Guidance

Preventing serious violence: summary

Published 21 October 2019

1. The Serious Violence Strategy

In April 2018 the government published its Serious Violence Strategy in response to increases in knife crime, gun crime and homicide across England. Action in the strategy is focused on 4 main themes:

• tackling county lines and misuse of drugs
• early intervention and prevention
• supporting communities and local partnerships
• law enforcement and the criminal justice response

The strategy has a call to action to partners from across different sectors to come together in a multi-agency public health approach to tackling and preventing serious violence at a local level.

To help local areas implement a whole system multi-agency approach, the government is introducing a range of initiatives including:

1. A new legal duty to support a multi-agency approach to preventing and tackling serious violence.
2. Investing in violence reduction units (VRUs), in the areas of the country most affected by violent crime.
3. Making £200 million available over the next 10 years to the Youth Endowment Fund.

1.1 Local partners

Every local area will have a range of organisations and bodies all of whom should come together to address and prevent serious violence. These include:

• police and crime commissioners (PCC)
• senior police officers and police services
• health and wellbeing boards
• local authorities, including public health, children’s services, education, housing, alcohol and drug commissioning
• relevant partnerships and collaborative bodies such as community safety partnerships and youth offending teams
• local safeguarding children boards
• local academy head teachers and education networks
• other, non-mandated local multi-agency partnerships, such as community multi-agency risk assessment conference
• clinical commissioning groups
• NHS England health and justice commissioners
• Public Health England (PHE) centres
• third sector services including providers of drug and alcohol services, including service users and family representatives
• Jobcentre Plus
• Department for Work and Pensions employment support providers

2. What we mean by a public health approach to violence

2.1 Why violence is a public health issue

Violence is a public health issue because living without fear of violence is a fundamental requirement for health and wellbeing.

It’s also a public health issue because violence is a major cause of ill health and poor wellbeing and is strongly related to inequalities. The poorest fifth of people have hospital admission rates for violence 5 times higher than those of the most affluent fifth. It affects individuals and communities and is a drain on health services, the criminal justice system and the wider economy.

Interventions to prevent violence, especially those in early childhood, prevent people developing a propensity for violence. They also improve educational outcomes, employment prospects and long-term health outcomes.

Addressin the issue of violence and its root causes can improve the health and wellbeing of individuals and communities and have wider positive implication for the economy and society.

2.2 The WHO 4 step public health approach

The World Health Organization (WHO) 4-step public health approach to reducing violence aims to improve health and safety for people by addressing the risk factors that increase the likelihood that someone will become a victim or a perpetrator of violence.

The 4 steps are:

1. Surveillance: define the problem through collecting information and data about violence.
2. Identify risk and protective factors: use research to look at the causes of violence, what’s linked to it, risk factors for violence and where interventions could be effective.
3. Develop and evaluate interventions: to find out what works in preventing violence by designing, implementing and evaluating interventions.
4. Implement effective interventions: also monitor the effects of these interventions on risk factors and evaluate their impact and cost-effectiveness.

WHO’s public health approach to violence seeks to identify the common risk factors driving violence and the protective factors preventing violence. It encourages identification of these factors and implementing interventions across all levels: individual, relationship, community and societal, at the same time.

Public health relies on knowledge and information from a broad range of disciplines including medicine, epidemiology, sociology, psychology, criminology, education and economics. It also uses inputs from a range of public and private sector organisations working in health, social care, education, justice and policy. So, a public health approach is also a multi-agency approach.

2.3 What we mean by a place-based approach

A place is a physical setting and social context. A place-based approach crosses organisational boundaries and brings partners together to focus on improving long-term outcomes of the ‘whole place’ and not just for individuals. To be effective, the place must be meaningful to and defined by local partners, including members of that community.

England has a diverse population and within any rural or urban geography there will be competing needs and priorities for public services. Partners within each local system are likely to already have ways of working that they have adapted to suit the needs of their populations. A ‘one-size fits all’ approach to tackling serious violence is unlikely to be successful across England. Partners need to define their own ‘places’ and boundaries which are meaningful to them and work within existing local systems.

3. Steps to help implement a multi-agency approach

Our approach to preventing serious violence needs to shift from traditional ways of working to a whole systems approach. It is important to recognise and accept that change is complex, potentially messy at the beginning, takes time and needs flexible approaches. Small steps and small amounts of funding can start the journey to building trusting relationships with communities.

