Health
When drunks lash out
An innovative scheme using data collected in hospital casualty units, which has led to a dramatic drop in
alcohol-related violence in South Wales, is coming to the North-East. Health Editor Barry Nelson reports
IT may have been seeing the imprint
of a size 11 trainer on a patientfs
face that made surgeon
Jonathan Shepherd vow to do
something to reduce drink-related
violence.
An expert in oral and facial surgery,
Professor Shepherd was tired of patching
up an apparently endless stream of
casualties who had been attacked,
stamped on or stabbed with a glass after
a nightfs drinking.
Glass injuries are particularly vicious,
often needing repeated operations and
leading to permanent scarring. Only this
week a judge at Teesside Crown Court
condemned the gterrifyingh use of pub
glasses before he jailed a 23-year-old Darlington
woman for 12 months for assault.
Her victim, another young woman, was
left with scars above her lip and eye
which had affected both her confidence
and her work.
Northumbria police say alcohol
played a significant part in at least 15,000
crimes last year, but senior officers believe
the true figure is much higher.
Looking at research into violent injury,
Prof Shepherd was surprised to
find that only 23 per cent of cases where
people were treated after such incidents
were recorded by police. He also found
that seven out of eight violent incidents
which take place on licensed premises
such as pubs, bars and clubs did not appear
on police records.
"This is one of the key pieces of evidence,"
says Prof Shepherd, speaking at
a regional conference organised by the
North-East NHS Public Health Group
last week entitled Raising the Bar: Tackling
Alcohol Misuse in the North-East.
Other international studies confirmed
this trend. Research in Denmark showed
that 62 per cent of victims of violence
treated in hospital were not recorded by
the police. And in Atlanta, Georgia,
fewer than a quarter of people requiring
hospital treatment after being injured in
a violent incident had been recorded by
the police.
Spurred on by this evidence, Prof
Shepherd and other members of the
newly-created Violence Research Group
at Cardiff University held talks with
hospital bosses, police chiefs and local
authorities to try to forge a partnership
which might have an impact on the number
of violent incidents on licensed
premises.
Hospital staff in Cardiff agreed to set
up a 24 hour-a-day electronic recording
of any incident involving violence. This
information was passed on to the police
who used the data to identify pubs, bars
and clubs which were violence hotspots.
This proved a huge help to the police and
local authorities in curbing alcohol-related
violence.
"For the first time, we could identify
the hotspots for violence which had not
been identified from any other data. It allowed
the police to target particular licensed
premises," Prof Shepherd adds.
The scheme began to pay dividends
immediately. "There is no doubt that targeting
hotspots does work. We saw a decrease
in injuries of up to 60 per cent in
the targeted licensed premises and a 40
per cent decline of victims of violence
coming into hospital for treatment," he
says.
The scheme also used closed circuit
television cameras to more accurately
target police street patrols at certain
areas at certain times. Other ideas such
as persuading licensees to switch to plastic
glasses and getting fast food outlets
in flashpoint areas to relocate were all
implemented.
The scheme had such an impact on violence
that Cardiff moved up to became
the safest city, compared with 14 other
cities.
gWe slipped a bit recently, but we are
going in the right direction,h says Prof
Shepherd, who has advised the Government
on measures to reduce alcohol-related
violence. The research also highlighted
the link between low alcohol
prices and increased levels of violence.
Now the professor would like to see
more done to take glass out of the hands
of violent assailants, advocating plastic
beer glasses in bars and plastic beer bottles
in supermarkets.
"We can do a lot more to reduce the use
of glass. Taking glass out of circulation
is a way of reducing casualties," he adds.
He points out that the weapon used to
kill ten-year-old Damilola Taylor in
Peckham, South London, in 2000 was
probably a broken lager bottle.
Apart from trying to prevent horrendous
facial injuries, Prof Shepherd has
also been involved in setting up a
scheme which encourages hospital A&E
staff to raise the issue of alcohol consumption
with people who have been attacked
or injured.
"Alcohol also increases peoplefs vulnerability
to injury. It is when they have
got a cut on their face and they are having
stitches removed that we should capitalise
on the moment and raise the issue
of alcohol consumption," he adds.
But crucially, hospital staff must be
sympathetic and avoid antagonising the
patient.
Dr Stephen Singleton, NHS director of
public health for the North-East, recently
launched an ambitious health
blueprint designed to move the region
from the place with the worst health to
the place with the best health in a
generation.
Addressing more than 200 delegates
from the NHS, the police, voluntary organisations, the NHS, the prison service
and the probation service at Hardwick
Hall Hotel, Sedgefield, Dr Singleton said
action to curb the harmful, excessive
drinking culture of the North-East
would need collective effort.
"We have a very successful NHS in
this region, very good local authorities,
great police forces, but the sum is still
not enough. We need to do more. We
need to work together and pool our resources,h
said Dr Singleton.
But the public health chief said he was
convinced that if the delegates returned
to the same room in 15 years time, the
ambitious targets on reducing alcohol
consumption would have been achieved.
"We can do it, he said. And we'll start
tomorrow morning to make that
change."
* A copy of Better Health, Fairer
Health: A Strategy for 21st Century
Health and Well-being in the North
East of England can be viewed by
visiting the public health section of
the Government Office for the North
East web site: www.go.ne.gov.uk
9:36am Friday 21st March 2008
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