in favour of other health priorities, as accidents are seen as being “an unavoidable part of life”, but nothing could be further from the truth.
We know from experience, from the many hundreds of excellent prevention programmes that happen across the world every day, that accidents don’t have to happen.
RoSPA’s vision of a life, free from serious accidental injury is drawn from our respect for life and all that it contains – the freedom to enjoy personal choices, health, happiness, wellbeing, relationships, and a huge variety of life-affirming activities. Serious accidental injuries are a burden – a burden which afflicts too many, preventing them from enjoying life to its fullest – and one RoSPA is determined to free people from.

But without the help of others, RoSPA cannot carry out its work, and so collaborations with large numbers of experts, ranging from individuals affected by accidents and their families to multinational corporations, is necessary to move forward and make positive changes for health and safety.

To find out more about RoSPA’s national accident prevention strategy and how you can get involved, visit: