A few thoughts

>He points out something we all know well; many assaulted persons that
present to A&E departments never inform the Police
Perhaps because they don't want the police informed. Maybe we should respect
that.


>2. Recording injuries treated in A&E has the potential for largely complete
coverage of serious community violence.
Provided we believe that patients are attend A and E with nearly all serious
violence (probably); that they always tell us that their injuries are due to
violence (possibly); that they are always accurate about the nature and
location of the violence (unlikely) and that this will contineue if they
know the information is to be forwarded to the police (not a hope).
Come on, anyone ever seen a fifth metacarpal fracture from 'fall onto
outstretched hand'. How many victims of domestic walking into doors does
your department see? And if you ever treat the person who started the fight,
it's worth writing up as a case report.

>4. Injury data would provide a new performance indicator of policing at
police force level.
Yes, I can see the value of this. If the resources were to be provided to A
and E departments to collect this information, we might be in a position to
help out. But accept that this is us doing no A and E work for the benefit
of another agency. Not a bad thing if we can afford to do it, but forgive me
my cynicism if I doubt that new resources will be allocated.

>5. Injury data can provide outcome information on the injured victim, which
is currently lacking in Police reports.
I'm not sure what this means. Do the police not find out how seriously
injured victims are before they decide whether to prosecute?

Leaving aside the possibility of victims of crime not attending A and E
(realistically, probably not too much of a problem for the more serious
assaults. Maybe we'll get a few late presentations of facial fractures with
persistent diplopia and minor limb fractures; but outcome of late treatment
is OK for most of these); and leaving aside the ethical implications of
informing the police, even with anonymised data (this can be dealt with by
patient consent for information release; without this, I have doubts about
laying hands on a patient with the implied purpose of caring for the patient
but the actual purpose of collecting data for an external agency); there
remains the problem of the work involved in data collection. This will tie
up resources. My own feeling is that the data will not be as complete as
Professor Shepherd believes for the reasons outlined above and thus
resources could be better directed.

Nice idea (with reservations), but for the money there may be better ways of
reducing violent crime (restriction on sale of baseball bats (anyone ever
seen anyone hit a ball with one?); compulsory helmets and boxing gloves for
anyone past their third pint cf cycling helmet controversy; reclassification
of scraps in and around public houses as a sport or art form)

BTW on stats of violence: Anyone know the ratio of fifth MC fractures to
injuries caused by being hit- i.e. are we treating more perpetrators or
victims.

Matt Dunn