The steps for starting a whole system multi-agency approach to serious violence prevention include:

1. Strengthen partnerships at a strategic level, including with members of the community.
2. Hold a serious violence summit to build a clear, agreed vision.
3. Use the summit to get senior strategic buy-in and identify ‘champions’ to lead change.
4. Recognise and build on what’s already going on: map local community assets and understand what data is collected by different organisations.
5. Use this local data and intelligence to understand where violence is most likely to occur, who the victims and perpetrators are and what the consequences and costs are.
6. Work together to produce an action plan or strategy that outlines a broad range of activities and desired outcomes for the community on violence prevention, with associated timelines.

4. Principles to help partners work together to prevent serious violence

This resource outlines principles for preventing serious violence which are made up of the following issues:

• collaboration
• co-production
• cooperation in data and intelligence sharing
• counter-narrative development
• community consensus

These principles can be used as a guide to help you consider the specific needs of your local population. It can help to reflect on geographies, operating systems, existing partnerships and community assets, resources and local need.

Ways of using these principles, the 5 C’s,are outlined below. There are case studies to help illustrate each of these in the full report.

4.1 Collaboration

Why collaboration is important

Violence is strongly associated with social determinants of health, the conditions in which people are born, grow, live, work and age. Violence is a result of several interacting risk factors which affect individuals, families, communities and society. No issue relating to violence has a single cause or a single solution. So, to have an impact on the context and underlying risk factors that lead to violence, different partners across local areas should work together and adopt a whole systems approach.

A collaborative whole systems approach means bringing partners together from a broad range of functions who have the shared goal of tackling and preventing violence. These partners need to have a collective understanding of what is public health approach to tackling violence. They should collectively develop and own the scope of work and develop ways of working which reflect the needs of the local population. They will also have to jointly identify resources to help them work effectively together.

Sometimes partners don’t think violence prevention is part of their remit, but they should be able to understand that violence can hinder many of the positive outcomes they want to see in their communities. Whether that’s exposure to violence which stops a child meeting their expected developmental targets, the fear of street-based violence reducing people’s use of outdoor spaces and preventing physical activity, or lost productivity for business due to the burden of victimisation.

A collaborative approach requires everybody to understand the broader implications of violence and come to a collective understanding across all partners within the local system.

Main actions

Local partners should:

• identify local system leaders and bring them together
• help each other to understand their roles in violence prevention
• define and create a common understanding of what a public health approach is, what that means locally and what each organisation’s role within the collaboration is
• use data and intelligence to achieve a shared understanding of current local issues, interventions and opportunities
• identify existing and required resources
• collectively agree the governance arrangements for strategic and operational violence prevention work and link with existing statutory boards where possible

4.2 Co-production

What we mean by co-production

The approach and work that local partners undertake to prevent and address violence should be informed by all their perspectives. It should include a broad range of activities covering:

• public protection
• identifying and supporting vulnerable people
• building personal and community resilience
• achieving joint aims of a healthy peaceful community

Involving the community is an essential part of co-production. It can positively influence contributions from community organisations and faith groups, which can create trust, as well as building capacity for violence prevention work.

Co-production and co-branding of all activities supports the idea of consensus and shared accountability.

Main actions

Local partners should:

• co-produce an action plan or strategy that includes a range of activities covering public protection, identifying and supporting vulnerable people, building personal and community resilience and achieving a healthy peaceful community
• explore opportunities for co-location of teams and secondments between organisations
• incorporate core actions of collaborative working

4.3 Cooperation in data and intelligence sharing

Why cooperating in data sharing is important

Data and information sharing is an important element for implementing public health approaches. But organisations often report obstacles in sharing and accessing relevant data sources, particularly since the introduction of the General Data Protection Regulation (GDPR) in 2018.

Partners can cooperate to overcome many of the barriers to effective data and information sharing. By understanding what data is available and agreeing appropriate data-sharing protocols, partners can protect personal information while gathering population level and aggregate data across agencies. This will help partners to create a common recognised information picture (CRIP) which they can use to inform effective preventative and operational interventions.

Health data has an essential role to play in preventing violence. When it’s combined with or used alongside data collected by other partners, it can:

• measure the levels and nature of violence in a local area
• identify the population groups and geographical areas most affected
• inform the development, targeting and evaluation of prevention activity

Fully anonymised health data is not regarded as personal data. So, its collection, use and storage does not come under GDPR. But you should consider the rules of the GDPR for all data that you collect, use and store.

