Is it time for a National Accident Prevention Strategy? 

In July 2025, the Royal Society for the Prevention of Accidents (RoSPA) urged the Government to establish a National Accident Prevention Strategy. By emphasising the human and economic costs associated with accidents, as well as fragmented responsibility for accident prevention, RoSPA called on the Government to act strategically to prevent accidents. With the Government’s current focus on a ‘revolution in prevention’ what does this shift mean for accident reduction, will it lead to a new national strategy, and what impact could this all have on rural communities? Jessica Sellick investigates. 

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In November 2024, The Royal Society for the Prevention of Accidents (RoSPA) published a seminal report titled ‘safer lives, stronger nation’. The report collated data from across the UK to create a comprehensive picture and evidence base of accidents and preventable deaths and their impact on society. RoSPA called on the Government to commit to a national accident prevention strategy. What has transpired since then, and what implications does this have for rural communities?   

What is an accident, and how many accidents are there? Back in 1904, barrister Stanley Atkinson published an article highlighting how the term ‘accident’ is intended either to refer to ‘the morbid effects upon the body of the person injured’, or to ‘the mechanical cause of the operative injury’, but that considerable confusion arises from a fundamental ambiguity of meaning. 

In 1956, the World Health Organization (WHO) defined an accident as an ‘unpremeditated event resulting in recognisable damage’; while in Britain, the Health and Safety Executive (HSE) specifies it is ‘a type of incident which is separate, identifiable, unintended and causes physical injury’. 

Within academic circles, an accident has been defined as ‘an unexpected and uncontrollable incident in which the action and reaction of an item or person causes personal injury or property damage’, or ‘undesired and unplanned (but not necessarily unexpected) events that result in (at least) a specified level of loss’. 

All of these definitions highlight the lack of intention or planning behind the occurrence of accidents, that accidents result in some form of damage or injury, and how they occur without warning. 

In November 2024, the Royal Society for the Prevention of Accidents (RoSPA) published a report drawing together data and research from across the UK. RoSPA found: 

  • Accident rates are rising steeply in the UK, creating an accident crisis: with accidental death rates rising by 42% over the last decade. 21,336 people died of accidents in 2022. Accidents are the leading cause of preventable death in people aged under 40 years. 
  • Accidents occur in all walks of life: with 55% of accidental deaths and 62% of accident-related hospitalisations due to accidents that occurred in the home. In 2022/23, 840,000 people were admitted to hospital due to accidents (equating to 5.2 million bed days), with a further 7 million people attending A&E due to accidents.  
  • Accidents affect groups differently, often compounding existing inequalities: with deprivation increasing the likelihood of accidental injury and ethnic minority groups having a higher likelihood of accidental injury. Older people have the highest accidental death and hospitalisation rates, mostly due to having serious falls whereas younger adults and middle-aged people experience higher levels of accidental poisoning and transport-related deaths. 
  • The economic costs of accidents are enormous: leading to almost 29 million lost working days across the UK in 2022/23, with 7.7 million for those admitted to hospital and their carers, and 21 million more for people who attended A&E. The combined cost to UK businesses is £5.9 billion due to lost output and indirect management costs relating to these absences.      

How many accidents are happening in rural areas? RoSPA describes how the city and countryside have differential rates of some accidents. The data shows approximately 1,000 people are killed annually on rural roads in Great Britain, compared with 627 people on urban roads. While the number of road collisions is higher in urban areas, fatalities are higher in rural areas which is attributed to the condition, layout and visibility of rural roads and driving above the speed limit, and/or the presence of animals on the road. The charity Brake, for example, identifies speed as a major factor in rural road crashes – finding that on single-carriageway rural roads a 10% increase in average speed results in a 30% increase in fatal and serious crashes. While the THINK! Campaign, run by the Department for Transport (DfT), found 25% of drivers reported having a near miss on a country road, while 40% had been surprised by an unexpected hazard, such as an animal. One-third of respondents also confessed to taking a bend too fast. This led to a road safety campaign to raise awareness of the risks when speeding or driving too fast for road conditions, especially on rural roads. 

