Are prehospital deaths from trauma and accidental injury preventable? A summary report 11 In addition, the five pillars of the United Nation’s 573,000 to 1.4 million by 2032 (ibid.). Support is, 2010 Global Plan for the Decade of Action for therefore, vital. Road Safety 2011–2020 (WHO, 2010) include the following: “Post-Crash Response: Working with The changes in demographics mean demand is the emergency services and NHS [national health growing for health and social care (Parliament services] to ensure that collisions are effectively UK 2013). While it has long been recognised that responded to and investigated.” prevention is better than cure, the UK’s health and social care system has largely focused on However, apart from safety awareness through edu- reacting to crises rather than preventing them cation there is no suggestion made that the public, (HM Government 2012). including those involved in or witness to a road traffic collision, have a role to play in saving lives. All parts of the UK have taken steps to shift the balance of care towards prevention. In 2014 the This is surprising, given that many other European ambition to shift towards a truly preventative nations require new drivers to learn first aid through system in England was enshrined in law. Section 2 a practical test in order to qualify for a licence, of the Care Act places a new duty on local thereby increasing the likelihood that they will be able authorities to ensure the provision of services that to respond with basic but life-saving skills during prevent, reduce or delay the need for care and an emergency situation on the road, or indeed in support (HM Government 2014). The law is clear: other situations (IFRC 2015). This is the case in while the ambition is always to prevent crises, we the Czech Republic, Germany, Hungary, Norway cannot prevent every crisis. Prevention is, therefore, and Switzerland, among other countries (House of also about ensuring the resources are in place to Commons Hansard 2016). reduce the negative impact of crises. Since Hussain and Redmond’s report in 1994, the At the same time in Scotland, legislation was passed Driving Theory Test has contained a number of which integrated health and social care (Scottish first aid questions. However, despite Hussain and Government 2014a). The Public Bodies (Joint Redmond’s recommendation (p.1079), first aid has Working) Act (Scotland) 2014 set out the duties not become a compulsory practical element of the and responsibilities for integration and outlined it as driving test. a key driver in delivering transformational change with person-centred care and prevention at its core In March 2016 Will Quince MP introduced a private (Scottish Government 2014b). members’ bill under the Ten-Minute Rule in the UK Parliament, which proposed attending a four-hour In Wales, The Social Services and Well-being practical first aid course with an approved provider (Wales) Act 2014 provides the legal framework as a minimum requirement for attaining a driving for improving the well-being of people who need licence (House of Commons Hansard 2016). While care and support, and carers who need support, the bill did not have sufficient time to progress during and for transforming social services in Wales the parliamentary calendar, it has helpfully raised the (Welsh Government 2016). The Act is designed profile of the issue and given impetus for change. to encourage a renewed focus on prevention and early intervention (Welsh Government 2014). Health and social care – falls Transforming Your Care in Northern Ireland has The UK’s population is ageing fast. More than been the key policy driver in shifting care towards 1 in 12 of the population is projected to be aged prevention (Northern Ireland Executive 2016). It 80 or over by mid-2039 (ONS 2015), and a large sets out a vision for improving care for people in elderly population means an increase in the number Northern Ireland by supporting people to live as of accidental injuries from slips, trips and falls independently and healthily as possible, for as long (Oliver 2013). as possible (Health and Social Care Board 2011). By 2032, 11.3 million people are expected to be Given the changes in the external context since living on their own – more than 40 per cent of 1994 – changes to both trauma care and the all households (The King’s Fund 2012). This has nature of injury – the Red Cross commissioned the implications for responding to accidental injury, original author (Professor Anthony Redmond) and such as falls in the home, given there may not be colleagues (Dr Govind Oliver and Dr Darren Walter) a bystander present to help. Indeed, the number at the Humanitarian and Conflict Response Institute of people over 85 living on their own and likely (HCRI) at the University of Manchester, UK, to con- to be vulnerable to falls is expected to grow from duct a revised version of the original 1994 study.