Professor Jonathan Shepherd
Professor of Oral and Maxillofacial Surgery at the School of Dentistry, Professor Shepherd set up the Cardiff Violence Prevention Group, which has improved safety in the city and now been adopted as a nationwide model. He was appointed a CBE in the New Year’s Honours List for services to healthcare and the criminal justice system…
Professor Jonathan Shepherd
Cardiff University has given me unique opportunities to research city centre violence – and more importantly, to work with colleagues to get our findings implemented. I arrived in Cardiff in October 1991, wanting to do something about the seemingly endless stream of facial injury victims who ended up on NHS operating tables after a night’s drinking.
It came as a real surprise to me to find that I was treating cases week in, week out, where the cause of the injury was simply not being investigated, let alone brought to book. These attacks were just not being reported. My reaction was one of shock – it seemed like such an injustice.
With a team of researchers, we investigated further, comparing police and Accident and Emergency (A and E) cases, looking at records in Cardiff, Bristol and Swansea. We found that only 23 per cent of accident and emergency cases where people were treated after all attacks were recorded by police. We also found that seven out of eight violent incidents on licensed premises such as pubs, bars and clubs did not appear on police records.
I thought there was scope here for prevention by working in an integrated way with the police, the hospitals and the local authorities to identify and target the violence hot spots. I felt it was essential to integrate the police and A&E data, particularly on locations and weapons.
As a result, we set up the Cardiff Violence Prevention Group – a partnership approach which was not being adopted anywhere else in the country at the time. The police, the local authority and A&E staff first got round a table in the summer of 1996. We introduced an entirely new system for sharing hospital data about violent incidents with the police and the local authority colleagues. No personal details were passed on, but the information allowed the police to build up a picture of those pubs and clubs which were the worst for violence.
There’s no doubt it had an effect. We saw a 60 per cent fall in injuries in the targeted licensed premises and a 40 per cent fall in the number of victims coming in to hospital for treatment. It had such an impact, Cardiff rose markedly up the league table for safest cities.
There were a number of other initiatives, including a research project we conducted which showed the use of city centre CCTV to be effective in reducing the number of victims of violence treated in A&E departments. This study also showed that the police’s own statistics were a very unreliable way of measuring crime rates. We recommended on the basis of this finding that police records should not be used to measure violence - nationally, regionally or locally.
One initiative which attracted a lot of media coverage was persuading the drinks industry to switch to plastic glasses. Our research in the laboratory and in communities showed toughened beer glasses were much safer than the ordinary kind. As a result, we started a campaign to persuade manufacturers to switch to the toughened variety. This they did, and, according to the British Crime Survey, led to a substantial decrease in assaults with glasses.
There have been a number of awards and honours for this research over the years, including the CBE and this year’s Stockholm Prize for Criminology. That has been a source of enormous pride but perhaps the highest accolade has been the way Violence Prevention Group methods have now been adopted nationally. The latest Government action plan on violence Saving Lives, Reducing Harm, Protecting the Public adopts the Cardiff model.
There’s no doubt that working in Cardiff has helped bring this all about. I’ve had the opportunity to conduct the necessary research and to set up the Violence and Society Research Group, involving other academics in this field. Strong University links with the health authorities, with the police, with government helped enormously in setting up partnerships and developing legislation. A conversation with Alun Michael in County Hall led directly to the inclusion of the NHS as a partner in the 1998 Crime and Disorder Act. That couldn’t have happened anywhere else.
However, the work doesn’t end there. Alcohol remains far too cheap, particularly from supermarkets. Services for the injured could be more comprehensive, particularly helping to reduce drink misuse. Post traumatic stress among victims often remains unrecognised and untreated. I’d also like to persuade the drinks trade to move to plastic beer bottles and glasses. It would be nice to think that, some day, surgery for victims of violence will be far rarer than it is now.