Mapping emergency care across Yorkshire: Study 2 update
A key part of the EmCASH project focuses on understanding how young people use urgent and emergency NHS services after they self-harm (known as Study 2). I wanted to share more about what Study 2 involves and what progress has been made so far!
Why does this study matter?
Every year, many young people come to A&E departments or contact urgent care services (like NHS 111 and ambulance services) because they have hurt themselves in some way. The care young people receive at this point can shape what happens next: whether they feel safe and supported, whether they want to seek help again, and their health and wellbeing in the longer term.
We still don’t fully understand how young people move through urgent and emergency care systems, and there are lots of unanswered questions. How often do young people come into contact with emergency services for self-harm? Are there patterns in how care is delivered? Can we predict whether a young person might come back?
Study 2 aims to answer these questions by analysing routinely collected NHS data from across Yorkshire.
What data are we using?
Study 2 uses a large, linked dataset called CUREd+, hosted by the University of Sheffield, which brings together information from different urgent and emergency care services (such as NHS 111, ambulance services, and emergency departments). You can find out more about CUREd+ here: https://sheffield.ac.uk/data-connect/data-assets/cured-research-database
Using this dataset means we can look at real-world data across the whole system, not just one service at a time. This helps us build a fuller picture of young people’s journeys.
What do we hope to achieve?
The findings from Study 2 will help us to:
Better understand how young people who self-harm use and navigate urgent and emergency care across Yorkshire
Identify patterns and gaps in care across services
Inform improvements to how services respond to young people after they self-harm
Strengthen future research by improving how self-harm is identified in routine data
Ultimately, this work aims to contribute to safer, more compassionate, and more effective care for young people when they need it most.
Identifying self-harm in NHS data: a key challenge
One of the most important (and complex) parts of this work is identifying which healthcare contacts relate to self-harm.
In routine NHS data, information is recorded using clinical codes. For self-harm, there isn’t just one single code, and there are many different ways it might be recorded. In fact, part of this project involved mapping over 1,500 codes that could indicate self-harm.
But coding in the real world isn’t always consistent. Emergency clinicians are (rightly) focused on immediate patient care and safety, which means coding may not always fully capture what has happened.
With this in mind, Study 2 will also explore how different approaches to coding can affect the results. By testing and comparing these approaches, we hope to improve how self-harm is identified in future research, with the goal of making studies like this more accurate and meaningful.
A big milestone: data access approved!
I am delighted to share that access to the dataset has now been approved. This follows a lengthy process of securing ethical approval and governance permissions, developing a detailed data management and protection plan, and working closely with the CUREd+ team to define the study and ensure it is both feasible and valuable.
I have started working with my statistics supervisor, Sam, to explore and analyse the data. This is an exciting (and slightly daunting!) stage, moving from planning into actually seeing what the data shows.
Looking ahead
As we progress with analysis, I will be sharing more updates about what we’re learning. There may also be challenges along the way, particularly around data quality and coding, but these are an important part of the research process!
Dan :-)
