Information Sharing to Tackle Violence: The Recording of Data in Emergency Departments to help Reduce Serious Violence

Emergency departments (EDs) across the UK frequently encounter patients suffering from violence-related injuries. It is estimated that with at least 50% of this going unreported to the police, the Royal College of Emergency medicine has sought to develop a national programme to use violence data collected in emergency departments to help to tackle serious violence and allow for greater consistency in information gathering nationally. The intention for monthly data sharing is that relevant authorities can use this to develop and work towards prevention strategies including weapons control, licencing applications, police presence and CCTV placement for example.

As the (previously extended) 1 July 2025 deadline for implementation across Type 1 ED’s fast approaches, it is essential that healthcare organisations, ICBs, and partner agencies work together to ensure that they are fully compliant with the Information Sharing to Tackle Violence minimum dataset requirements at a national level, including what data needs to be collected and shared. In this article, we also consider the benefits and challenges of information sharing to tackle violence in the context of that national programme.  

What is the intention?

This Information Sharing to Tackle Violence (ISTV) Standard Operating Procedure is based on the Cardiff model of violence prevention, which utilised a joint committee to bring together the NHS, local authority, police, and licencing officials to share data on violence trends to inform inter-agency violence prevention. The underlying data gathering process of ISTV is now being integrated as a national mandate across all Type 1 emergency departments through an updated Emergency Care Data Set (ECDS - version 4) which is being rolled out nationally.  It can also be implemented optionally in other emergency department settings.  

ISTV data collected in the emergency department will be collected automatically in line with the updated Emergency Care Data Set, allowing free text submissions, including, for example on the location of assaults and location trends.  It also focuses on areas such as weapon trends and repeat victimisation. This data collection is expected to be regularly followed up (monthly with relevant local partner agencies) to help implement violence reduction plans targeted specifically at those key trends, areas or hotspots picked up. This information is not intended to identify any patient, any assailant nor to specifically assist in offender detection – in fact the information shared is expected to be anonymous to preserve confidentiality. However, it is designed to help in the development of targeted prevention strategies based on those trends and the data collected.

The benefits of ISTV and The Cardiff Model

Mandated information sharing to tackle violence and the use of the updated Emergency Care Data Set in Emergency Departments does not aim to alter clinical practice but looks to streamline existing data collection and ensure national consistency. 

A significant percentage of those who attend emergency departments with violence related injuries do not report these to the police. This often means emergency departments will collect more data of local violence, crime hotspots and weapons trends than the police, despite police efforts to detect crime.

The Royal College of Emergency Medicine has suggested that the original data sharing initiative in Cardiff has been “linked to reduced violent injury presentations in the ED from 80 per week in 2000 to 35 per week in 2023”. Further, the Royal College of Emergency Medicine suggests that violence related injuries being treated in the ED potentially “reduced by up to 1/3rd when data was collected and used effectively” and also resulted in financial savings within local services as a result of subsequent prevention strategies implemented. The prevention efforts across Cardiff have included targeted police presence, CCTV, removal of shrubbery to increase natural surveillance, bans on glassware during city wide events, and agreements with local businesses regarding opening hours for example. 

However, the Emergency Care Data Set process also intersects with, and feeds into wider legal obligations under the Police, Crime, Sentencing and Courts Act 2022, which imposes a ‘Serious Violence Duty’ on both specific and relevant authorities (including health bodies such as ICBs) to work together to prevent and reduce serious crime in their area.  This includes those authorities identifying the kinds of serious violence that occurs in their area, the potential causes of that violence; and to implement a strategy for prevention. Therefore, the collection of data, including from the ED, is said to be a vital part of that process, and helps not only in the consideration of steps to tackle key issues which are identified, but also in terms of monitoring the effectiveness of strategies which have been implemented.  

Concerns about ISTV

There are, of course, recognisable concerns about ISTV. A widespread concern is that the organisation must be careful to share this information responsibly and appropriately to ensure that public trust is maintained. Whilst information sharing to tackle violence should ultimately be anonymised (with no patient consent or consideration of wider data protection provisions under the UK General Data Protection Regulation and Data Protection Act 2018 needed where this is truly the case); even anonymised data can sometimes inadvertently risk potential identification, and so the scrutiny and protection of that data by all organisations collating, handling and receiving it at every step is crucial to ensure that data protection legislation is not inadvertently breached. 

Staff fear that this will mean taking on additional work in an already overwhelmed system. While we will need to see how this operates in practice, it is the aim of an updated Emergency Care Data Set to try to streamline data collection so that clinical and operational practice is not altered, but that there is greater consistency in capturing information, and free text available. Pilot hospitals have also made use of contextual training, discussing the relevance of data collection to their community and neighbourhoods. 

There is also sometimes the challenge of inter-agency working. With police focus being on crime detection, inter-agency arrangements should be clear about what information health staff are expected to share as part of the ISTV procedure.

Conclusion 

The implementation of Information Sharing to Tackle Violence (ISTV) through the Emergency Care Data Set is intended to feed into strategies to help try to reduce serious violence in local communities. By embedding that structured data collection within existing NHS systems and encouraging inter-agency collaboration, it is hoped that long-term benefits could include - reduced harm, safer communities, and more effective use of public resources. However, as the 1 July 2025 deadline approaches, it is essential that health and partner organisations are aware of the ISTV minimum dataset requirements and are prepared in terms of data collection and data sharing. 

For further information, the Royal College of Emergency Medicine has available the detailed ISTV Standard Operating Procedure, frequently asked questions, a checklist as well as a guide for clerical, clinical, and healthcare workers on the ISTV process  - Information Sharing to Tackle Violence with which relevant organisations should be familiar.  

Additionally, our specialist team brings a unique combination of experience and skill from across the health, social care, and local authority sectors to help you meet the wide-ranging challenges faced organisationally as you deal with the various and complex legislation in respect of information law.  That team understands the practical way these legal frameworks impact the range of issues faced, as well as the diverse nature of both public and regulatory expectation in relation to “personal data”, “data protection”, “freedom of information”, “access to health records” and wider “information governance”.  As well as assisting your organisation in dealing with challenging requests for disclosure, we can also help to provide strategic advice in relation to policy and information security, as well as bespoke organisational training on key legal issues.

If you wish to discuss the issues within this article or indeed any information law issues facing your organisation, and how we may help, for further information, please contact Jane Bennett, Associate or Julia Jones, Partner.  This article was also contributed to by Harriet Tinsdeall (Paralegal).