Leading article - Why the Government was right to change the 'Our Healthier Nation' accidental injury target

We congratulate the current UK Government on their inclusion of accidental injury as one of the national targets in the White Paper: Saving Lives-Our Healthier Nation (Ol-TN). We had concerns about the particular target that was proposed in the Green Paper: '... to reduce the rate of accidents - her e being defined as those which involve a hospital visit or consultation wit h a family doctor-by at least a fifth...'. The limitations of this target w ere: firstly, it would Focus attention on minor injury and so not reflect t he main burden of injury; and secondly, that ascertainment of cases would b e influenced by social factors as well as provision of service and access f actors. The new target stated in Saving Lives also has its limitations sinc e it will be influenced by service factors. This target is to reduce by 10% the rate of serious injury, defined as injury resulting in four or more da ys in hospital. We have proposed the use of an alternative indicator of uni ntentional injury occurrence, based on serious long bone fracture admitted to the hospital. This alternative indicator is based on the occurrence of s erious rather than minor injury. It is likely that a high proportion of cas es of these injuries can be identified from existing data sources. Ascertai nment of cases is likely to be independent of social, service or access fac tors. Finally, these injuries are associated with significant long term out comes including disablement, reduced functional capacity and reduced qualit y of life. It does have the limitation that it does not measure all serious injury. Such a measure is much more difficult to achieve. Further improvem ents to our proposed indicator could be made in a number of ways, through i nvestigating an extended definition of the indicator to include a range of other serious injuries, improving the quality of existing data, making othe r data sources available, including outpatient data, and making serious inj ury a notifiable disease.