ISTV – Wider Resources
Understanding urgent and emergency care
Urgent and Emergency care facilities in England and Wales are classified depending on the type of activity they perform.
Under the NHS Information Standard – ISB1594 – it is mandatory for Type 1 Accident and Emergency Departments (ED) to collect and submit ISTV data.
A Type 1 ED provides a consultant-led 24 hour service with full resuscitation facilities and designated accommodation for the reception of accident and emergency patients.
The collection of ISTV data is recommended (but not mandatory) for all those services listed as Type 2, 3 and 4. The definitions of these three types of Emergency Care facilities can be found in the NHS Data Dictionary
What is a Major Trauma Centre?
A Major Trauma Centre (MTC) is a specialist hospital responsible for the care of the most severely injured patients involved in major trauma. It provides 24/7 emergency access to consultant-delivered care for a wide range of specialist clinical services and expertise. A hospital which is a designated major trauma centre will have a Type 1 ED and, as such, MTCs are also required to share ISTV data with their local Community Safety Partnerships.
MTCs are part of a major trauma network. The London Trauma System encompasses four networks, each led by an MTC. The London Trauma System is made up of: North West London Trauma Network (St Mary’s MTC) North East London and Essex Trauma Network (Royal London Hospital MTC) South West London and Surrey Trauma Network (St George’s MTC) South East London, Kent and Medway Trauma Network (Kings College MTC).
Why it is important to be aware of this?
- Walk-in patients are free to attend any ED independent of where they live (albeit that analysis of ISTV data has shown that most of victims attend the EDs closer to the location of the assault). This means that victims of violent assault will not necessarily present at their nearest ED or the ED in the area where they live.
- The London Ambulance Service (LAS) generally conveys victims to the ED closest to the location of the assault while more seriously injured patients are often taken directly to MTCs, (even if far from the location of the assault).
- MTCs receives patients from anywhere within their network including people victimised far outside of London’s boundaries. This means that data from MTCs is of even more significance as it will include data on the most serious injuries as well as from across a wider area.
- Some victims of violence will attend non-Type 1 EDs (such as walk-in centres, Urgent Treatment Centres and Urgent Care Centres). As such ISTV is not a full reflection of the complete picture of interpersonal violence occurring in London, but does contain data on the most serious incidents.
Spatial analysis
ISTV data can be analysed at different geographical levels, from boroughs-wide analysis down to point data analysis (and anything in-between such as LSOA) thereby allowing thematic and hotspot mapping.
As ISTV data is limited to four pieces of information (discussed elsewhere on this site) it is recommended to analyse the data alongside other datasets, such as that provided by the Metropolitan Police and London Ambulance Service. This supports the contextualisation and interpretation of the analysis. If available, a subset of Violence with Injury (VWI with serious or moderate injuries) should be used as this dataset will include those incidents that are most likely to require emergency treatment.
ISTV data can also be used to:
- Investigate the prevalence of serious violent incidents in/around schools: thanks to the free text location information as well as the date and time of incidents, analysts can identify individual educational premises or schools clusters that are experiencing incidents of violence. This can be used to inform targeted interventions such as the involvement of schools officers, the introduction of staggered starting/finishing time or the provision of after school activities.
- Inform the prevalence of incidents committed at private addresses as a proxy for domestic abuse within a certain area. Location is never collected for incidents committed at home (i.e. personal addresses are never recorded as part of the location data). However, a higher than average proportion of attendances for incidents “at home” may be an indicator of domestic abuse and may therefore go some way to addressing the under-reporting of this issue.