Testing an Accident and Emergency (A&E) violence intervention programme

Plain English summary of protocol

Background and study aims
People who are seriously injured due to violence often go straight to A&E for treatment. Organisations, such as the police, are not aware of these patients. There are over 170,000 such visits each year in England and Wales, and up to 60% of these patients will return to A&E within two years. This highlights the cost of violence to the NHS. There are many reasons why people are exposed to violence. Some are victims of ongoing domestic violence, some misuse alcohol, or drugs, and some are children living in chaotic households. To stop people from becoming involved in violence, we need to address these underlying causes and not just treat their injuries. Police-led nursing teams in A&E are well-placed to do this. In this research, we aim to understand whether a dedicated team in A&E can identify patients’ needs, refer them to services able to support them, and if this approach reduces these patients’ subsequent use of emergency healthcare.

There are several schemes based in A&Es that refer patients with violence-related injuries to services that offer support. Those who are victims of domestic violence can be referred to as Domestic Violence Advocates who can offer support. However, there is little support for those who are most likely to visit A&E because of violence - young men. Violence Prevention Teams are funded by and work closely with the police. It is run by a nurse familiar with A&E. They approach all those attending A&E with injuries due to violence, irrespective of their age and gender, and work with them to identify the support that they need. This collaboration between the police and clinical staff is unique across the UK and we wish to understand if it reduces later emergency healthcare use in those who were offered support.

Who can participate?
People with violent injuries who go to A&E for treatment

What does the study involve?
We will identify patients who have been supported by the Violence Prevention Teams in Cardiff (from October 2019) and Swansea (from January 2022) and, using a Secure Anonymised Information Linkage facility, access their routinely collected healthcare records. For children, we can also access their school records. We can also do the same with other A&E patients across Wales who have no contact with a Violence Prevention Team but attended their local A&E with violence-related injuries. In this way, we can see whether the approach in Cardiff and Swansea means patients are less likely to later access emergency healthcare due to the support provided by the Violence Prevention Team.

Patients and the public have commented on the proposal and their suggestions have been incorporated. We will further arrange focus groups with a broad range of people, including those who have experienced emergency healthcare because of their drug and alcohol use, and survivors of domestic violence. The research team includes two co-applicants experienced in providing patient and public involvement support. One promotes the involvement of patients and the public in research, and the other has experiences of equality and diversity.

Little research has looked at how A&E staff can refer patients for support beyond their immediate health needs. The UK Government has invested money to tackle violence and it is likely that our research will be of general interest. We will engage with the local and national government, police forces, practitioners, and the public through regular newsletters. We will also publish our findings in academic journals and present this research at international conferences.

What are the possible benefits and risks of participating?
There are no known benefits or risks to participants

Where is the study run from?
Cardiff University (UK)

When is the study starting and how long is it expected to run for?
October 2019 to December 2024

Who is funding the study?
National Institute for Health Research (NIHR) (UK)

Who is the main contact?
Professor Simon Moore (UK)
mooresc2@cardiff.ac.uk

Contact information

Prof Simon Moore
Principal investigator

Security, Crime and Intelligence Innovation Institute
SPARK
Cardiff University
Maindy Road
Cardiff
CF24 4HQ
United Kingdom

ORCID ID	0000-0001-5495-4705
Phone	+44 (0)7540825513
Email	mooresc2@cardiff.ac.uk

Study information

Eligibility

Locations

Countries of recruitment

• United Kingdom
• Wales

Study participating centre

Results and Publications

Study outputs

Editorial Notes

04/11/2025: Publication reference added.
20/06/2022: Trial's existence confirmed by SAIL Databank, Swansea University.