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Update on the feasibility of re-establishing the UK-wide injury database

27th October 2008

RoSPA, in partnership with Electrical Safety Council and Intertek, are researching the feasibility of setting up a new, UK-wide injury surveillance system in the UK. The objective of the database is to facilitate the prevention of accidental injury by providing data for research, policy development, injury prevention programmes, risk assessment, and product development.

Background

In 2002, the former Department of Trade and Industry (DTI) ceased to collect injury data for its Home Accident Surveillance System (HASS) and Leisure Accident Surveillance System (LASS). Since that time, the database has been accessible through RoSPA’s website and is used by 70,000 visitors per year. The number of website visits is growing by 40% per year. Users range from health care professionals and lawyers, to risk managers and product designers. Unfortunately, the HASS/LASS database is now out of date and can no longer be used to identify emerging injury trends.

Current surveillance systems A number of injury databases have been identified in the UK and internationally. All of these databases include unintentional injuries in all settings and some include intentional injuries. In addition, there are many specialist databases at international, national and local level.

The most frequent source of data is from hospital Emergency Departments (also known as A&E), although some databases are supplemented by hospital discharge data. Most databases use a sample of hospitals and there are two main methods for collecting this data either by a specialist interviewer (like the old HASS and LASS system) or by the Emergency Department’s staff. Another method is to use a combination of patient self-reporting supplemented by medical details from the Emergency Department’s staff. ‘All-Injury’ databases are usually funded through the Public Health budget whilst those databases covering specialist areas are often funded locally by the public and, occasionally, the private sector.

Potential data users and their needs The project team has identified potential users and their data needs through a series of meetings and questionnaires. Existing users of the HASS/LASS database, managed by RoSPA, and potential new data users come from the public, private and third sectors and include professionals such as:

From Figure 1 (Potential use for the Injury data.), it is evident that existing injury data available through the HASS and LASS database has provided users with the ability to influence policy and practice at various levels, evaluate the effectiveness of existing programmes, and focus on priority areas for injury prevention. It has provided a foundation for evidence-based practice and product design.

It is clear from the joint research that there is wide support for access to an up to date UK-wide searchable injury database. It should have as much information as possible about the victim, the circumstances leading to the injury, and the injury itself. Case studies or free text about the incident, provided by the victim or health professional would give information felt to be essential for the prevention of injury. Producing reports (annually or monthly) was thought to be very useful.

Users would like the data to be as representative as possible at both a regional and national level with a maximum lapse of two years for data availability. It should also be linked in with the work that is being completed at a European level.

There has been indication that when this data is made available, access should be free, as currently applied to the HASS and LASS data. However, it is common practice for charges to be made for more complex, time-consuming and highly specialised searches especially those through free text fields.

Data providers

Discussions have taken place with various groups within the National Health Service to assess the feasbility of collecting data through A&E departments in England. Parallel discussions have also taken place in Scotland. Whilst there is widespread support for a UK injury database, there are many more details that need to be discussed. Below is a possible model of how this could be processed.

A sample of Hospital Emergency Departments from each country in the British Isles would supply data to a local “data warehouse” where the data would be anonomysed. Data is anonymised using various methods; therefore in this instance we are referring to this as “data warehouse”. The data would then be sent to a central data processing centre for consolidation and analysis. Depending on funding arrangements, this centre could provide regular trend reports and free access for users to carry out their own searches of the database. In addition, the centre would potentially be able to supply comprehensive data from the UK to the EU Injury Database in order to allow EU-wide comparison.

Design and funding

Once the preceding tasks have been completed the project team will develop and consult on a range of design proposals for a new system. At this stage it is thought that there are likely to be a range of options and associated costs. Stakeholders and users will be consulted to identify the most sustainable and cost-effective solution.

The research project is due to report its findings shortly.

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