The BMJ Awards 2019: Prevention and Lifestyle Team of the Year

Investment in upstream interventions can curb future illness. Jacqui Wise meets the teams focused on prevention.

Violence reduction project

The Royal London Hospital is the busiest unit in western Europe for penetrating trauma. “We admit, on average, two stabbings a day and see around ten assaults a day in our emergency department,” says Martin Griffiths, consultant vascular and trauma surgeon at Barts Health NHS Trust.

Data collected at Barts showed that 97% of stab injuries are sustained by males, 70% of them from the most deprived quintile of the population, and 56% are aged under 25. “We were seeing a population of young angry people who had good clinical results, but around a third of them would be readmitted within five years for another injury,” says Griffiths. “Patients don’t just need sewing up, they need supporting,” he adds.

The team set up a ward based intervention programme in conjunction with the St Giles SOS project aimed at preventing future re-attendance with further injury. From admission, case workers support the patients and their families by carrying out a needs based assessment and providing practical help. This support, which continues for up to six months, can include help with education, training, court appearances, and housing. The case workers are fully integrated with the trauma service; they take part in ward rounds and are involved in discharge planning.

In the 18 month reporting period between 2015 and 2017, the service engaged with 525 patients. The re-attendance rates for people engaging with the service were down to 1% from 35%. It has also resulted in a calmer atmosphere on.

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