Preventing accidents as well as sickness is essential for fixing the NHS

The 10 year plan for the NHS in England has ‘focussing on preventing sickness, not just treating it’ as one of the three key shifts necessary to fulfil the government’s ambition to ‘build an NHS fit for the future’. While this focus is both commendable and understandable, the Royal Society for the Prevention of Accidents (RoSPA) believes it overlooks a critical dimension of public health—accident prevention. Preventing illness must go hand in hand with tackling the growing and preventable burden of accidents, which continue to place immense and avoidable pressure on NHS services. 

RoSPA’s recent report ‘Safer Lives, Stronger Nation’ revealed that: 

• 21,336 people died of accidents in the UK in 2022 

• The per capita rate of accidental deaths has increased by 42% since 2013 

• There were 741,755 hospital admissions related to accidents in England in 2022/23, the majority of over 870,000 accident-related admissions in the UK 

• Accident-related hospital admissions in England have increased by 29% since 2002/03 

• In 2019/20, the estimated total number of A&E attendances for accident-related injuries in England was 6,020,850 (27% of all attendances). Adjusting for the whole of the UK gives an estimated 7,126,961 accident-related A&E attendances 

• Accidents cost the NHS millions of bed days and £6 billion in direct treatment costs annually. This does not include any ongoing costs for rehabilitation following accidents, which would make the figure much higher. 

The cost of treating accidents is close to the equivalent cost of treating conditions related to obesity (an estimated £6.5 billion) and over twice the cost of conditions related to smoking (estimated at £2.5 billion), both of which have been identified as urgent public health issues.  

While accidents affect people across the whole of society, there is also a strong correlation between accident rates and deprivation. For example, a study of childhood deaths in England and Wales from 1981 to 2001 found that children of the long-term unemployed were 21 times more likely to be killed in road accidents as pedestrians, 28 times more likely to be killed as cyclists and 38 times more likely to die in fires than the children of managers and professionals. This makes accidents a clear – yet overlooked – example of the health inequalities the NHS 10 year plan sets out to tackle. 

But while the NHS bears the brunt of the crisis, reducing accident rates is not the responsibility of the health service alone. Accident prevention work currently takes place across different departments and offices such as Department of Transport, Office for Products and Safety Standards (OPSS) and the Health and Safety Executive (HSE). RoSPA believes that the lack of co-ordination between these departments means resources and expertise are not being used as efficiently as possible, risking lives and increasing the strain on the NHS. 

RoSPA is calling on the government to implement our National Accident Prevention Strategy and appoint a dedicated minister to provide strategic oversight to accident prevention work taking place across different government departments. This will enable government to: 

• Take a joined-up approach 

• Implement ambitious and evidence-led policy interventions 

• Cover the core sectors of the UK economy: home, work, product, leisure and travel 

• Address emerging challenges, like the climate crisis, AI, and the gig economy 

• Address inequalities like deprivation, age, ethnicity and region 

• Strengthen data collection to ensure work is targeted effectively 

 Co-ordinated action will address the enormous challenge rising accidents prevent – a challenge we cannot avoid if we are to improve the NHS and the lives of everyone who relies on it.