Royal College of Emergency Medicine 4 March 2015 Presentation By: Tom Mullarkey CEO

The AlliancE

The Clue’s in the Name RoSPA’s mission is to save lives and reduce injuries

Accidental Mortality - Landscape RoSPA’s mission is to save lives and reduce injuries WorkplaceRoadHomeLeisure Scale Deaths1331,7136,1005,300 Gov Spend£250m£300m£100m Total Spend£750m£450m£100.5m£250m Baseline Spend per life lost £5.6m£260k£16k£47k

Preventable Mortality RoSPA’s mission is to save lives and reduce injuries Preventable mortality A death is preventable if, in the light of current understanding of the determinants of health, all or most deaths from that cause (subject to age limits if appropriate) could be avoided by public health interventions in the broadest sense. ONS Preventability Table Unintentional injuries Transport Accidents V01–V99 All Accidental Injury W00–X59 All

RoSPA’s mission is to save lives and reduce injuries Unintentional (accidental) injuries * others is a catch-all which includes all the causes of death not separately listed including skin disease, pregnancy/childbirth, mental disorders and diseases of the endocrine, nervous, digestive, musculoskeletal and genito-urinary systems.

RoSPA’s mission is to save lives and reduce injuries Unintentional injuries (accidents) account for 2% of all deaths * others is a catch-all which includes all the causes of death not separately listed including skin disease, pregnancy/childbirth, mental disorders and diseases of the endocrine, nervous, digestive, musculoskeletal and genito-urinary systems.

RoSPA’s mission is to save lives and reduce injuries * others is a catch-all which includes all the causes of death not separately listed including skin disease, pregnancy/childbirth, mental disorders and diseases of the endocrine, nervous, digestive, musculoskeletal and genito-urinary systems. Unintentional injuries (accidents) account for 11% of all years of life lost in the working age population

RoSPA’s mission is to save lives and reduce injuries Unintentional injuries (accidents) account for 19% of all the preventable years of life lost in the working age population

RoSPA’s mission is to save lives and reduce injuries Up to age 60, unintentional injuries (accidents) are the leading cause of preventable years of life lost, accounting for 23% of these YLL

RoSPA’s mission is to save lives and reduce injuries 1st 2nd 3rd Unintentional injury is the leading cause of preventable YLL until age 75 when it drops to 2 nd behind cancer. At 85 years, it drops to 3 rd behind cancer and cardiovascular disease.

RoSPA’s mission is to save lives and reduce injuries

English Public Health Priorities No 1Tobacco Control 2Alcohol and drug misuse 3Obesity and nutrition 4Physical activity 5Lifestyle interventions 6Mental public health 7Dental public health 8Birth defects 9Cancer 10Workplace health 11Immunisation 12Sexual health 13Seasonal mortality 14Health protection 15Community safety 16Social exclusion 17Accident prevention TOTALS RoSPA’s mission is to save lives and reduce injuries Resource Calculations - Matrix % of available resource Predicted Distribution £m 7%201 8%246 4%125 4%112 4%120 8%228 4%113 4%122 5%142 5%139 8%238 7%208 5%146 7%220 6%172 5%142 11% %3000

What does good look like? Under 5s Safe At Home Programme  Between we ran SAH with the Dept for Education.  In Liverpool, we reduced A&E admissions by 51%.  In the Top 10 areas, we reduced A&E admissions by 29%.  The RoI varied from 1:100 to 1:30 Over 75s Falls Prevention Programmes  There are too few in the UK.  Regular, social exercise including balance classes.  Practical advice e.g. Decluttering, lighting, slippers, meds, comms.  Typical reduction 30-40%  RoI 1:30 RoSPA’s mission is to save lives and reduce injuries

What Does Good look Like? RoSPA’s mission is to save lives and reduce injuries 0 80 Safe Community A community in which no person need die or be seriously injured by an ‘accident’ Risk LiteracyCycling* LASER* Young Drivers* Young Workers* Mums & Dads* Driving Continuation* Elderly*Road safety* Workplace Safety* Public/Private/Volunteer Partnership

How RCEM Can Help  Awareness – who knows about this issue?  Many people including professionals have a myopic understanding of accidents (e.g. RTAs) and do not understand the scale – please inform.  Accident Prevention – part of the narrative:  We need upstream, simple, inexpensive intervention to prevent needless death and injury, releasing pressure on A&E resources so that focus can be on the immediate and essential – a moral and practical message.  Tough Love – what’s wrong with being judgemental?  Social disapproval from medics is powerful stuff.  Lobbying & Campaigning – our weapons in your armoury  Explaining how treatment and prevention can work together is novel, intelligent and far-sighted. RoSPA’s mission is to save lives and reduce injuries

Thank you