Back in May 2021, the AA Charitable Trust published research on the most dangerous rural roads for young drivers. The study found that 71% of fatal crashes involving young drivers are on rural roads, and that young drivers are over-represented in rural crashes by 9%. The study looked at more than 70,000 young drivers involved in crashes on rural roads over 6-years, Young drivers were also shown to face a higher risk of death (2%) or serious injury (15.2%) when involved in a crash on a rural road compared to an urban road (0.6% and 11.3% respectively). Researchers identified the top 10 most dangerous rural roads for young drivers in terms of collision density: A229 in Kent, A2 in Kent, A3 in Surrey, A1 in Hertfordshire, A243 in Surrey, A414 in Hertfordshire, A1 in Wakefield, A322 in Surrey, A249 in Kent, and A595 in Cumbria. The relative risk from all crashes put the following roads in the top 10: A6076 in County Durham, A704 in West Lothian, A419 in Gloucestershire, A388 in Cornwall, A41 in Hertfordshire, A846 in Argyll and Bute, A5093 in Cumbria, A885 in Argyll and Bute, A4068 in Powys, and A436 in Gloucestershire. The rural road risk decreases with each year of age. This has led to calls for an ongoing campaign to improve the education of young drivers on rural roads. Indeed, the Road Safety Foundation and AA Charitable Trust have produced an interactive map showing the relative risk of collisions involving young drivers on rural routes. 

NFU Mutual has also published data showing the disproportionate danger of death on countryside roads.  In 2023, 1 in every 32 collisions on rural roads resulted in death, compared to 1 in every 122 on urban roads. In England, the South East had the highest number of rural road fatalities in 2023. While fatalities fell in all regions, fatalities increased in the West Midlands and North East. The data included a survey of 2,068 people across the UK. 13% of respondents had been involved in a collision on a rural road. More than half of respondents said one of their biggest concerns about rural road safety was blind corners (56%) and narrow roads (51%), followed by road quality (48%), driver impatience (45%), and people breaking the speed limit (42%). 24% were also concerned about dealing with agricultural traffic. 

RoSPA’s data shows: 

  • 10 times as many people die on rural roads than on motorways in Great Britain. 
  • 57% of all serious injuries to car users in Great Britain occurred on rural roads. 
  • Cyclists are more likely to be injured on rural roads than urban ones. 
  • Over two-thirds of motorcyclist fatalities occur on rural roads, with the most common causes being failure to negotiate bends, collisions at junctions or while overtaking, and the rider losing control. 
  • Pedestrians are more often injured in urban areas, but serious injuries frequently occur in rural areas. Per mile travelled, vehicles on minor roads cause more pedestrian injuries than vehicles on major roads. 
  • There were 3,383 road incidents involving horses in 2023. 85% of these incidents occurred because vehicles passed too closely or too quickly. 3 riders were killed on the roads in 2023, and on average, 1 horse a week. 

Agriculture, quarrying, forestry and fishing are commonplace rural industries and have high accident rates. Figures from the Health and Safety Executive (HSE) show that 23 people lost their lives on farms in 2024/25. While agriculture accounts for less than 1% of the working population, 18.5% of all workplace deaths were in this sector. Data from NFU Mutual shows that there were 937 farming accident claims in 2023/24, totalling more than £68 million. Claims related to falls from height, trapped body parts, and falling objects. 21-25 July 2025 marked the 13 annual Farm Safety Week, led by the Farm Safety Foundation / Yellow Wellies. The annual week brings together over 400 farming organisations in England, Scotland, Wales, Northern Ireland, and Ireland to raise awareness and inspire change to make farms safer places to work, live and visit. 

In July 2025, the Marine Accident Investigation Branch (MAIB) published its latest annual report. The MAIB recorded 1,631 reports of accidents to UK vessels worldwide or any vessels within UK coastal waters during 2024. A total of 1,753 vessels were involved. This resulted in 91 crew being injured and 2 fatalities in 2024. The MAIB cited systemic failures in the commercial fishing industry, including poor compliance, inadequate risk assessments, and outdated practices as core contributors to fatalities and serious incidents at sea. 

