Violent Crime Task Group, Cardiff Community Safety Partnership

Violent Crime Task Group, Cardiff Community Safety Partnership
Cardiff, United Kingdom

Not surprisingly perhaps in view of the age old 'tooth for a tooth' principle, links between dentistry and violence are strong. The Violence Research Group was founded in 1991 in what was then the University of Wales College of Medicine, now Cardiff University. Around 85% of 3,500 victims of violent crime treated each year at the University Hospital of Wales have injuries of the teeth, mouth, jaws and face reflecting the anatomical target for blows in assault nationally and around the world.

In the great tradition of medical and dental schools, the group is led by clinical academics in partnership with scientists: colleagues in the Cardiff University psychology and business schools. An early finding from which much subsequent work has developed is that a substantial proportion - even a majority of some categories of violent offences - which result in NHS treatment do not appear in police records. The vitality and international reputation of the group comes from its interdisciplinary research across dentistry, medicine, public health, criminal justice, police, psychology and economics. Its implementation partner, the WHO Violent Crime Task Group of the Cardiff Community Safety Partnership provides opportunities for field trials, violence measurement and implementation of evidence-based prevention and interventions to help victims.

  • To maintain a high quality multidisciplinary research programme to further understanding of the causes of violence.
  • To implement research findings to improve violence prevention, services for the injured, health promotion, social policy in relation to problems of substance abuse, and drug and alcohol treatment programmes.
  • To evaluate violence prevention initiatives, particularly those which involve health services in multi-agency partnerships with social services, criminal justice agencies, local government and the voluntary sector.

VPA focal person

The Violence Research Group has the following aims:

Professor Jonathan Shepherd
Director, Violence & Society Research Group
School of Dentistry
Cardiff University
Cardiff CF14 4XY Tel: 029 2074 4215 Mobile: 0777 949 0022 Email: shepherdjp@cardiff.ac.uk

Jonathan Shepherd is Professor of Oral and Maxillofacial Surgery (Head of Department 1991-2003) and Vice Dean at Cardiff University. On completion of his clinical training at King’s College Hospital he graduated from the University of London in 1973. After House and Senior House Officer appointments at Kings, the Queen Victoria Hospital East Grinstead and the Eastman Dental Hospital in London he was appointed Registrar in Oral and Maxillofacial Surgery in Oxford where he held a Research Fellowship in the Nuffield Department of Surgery.

His research for his Oxford MSc established that lack of scarring following low temperature injury reflects preservation of the extracellular matrix and that healing by primary and secondary intention represents a continuum rather than distinctly different processes. He completed his specialist surgical training in Leeds University Hospitals during which a UK Government Overseas Development surgical appointment took him to the Ahmado Bello University Hospital in Nigeria where he investigated the association of Epstein Barr virus with ameloblastoma and found no evidence of a link, except in immunocompromised patients. These findings were published in the journal Cancer.

Observations that the miners strikes in the Yorkshire Coalfield in the early 1980s were associated with increased community violence prompted his PhD dissertation titled Assault: characteristics of injured and injuries after his appointment as Senior Lecturer/Consultant at the University of Bristol.

This interdisciplinary research, spanning the social and medical sciences, provided many new insights – particularly the great extent to which assault resulting in NHS treatment is not reported to the police and the substantial mental health impact on victims in terms of posttraumatic disorder and other conditions. These discoveries were published in medical and social science journals and he summarised implications for clinical services and violence prevention in a series of 10 BMJ and Lancet editorials, which have informed his implementation and research work since then.

His research has made many contributions to clinical and public policy and legislation. Funded mainly from charitable sources the Clinical Decisions Research Group (1991-1999), which he led, produced more than 40 publications relating to decision making in surgery, dentistry and anaesthesia and prompted the influential Royal College of Surgeons of England guideline published in 1996 and the historic first National Institute for Clinical Excellence (NICE) technology appraisal – on prophylactic removal of third molars (wisdom teeth) in 2000. As a result of these guidelines and his advocacy for selective surgery in the national media, third molar removal has declined very substantially: 30,000 fewer third molar operations were carried out in NHS dental services in 2003 compared to 1996.

