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New research shows that hospital accident and emergency violence prevention programmes are effective in reducing harm, costs to the NHS and improve emergency care.
A series of research studies, led by Cardiff University, University of York, and Swansea University, looked at the effectiveness of hospital violence intervention programmes in Wales - known as Violence Prevention Teams.
Violence Prevention Teams aim to break cycles of harm and prevent future victimisation and offending. The teams consist of specialist nurses and advocates embedded directly within A&E. They identify patients attending due to violence, sensitively explore personal circumstances and risk factors, provide immediate support, and refer patients into health and social care.
Violence Prevention Teams were first introduced at the University Hospital of Wales in Cardiff in 2019, and at Morriston Hospital in Swansea in 2023.
This new body of research provides the first evidence that a targeted A&E-based public health approach can meaningfully reduce repeat harm while easing the burden on stretched emergency services – with UK-wide implications.
The researchers analysed data from Violence Prevention Teams in the University Hospital of Wales and Morriston Hospital, spanning over a decade, to evaluate their impact and cost-effectiveness.
Their key findings were:
- From both a health system and societal perspective, Violence Prevention Teams were cost-effective and cost-saving, mainly due to reductions in follow-up A&E attendances and hospital admissions, and visits to patients’ GP;
- Among the patients who engaged with Violence Prevention Teams, repeat unplanned A&E attendances fell by 5 per cent overall, with women and girls seeing a 14 per cent reduction in repeat attendances. Young people aged 11-17 and 18-30 experienced reductions of 12-14 per cent;
- Reductions in attendances were observed, not only for violence-related injuries but across all reasons for future A&E attendances, suggesting that the Violence Prevention Teams were able to identify underlying vulnerabilities, and provision support that translated to a general improvement in patients’ circumstances;
- A qualitative evaluation of 49 practitioners found that Violence Prevention Teams are widely viewed as credible, trusted champions within the clinical team; and,
- Nurses described supporting patients with needs including mental health conditions, homelessness, substance misuse, neurodevelopmental conditions, exploitation, gang involvement and criminal justice contact - many requiring long-term, coordinated support.
The researchers looked at more than 6.7 million emergency department visits across Wales. They found that after Violence Prevention Teams were introduced in Cardiff and Swansea, the hospitals became much better at spotting when someone’s visit was caused by violence.
Professor Sinead Brophy, from Swansea University Medical School said: “This work shows that by listening to people and recognising them as individuals, they can be empowered to access the right help and support to protect themselves from violence and abuse.”
The research recommends that Violence Prevention Teams should be prioritised for national rollout, offering long-term benefits for patients, the NHS, and wider society.
The findings also suggest that Violence Prevention Teams contribute substantially to NHS and UK Government priorities on violence against women and girls and high-intensity Emergency Department users.
Read the research papers co-authored by Professor Brophy: Effectiveness and Cost-Effectiveness of Emergency Department–Based Violence Intervention Programs in the United Kingdom: Protocol for a Quasi-Experimental Study and A Quasi-Experimental Effectiveness Evaluation of a Nurse-led Hospital Violence Intervention Programme in the United Kingdom Using Linked Routine Health and Administrative Data.