Also in July 2025, The International Council on Mining and Metals (ICMM) released a safety performance report of its 24 member companies, representing approximately one-third of the global mining and metals industry. There were 42 fatalities in 2024, compared to 36 fatalities in 2023, and 33 in 2022, signalling an upward trend over the past 3-years. The leading hazard was powered mine vehicles (such as haul trucks, dozers and light-duty vehicles used for excavation, loading, hauling and transporting materials) followed by underground operations (including rock falls, energy isolation failure, and inadequate ground support in high-stress areas). The Mineral Products Association (MPA) ‘Stay Safe’ campaign aims to prevent members of the public from being killed or injured in quarries and related sites due to venturing in uninvited. According to the MPA, most fatalities in quarries involving members of the public are water related and, predominantly, involve males in the 12-32 years age range. The fatalities and serious injuries tend to occur at disused sites that are no longer managed or owned by members of the MPA.  

In 2024, 193 people accidentally died in water-related incidents. The 2024 Water Incident Database (WAID) shows that inland waterways such as rivers, canals, lakes, reservoirs and quarries continue to be leading locations for accidental drowning, accounting for 61% of deaths. Respect the Water is a national campaign for members of the National Water Safety Forum (NWSF). The leading cause of death is accidental drowning during everyday activities such as walking or running near water, which can lead to unexpected falls. Evidence from the World Health Organization (WHO) suggests populations at an elevated risk of drowning include people living in rural and remote settings: a sample of 162 inland water incidents found 22% occurred in cities and 78% outside of cities.

Between December 2020 and February 2022, eleven deaths were recorded in the UK arboriculture and forestry sector according to the Forest Industry Safety Accord (FISA). Falling trees or branches killed 9 people, 1 death involved an overhead power line, and another died using a log-splitting machine. In 2024, the FISA shared four work-related fatality notifications with the HSE, and between January and September 2025 four fatal notifications were published: two individuals were struck by branches, one individual was struck by a falling tree trunk while unloading it from a trailer, and another individual died after falling from height while performing tree work from a ladder.      

As well as sectors, there are particular cohorts of the population more prone to accidents. For example, according to RoSPA, “It is worth remembering that the elderly population is not evenly distributed around the UK. In many local authorities, especially in rural and coastal areas, a third of the population is over 65 today. In these areas, accident rates will already be higher, and they are only going to get worse” (page 133). According to Defra’s Statistical Digest of Rural England, more than one-in-four living in rural settlements were at least 65 years of age in mid-2022, whereas in urban areas it was fewer than one-in-five people. Three-in-ten people living in rural settlements further from a major town or city were at least 65 years old in mid-2022. More than half of rural people living alone are aged 66 years and above.  

Rural England is quietly bearing the weight of a crisis that is measured in statistics but felt in lives irrevocably changed or lost. From winding country roads to isolated farms, the data reveals a stark trend: rural areas are disproportionately more dangerous, with higher fatality rates across road traffic, agriculture, and water. Campaigns and safety initiatives led by charities and industry bodies are working to reverse this trend, but the reality remains: behind every number is a person whose story has been altered or ended too soon, and a rural landscape that must confront the human cost of its hidden dangers.

What is Government currently doing? Managing accident prevention sits within multiple Government departments. Back in May 2022, the HSE published its 10 Year Strategy, ‘protecting people and places 2022 to 2032’. Here prevention underpins five strategic objectives to reduce work-related ill health (especially mental health), ensure public trust, enabling safe innovation, maintaining a high safety record, and fostering a great workplace for HSE staff. The strategy also expands the HSE’s role from worker protection to include public assurance and safety. At a safety management event in Manchester in January 2025, the chair of the HSE, Sarah Newton, said “for too long, we have prioritised traditional safety risks over health…a fundamental shift is required to address the issue” in urging employers to provide suitable health surveillance for workers, to look closely at how they approach work-related stress, and to commit to sharing best practice with other companies operating in the same sector.   

