How research undertaken in Wales prompted UK reform
From violence prevention to better public services – research in Wales has prompted UK government reform. Professor Jonathan Shepherd outlines key work
As a surgeon who treats people injured in assaults and accidents, the biggest surprise from my research was that the police didn’t know about two thirds of violent incidents which put people in hospital. This is because injured people often don’t report these offences.
This startling discovery prompted the now historic meeting in Cardiff in July 1997 of police, local authority and accident and emergency colleagues to pool anonymised information about where and when violence was happening.
Careful testing proved that much more violence could be prevented if prevention is based on information from A&E as well as intelligence available to the police.
Violence fell more than 40% in Cardiff compared with 14 similar UK cities. Cardiff became the safest city in its Home Office designated family of cities in 2007. In 2002, violence related attendances at the University Hospital A&E were running at 80 per week. Today, it’s down to 30 per week.
This dramatic decrease is down to sustained, joint effort by police, council and health professionals over two decades, but it’s based on scientific targeting of prevention resources and the use of strategies which have been found to cut violence in cities where they were implemented compared to cities where they weren’t.
But as the years went by, chairing the Cardiff Violence Prevention Board brought to mind some puzzling questions about much wider issues than city safety. Why was it, for example, that we have medical and dental schools in our best universities where new treatments are discovered and tested but no police research centres?
Whereas my professional home is the Royal College of Surgeons, why were there no similar national institutions for police or probation officers, or, come to that, for school teachers? And why was there a National Institute for health and Care Excellence (NICE) but no similar bodies churning out authoritative guidance for police, teachers and local authorities?
And these weren’t academic, “Ivory Tower” questions. As citizens and tax payers, we need to know whether, say, cameras worn by police officers or teaching assistants in schools are effective and worth paying for just like we need to know whether we should have our wisdom teeth out before they give trouble (research shows it isn’t).
The answers often aren’t obvious. For instance, careful testing shows that some seemingly sensible policies, like showing delinquent youngsters the grim reality of prison life, actually increases their chances of offending.
“Ecosystem” is perhaps an overused word, but it seemed to me that “evidence ecosystem” is very fitting here. Evidence on what works and what doesn’t needs to be generated – hence the need for high grade testing by university and other researchers. Then, all the evidence about a particular practice or policy needs to be brought together – synthesised, and the conclusion published.
This is a task for bodies like NICE. And then, crucially, policy and practice informed by all the evidence needs to be acted on. In medicine and dentistry, the Royal Colleges play an important role here; qualifying and practicing as a GP or orthopaedic surgeon means achieving and maintaining Royal College standards in fellowship exams and continuous professional development.
So what happened next? It was clear that the gaps in this evidence ecosystem in policing and teaching wouldn’t be filled just by publishing research concluding that this ought to happen. A campaign was needed.
The first breakthrough was the establishment in 2007 of the Police Science Institute at Cardiff University, which has since, through its research, transformed neighbourhood policing.
Encouraged by this, the next step was to promote these proposals, all based on my Cardiff research, through the Economic and Social Research Council, the Department for Business Innovation and Skills and in a conference at the Institute for Government in London – a conference I was privileged to open.
This was the genesis of NICE equivalents, designated “What Works Centres”, for crime reduction, education, local economic growth, early intervention and better aging, soon joined by the Public Policy Institute for Wales.
Further, as I recommended, a new board was formed – the What Works Council based in the UK Cabinet Office – in which expertise about evidence is shared across sectors.
My recommendations for a national College of Policing, Probation Institute and College of Teaching also found favour, all applying, as far as possible, medical Royal College principles. These have developed rapidly. For example, the Chartered College of Teaching, seed funded by the Department for Education, has in less than a year attracted over 7,000 teacher members. A
police research funding scheme, the Police Knowledge Fund, is now facilitating research collaboration between forces and universities.
There’s still a distance to go before public service policies are fully informed by reliable evidence, and before we all realise how evidence can improve our lives and save us money.
But the days are surely almost gone when, in the words of a distinguished Welsh Government permanent secretary, “We used to sprinkle evidence on policy”. ■ Jonathan Shepherd is professor of oral and maxillofacial surgery and director of the violence research group at Cardiff University; a Fellow of the Learned Society of Wales and the Academy of Medical Sciences; and the independent member of the Cabinet Office What Works Council