He directs the Cardiff University Violence and Society Research Group which bridges the Schools of Dentistry, Medicine, Psychology and Business, and collaborates with the Institute of Criminology, University of Cambridge. His proposals that the NHS should be a responsible authority in the 1998 Crime and Disorder Act and the 2002 Police Reform Act which underpin modern crime prevention were adopted by the Government. In 1996 he set up what proved to be the prototype UK Crime and Disorder Reduction Partnership (CDRP) – a collaboration between Cardiff County Council, South Wales Police, the Cardiff Health Authority, Victim Support and the University of Wales College of Medicine – the Cardiff Violence Prevention Group. Among other initiatives, this Group pioneered the combination of police and A&E data as a means of targeting police and other violence prevention activity, prompted a switch from annealed to tempered glassware in the licensed trade (1997/8) which led to a substantial fall in glass-related injury and set up a prototype care pathway for the treatment of victims of violence in the NHS involving a new traumatic stress clinic, Victim Support services and CDRP-funded mental health A&E nurses who screen for mental health problems and deliver early mental health interventions.

The Group is highlighted as a model of good practice in the 1998 Act, and the prototype care pathway continues to be the subject of Home Office and Department of Health publications and ministerial visits. His research findings have been adopted in the 2003 Licensing Act, in the national Alcohol Harm Reduction Strategy and by the Law Commission. As a founder Trustee and Vice Chair (2001-2004) of the national charity Victim Support he has led the development of integrated services for victims. His work for the 1993 Royal Commission on Criminal Justice included a BMJ editorial on the role of expert evidence in criminal proceedings. He represents the National Assembly for Wales in the WHO Violence Prevention Alliance and has served as a member of many government committees and reference groups including policy seminars chaired by successive Home Secretaries. He continues to chair the Cardiff Partnership Violence Task Group: since 2003, Cardiff violent crime rates have been lowest in its Home Office family of 15 similar cities.

His research on alcohol misuse established a causal link between binge drinking and injury in assault, in part through NHS R&D and Research Council funded randomised experiments of brief (motivational interview) interventions in the lives of victims and offenders. His work established the predominance of facial injuries in violence and, capitalising on this, he developed cost-effective one-stop alcohol misuse intervention/trauma clinic care, now the subject of nurse training material and implementation nationally. A current priority is the national implementation of routine screening for alcohol misuse and interventions for violent offenders in UK courts.

Other recent research findings include the strong link between alcohol prices and injury sustained in violence in England and Wales; that the rate of assault injury in England and Wales remained stable from 1995-2000 and then decreased sharply to 2004; and that financial incentives for glass recycling substantially decreases glass injury risk in public places. Jonathan Shepherd’s research with Michael Harrison on the design of cycle helmets led to the development, production and retail sale of the patented FaceSaver helmet, launched by the Formula One driver David Coulthard at the National Motor Show in 2002.

He proposed the establishment of university police schools as a foundation for police services, and is a keen advocate of rigorous evaluation in public services, for example by developing an Economic and Social Research Council (ESRC) field trials unit to mirror the Medical Research Council Clinical Trials Unit, through collaboration between NICE and the National Centre for Policing Excellence (NCPE) and by developing the roles of practitioner-academics. As founder secretary and chairman of his national specialty academic Association, he pioneered an integrated clinical/academic training programme which has become a model in UK medical academic training. He has served as President of his specialty international research society, chairs his specialty qualifying examination for aspiring consultants and leads postgraduate education at the Faculty of Dental Surgery, Royal College of Surgeons of England.

Professor Shepherd is an Honorary Fellow of the Royal College of Surgeons of Edinburgh and of the Faculty of Public Health at the Royal College of Physicians. He is a Fellow of the Faculty of Accident and Emergency Medicine at the Royal College of Surgeons of England and was elected a Fellow of the Academy of Medical Sciences in 2002. Recent awards include the Sellin and Glueck Award (2003) of the American Society of Criminology for outstanding international contributions to criminology.

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