Other, recent examples include:  

  • The Department for Health and Social Care’s (DHSC) 10 Year Health Plan for England (July 2025). Chapter 4 presents a shift from ‘sickness to prevention’ which aims to reach patients earlier, catch illness before it spreads, and prevent it in the first place, by making the healthy choice the easy choice for people. The Plan includes initiatives to reduce nicotine products, end the obesity epidemic, expand Free School Meals, a new health rewards scheme to incentivise healthier choices, set new standards in alcohol labelling, expand mental health support teams in schools and colleges, increase the uptake of HPV vaccination among young people who have left school, and the creation of a geonomics population health service. The Plan highlights the need for cross-sectional working with businesses, employers, investors, local authorities and mayors to create a healthier country.
  • Also in July 2025, the Cabinet Office published the UK Government’s Resilience Action Plan. This policy paper sets out a strategy to strengthen the nation’s ability to withstand and recover from crises. It contains a commitment to establish a network of National Biosecurity Centres with £1 billion investment to bolster the UK’s biological incidents, attacks and accidents. 
  • In April 2025, the Government launched the UK Resilience Academy (UKRA) to train more than 4,000 public and private sector workers in crisis skills and expertise every year at its campus in North Yorkshire. The UKRA aims to ‘keep ahead of the curve and support the nation to be better prepared for current and future risks, on a whole of society basis’. 
  • In April 2025, there was a written question to the Department for Transport to ask about the potential merits of establishing a dedicated road safety investigation branch to investigate road deaths and incidents as well as to recommend any necessary improvements. In her response, Lilian Greenwood (Parliamentary Under-Secretary of State, Minister for Local Transport) highlighted how “The Department is continuing to review potential future road safety interventions and available options to increase the overall safety of our roads. We are committed to delivering a new Road Safety Strategy – the first in over a decade – and will set out next steps on this in due course”.  The Government has indicated that the Strategy, due to be published in autumn 2025, will focus on the causes of serious collisions and includes measures to introduce mandatory eyesight tests for drivers over 70 and to reduce the legal drink drive limit.  
  • In January 2025, the Cabinet Office and Office for National Statistics (ONS) published a Risk Vulnerability Tool for Departments to visualise where vulnerable groups of people are located in the UK (e.g. by age, disability, and whether they are receiving care). The tool aims to improve understanding of where to find disproportionately impacted groups ahead of and during crises, and enable the local targeting of support. 
  • In response to the fire at Grenfell Tower, the Government has highlighted how it wants to do more to improve the accessibility and transparency of information from Prevention of Future Deaths (PFD) reports produced by coroners to ensure lessons are learned, disseminated as quickly and widely as possible and effectively monitored and evaluated. 

RoSPA describes how action on accident prevention is “fragmented, inconsistent, and lacking coordination between different departments and offices…That accident prevention does not have the urgent priority such important work requires is apparent in the new NHS 10 Year Plan. Despite the enormous pressure avoidable accidents currently place on the NHS, the plan’s focus to move from sickness to prevention overlooks accident prevention, even though the cost of treating accidents is comparable to that of treating conditions related to obesity (estimated £6.5 billion) and over twice that of treating conditions related to smoking (estimated £2.5 billion)”.  

More broadly, RoSPA highlights how there is no single Government department that manages drowning prevention, which sits with the Department for Transport (DfT) and Department for Environment, Food & Rural Affairs (Defra).

On 17 July 2025, RoSPA secured a short debate in the House of Lords, to ask what plans the Government has to create a national accident prevention strategy. 

“The Labour Government are right to keep repeating that prevention is better than cure, but I am not sure that they recognise just how much that involves challenging vested interests…For me, it is hard to think of anything better that you can do with your time – particularly for politicians – than prevent deaths and injuries. The well-being of the people has to be our first job. So I hope that Ministers will adopt this call for a crash prevention strategy, but I also hope that they will learn the big lesson from Grenfell Tower and our lawless roads: you have to face down vested interests in order to save lives and progress this agenda”, Baroness Jones of Moulsecoomb.  

“I spent more than 20 years of my working life on the shop floor in manufacturing. That was time enough to see accidents up close and ugly, traumatic enough to make my first representative job that of safety shop steward, deep-lasting enough to make me later join Britain’s oldest and most effective safety organisation, RoSPA… It can change the depressing recent history of increasing accidents that target in particular the elderly, the very young and the most disadvantaged people. The Labour Government now need to send out a clear signal to the whole country not only of intent but of priority that there will be a national accident prevention strategy and that a Minister will lead it. That sort of leadership will tell the British people they now have a Government who will treat the colossal cost of accidents, in lives and resources, with the urgency it deserves”, Lord Jordan. 