Establishing successful, regular data sharing processes for anonymised health data between local health services and partners involved in addressing violence is crucial for supporting local prevention activity. Studies in Cardiff and London have shown the benefits of collecting and sharing anonymised health data for violence prevention.

There are a range of public sector data sources available that partnerships could agree to share including police, local housing association, JobCentre Plus, local troubled families programmes and community safety teams. Service provider organisations can also provide data on the work they do.

Main actions

Local partners should:

• understand what data is routinely collected by different organisations and determine what role data could play in interventions, such as having protocols to share information
• agree which agency has the expertise and resources to combine,analyse and interpret data into meaningful analytical products
• draw up data sharing agreements which include arrangements to protect identifiable individual level data
• agree the different analytical products that will be produced and for what purposes, such as for needs assessment, licensing decisions, police patrol routes or evaluation
• use the data to understand where violence is most likely to occur, who the victims and perpetrators are and what the consequences and costs are
• use data to evaluate the long-term impact of preventative and operational interventions

You can read more about cooperation in data sharing and some case studies in the full report.

4.4 Counter-narrative

What we mean by counter-narrative

To address the root causes of violence and prevent it from happening in the future, local partners must be able to provide positive messages to young people as an alternative ‘counter-narrative’ to any negative messages they might be hearing. Partners need to make a commitment to creating environments that include the protective factors we know can help prevent violence.

Local partner organisations should work with children and young people and community members to create opportunities for development and help them pursue alternatives to criminal activities. Partnerships should help to support positive aspirations and promote positive role models.

There is good evidence that addressing the social determinants of health such as housing, education, and access to healthcare will result in better health outcomes for people. This can be enhanced by taking a life course approach, considering interventions from birth to old age.

PHE’s CAPRICORN framework outlines how health, education, social care, criminal justice, voluntary sector services and others can work together to stop children and young people offending, using a public health approach.

Main actions

Local areas should:

• recognise and identify risk and protective factors
• promote preventative approaches that mitigate against violence through the partnership and its work
• work with the community to identify alternative pathways to employment, including training, apprenticeship
• make sure that all agencies working with children and young people are aware of all available opportunities

You can read more about creating a counter-narrative and some case studies in the full report.

4.5 Community consensus

Why community consensus is important

Community consensus lies at the heart of a place-based public health approach to serious violence prevention. Local partner organisations must work with and for local communities by empowering them to actively take part in tackling issues that affect them. It’s essential that any new work being done by partners is seen as valid by communities.

Most communities will already have several small, local organisations working to address the challenges affecting them. Partners should use their local intelligence and experience, which can make it easier to support communities which are not always receptive to statutory services such as education, police or social services.

Local areas need to balance engaging the community with targeted interventions and support which address the needs of specific groups. Community engagement strategies should include community members who are most at risk of violence, both as victims and perpetrators, and those who have already been affected by violence.

There are a range of community engagement techniques and methods that local areas can use. The choice will depend on the goal but most effective community engagement processes involve:

• having a clear scope
• being connected to a local governance and decision-making structure
• being inclusive
• focusing on building relationships and trust
• having regular feedback to show how involvement has been influential in affecting change

The Home Office’s Ending gang and youth violence document was written in consultation with peer reviewers who have experience in community engagement.

It’s clear that there is no ‘one size fits all’ solution to building meaningful relationships with local communities, but it suggests some general principles that seemed to work, which includes:

• having strong leadership
• making use of existing resources and avoiding duplication
• making use of statutory partners’ existing resources
• looking out for perceptions that violence is normal or that it cannot be tackled
• involving the community in decisions that affect them
• engaging a wide range of communities and individuals
• making use of expertise, programmes and service providers that are already available
• involving businesses, faith groups and civil society organisations
• engaging young people
• creating opportunities for community members to get involved
• having commitment and patience, recognising that prevention interventions can have short and long-term outcomes

Other methods include:

• working with voluntary sector which have ‘user groups’ to tap into
• running a range of consultation events in partnership with local organisations
• linking with existing youth engagement networks such as youth police and crime commissioners, children in care councils or youth parliaments

Main actions

Local areas should:

• map out community assets and consider how you can build on these
• involve community members so they can take part in service design, delivery and evaluation
• reduce barriers to engagement
• work with people who are most at risk of being victims or perpetrators of violence
• consider community-level factors such as social networks, social capital and empowerment