Wales reduced police-recorded violence by 42% in its capital by encouraging hospital emergency departments to share anonymised data with law enforcement. In the “Cardiff Model”, data is analysed to isolate violence hotspots, giving policymakers information on where they should change alcohol licensing and pedestrianise streets. It has saved the city an average of $6.6 million a year in health, social and criminal justice costs.
Results & Impact
The Cardiff Model halved violence-related admissions to Cardiff Accident and Emergency Departments between 2002 and 2013. Violent incidents recorded by the police dropped by 42% and incidents in premises licensed to sell alcohol plummeted by 39%.
Cardiff City Government, NHS, UK Police
Frontline hospital staff collects information from patients on the cause of their injury. This information is given to the hospital's IT team which anonymises patient data and builds a data set that is shared with local police services. The combined hospital and police data is then used by Violence Prevention Boards—made up of a senior police representative, a city government official, and a data analyst—to develop policies that intervene where most needed.
Cost & Value
Setup costs of software modifications and prevention strategies were around $140,000, while the annual operating costs of the system were estimated as $330,000. On average, the Cardiff Model saves the Welsh capital an estimated $6.6 million per year with $9.1 million saved in 2007.
Running since 1997
Accident and emergency departments are reluctant to share any of their data for fear of breaching confidentiality laws. The anonymisation process was verified by the UK’s Information Commissioner, however, which has convinced most public health trusts in England to implement the model. Some challenges also arose in designing software that could safely and securely share data between hospitals and police forces, though that software has since been perfected. A final challenge is uptake by police services: ensuring that law enforcement engages with the data depends upon proactive department leaders.
The data collection element of the Cardiff Model is now mandatory in all public hospital trusts in England. Replications of the model are underway across the United States, Australia, the Netherlands and South Africa.
The Cardiff Model slashed reported violence by 42% by sharing anonymised data gathered in hospital emergency departments with police forces.
Some 65% of violence-related injuries treated by Accident and Emergency (A&E) rooms in the UK are never taken to the police. Suspicion of law enforcement, fear of reprisals in the case of assault, or an inability to access services all prevent the reporting of violent crime. By using information gathered in hospitals, the Cardiff Model offers the data police forces and policymakers need to prevent violence where it occurs.
“The power of the model is that it doesn’t just target one demographic,” said its founder, Professor Jonathan Shepherd CBE of Cardiff University. “While we have spectacular results for providing data on young people who are victims of violence—and the least likely to report it—this project covers everyone. Whether it’s a child who gets injured, an alcohol-related incident, or a case of domestic violence, the model covers the whole population.”
The Cardiff Model is simple and is divided into three stages. First, every person admitted to A&E is asked four questions: Where exactly did you come to harm? What weapon—if any—was used to inflict injury? How many assailants were involved? What exact time and date did the incident take place?
In a second stage, responses are sent to the hospital’s IT department who compile and anonymise all responses. The anonymous findings are shared with police departments who then allocate officers to violence hotspots.
Thirdly, the findings are reviewed by a Violence Prevention Board comprised of a senior member of the police force, usually at the rank of chief inspector or superintendent, a local government official, and a data analyst to interpret findings.
In essence, the Cardiff Model records incidents that elude law enforcement and provides reliable data to inform policy. With the data provided, police chiefs can isolate hotspots for violence and increase police officer numbers in a circumscribed area. Alternatively, policymakers can revoke the licenses of premises identified as being primary sites of violence. Or in cases where vehicle collisions are common, city centre streets can be pedestrianised.
The model has yielded impressive results. The number of violence-related admissions to emergency departments halved between 2002 and 2013 and the number of violent incidents recorded inside premises licensed to sell alcohol plummeted by 39%. The savings to the city government were substantial: some $6.6 million is saved every year, including $9.1 million in 2007.
The model has since been rolled out in modified forms nationwide. The model’s initial data collection stage has been made mandatory in all public hospital trusts in England. The following two stages are estimated to be in operation in two-thirds of English and Welsh hospitals. Previous Home Secretaries Jack Straw, Alan Johnson and current Prime Minister, Theresa May, have all encouraged the nationwide rollout of the project, which has been officially endorsed by the World Health Organisation.
Another advantage is that the model sheds light on surprising hotspots for violent injury. Shepherd recalls one particularly unexpected finding from Wisconsin, where the model is now being replicated.
“In Milwaukee, Wisconsin, one of the most violent places we discovered was not a bar or a nightclub, it was a school.” This information allowed policymakers and police services to take action in an unlikely setting.
The simplicity of the model has minimised barriers to implementation. One hurdle has been convincing reluctant A&E departments to share data for fears of breaching confidentiality. A detailed investigation by the UK’s Information Commissioner, however, deemed the project entirely legal and appropriate thanks to the anonymisation of all information provided.
Another challenge came with the software required to securely compile and share data, a problem since remedied with simple technical fixes.
A third hurdle has been the capacity and willingness of police forces to investigate the increase in violent incidents that data sharing allows.
No hurdle, however, has been significant enough to prevent the model from rolling out nationwide. Now, it’s going global.
All hospitals in Amsterdam implement the Cardiff model. Sites in Melbourne, Sydney, Canberra and Cape Town all have replications underway. A joint replication by the Robert Wood Johnson Foundation and the CDC in Atlanta and Philadelphia will publish national recommendations in the coming months.
Fostering collaboration between health services and law enforcement, it seems, could be on the cusp of changing the way states across the world prevent violence.
(Picture credit: Pixabay)