“It is essential for us to redouble efforts to address the issue of accident prevention to save more lives and reduce the pressures on our oversubscribed health services. This disparity is a concern and it is essential that the Government put measures in place to understand the causes of these differences, close the gap and improve outcomes for all the regions. From this [RoSPA] report, we can understand that one of the underlying causes of accidental deaths is the dispersed nature of health and safety regulations between the different agencies”, Viscount Younger of Leckie. 

In response, Baroness Sherlock, the Minister of State at the Department for Work and Pensions (DWP) responded that: 

“We should not assume that these things are not preventable. In a sense, that is the whole point of the RoSPA report. It is about trying to prevent what is preventable, which is what we are all here to discuss. The report presents a striking analysis of the scale and impact of accidental injuries and deaths across the UK…Of course, these are not just statistics: every one represents a family member or friend and a future that has been lost…We also absolutely recognise the value that strategic leadership can provide in tackling complex cross-cutting issues. We are committed to working across government to ensure that our approach to accident prevention or incident prevention is coherent, proportionate and responsive to the needs of people across the country. That is reflected in one example in the report. It mentions climate change as an emerging risk that will make accident rates worse in the future. The Government are focused on taking a coherent, mission-led approach to address that risk. We are working across regulators and across departments to take co-ordinated action to deliver the legislated 2050 net-zero target…There are some encouraging examples of cross-sector collaboration on accident prevention. The HSE’s 10-year strategy…spans a wide range of areas, including workplace safety, chemical regulation, environmental protection, and the adoption of emerging technologies. All those areas require co-ordinated action across government departments and industry, and the efforts there reflect a broader recognition that many of the risks people face in daily life do not fall neatly within the remit of a single agency or sector…We should regulate, where necessary, allowing space for discretion and responsible behaviour, but the RoSPA report addresses the whole of society and touches on the legislation and regulatory duties of multiple government departments and their regulators. Although it is complex, our current regulatory approach does provide a focus on accident prevention that responds to those multifaceted needs. On the protections provided by that sort of regulatory and policy framework, there might be a complicated diagram, but it does mean that the best-placed organisation takes the lead on specific issues, and that is crucial to our response… the Government are not complacent. We recognise the importance of prevention in reducing harm, protecting lives and easing pressure on public services. We also appreciate that the landscape of accident prevention is evolving…not just climate change but artificial intelligence and autonomous technologies. We may think…that we get safer and look after ourselves, but maybe we just find new ways in which to damage ourselves and other people…No matter what the challenges are, it is the job of government to make sure that we are ready for them. The RoSPA report is a valuable contribution to the national conversation on safety, and we welcome its insights and ambition. We will continue to work across departments, with local authorities, industry and the voluntary sector, to ensure that our approach to accident prevention is evidence-led, proportionate and responsive to the needs of the country. We are committed to building a safer, healthier and more resilient society”. 

During and since the short debate the Government has not confirmed if an individual minister would be appointed, nor if they would lead on the production of a national accident prevention strategy.  

Where next? RoSPA has urged the Government to “implement a National Accident Prevention Strategy which accounts for inequalities caused by factors such as deprivation, gender, age, ethnicity, and urban-rural divide” (page 137).  It is evident that rural areas – where residents are more prone to accidents, injuries and fatalities – due to sectors, demographics, and geography – would benefit significantly from such a strategy.  Will the Government now commit to a new national strategy? Watch this space. 

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Jessica is a project manager at Rose Regeneration and a senior research fellow at The National Centre for Rural Health and Care (NCRHC). She is currently collating initiatives and plans to tackle economic inactivity and support people into good work; developing a community masterplan; and evaluating a heritage skills programme. Jessica also sits on the board of a charity supporting rural communities across Cambridgeshire and is a member of her local Patient Participation Group. 

She can be contacted by email jessica.sellick@roseregeneration.co.uk 

Website: http://roseregeneration.co.uk/https://www.ncrhc.org/ 

LinkedIn: 🌈Jessica Sellick