A two-year review led by the London NHS Violence Reduction Academy identifies a number of approaches to reducing violence affecting young people, including improving access to healthcare services, building trusted relationships and stronger joint working.
In collaboration with academic partners, Queen Mary University of London, the Violence Reduction Academy is publishing the first UK-based review of health-related interventions focused on reducing violence affecting young people.
It supports NHS Integrated Care Boards, local authorities and other commissioning bodies in tackling population health needs to meet statutory requirements outlined in the Serious Violence Duty.
The academy has worked with more than 1,000 healthcare professionals to guide the understanding of healthcare’s unique role in reducing violence. This initiative works in partnership with more than twenty other organisations, including the health service, local government, charities and others – who work together to support people most affected by violence.
In the last two years, the academy has published resources, provided specialist expertise to areas looking to develop violence reduction systems and hosted learning events to share best practice.
The last learning event showcased a model of care provided by the London Vanguards, which involves a hybrid of community and psychological support for young people and parents affected by violence. It has also promoted guidance documents developed for primary care staff interested in the role social prescribing plays in violence reduction and on in-hospital violence reduction services.
The review looked at evidence of health interventions aiming to prevent violence affecting young people. It outlines four categories of health interventions: hospital-based violence reduction, psychological models of care, bleed control and’ zero responder’ (bystander First Aid) skills, and integrated health approaches, such as GP practices in youth centres
The review illustrates that there are novel ways of working that greatly benefit the health and wellbeing of young people affected by violence. Some interventions, such as hospital-based violence reduction, have a stronger evidence base which shows this work is having a positive impact. Other models of violence reduction are less well researched, but nonetheless show a positive effect, especially for young people with unmet needs and those facing health inequalities .
The review Health-based interventions for violence affecting young people also sets out some clear recommendations and next steps.
Trusted relationships between practitioners and young people are a key mechanism for success.
Some healthcare remains difficult for young people to access, and models of care such as violence reduction services can bridge that gap and help young people access the care they are entitled to.
There is further need for innovation, rigour and meaningful collaboration to improve the evidence and the implementation of violence reduction interventions
Focusing too much on interventions alone however can detract from the wider issue that health and social care services need to adopt more of a preventative approach, while also providing accessible services for communities.
Service design through a trauma-informed lens, which is considerate of health inequalities and social determinants of health, is a good starting point. Improving evaluation approaches and addressing further gaps in the evidence base is also key.
Report authors, Dr Sania Shakoor and Dr Heather McMullen, said “This review describes the important work being done by healthcare and allied professionals to prevent violence affecting young people and highlights promising approaches to violence reduction. However, more needs to be done, and community led, coproduced initiatives involving people with lived experience show the most promise, as these approaches are most likely to build trust among young people and their communities.”
The academy has developed a three-year plan to build on the findings of the report, with a goal of providing guidance on how healthcare services can implement some of the recommendations above. By improving access to healthcare, and by innovating ways in which professionals can better support young people (such as co-design of services, implementation of hybrid models of care, or providing healthcare services in non-traditional environments), healthcare services can address wider unmet needs that in turn have a significant impact on the likelihood of someone being exposed to violence, either as a victim or a perpetrator.
Michael Carver, Clinical Lead for the London Violence Reduction Academy said: “Sharing knowledge and best practice, as well as training and education, are at the heart of the academy’s work. This report demonstrates that while the evidence base is building, there is still a lot more work to do. The NHS as part of a wider violence reduction strategy have made great strides in how we provide more tailored, responsive care to young people affected by violence.”
