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Flail Chest with Paradoxical Motion | NEJM

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The Wessex Trauma Network is a regional network comprising of all hospitals and ambulance trusts in the Wessex region.

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About this release
This release provides an estimate of the number of personal injury road traffic casualties in Great Britain that were reported by the police in the year ending June 2023 using the STATS19 reporting system. These figures are provisional as they will change following the end of year validation process.
Data by road user type and police force are available in the accompanying data tables.

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Headline figures

Chart 1 shows the trend in killed or seriously injured ( KSI) road casualties over the last decade. Since 2013, there has been a general downward trend in the number of KSI casualties in Great Britain with a notably decrease in the years affected by COVID-19. In the year ending June 2023, road casualties showed signs of a continued return to pre-pandemic trends, whilst still being higher than in the years 2020 and 2021 where casualty numbers were low, largely as a result of periods of lockdown leading to a reduction in road traffic.

In reported road collisions in Great Britain in the year ending June 2023 there were an estimated:

1,633 fatalities, a decline of 9% compared to the year ending June 2022

29,429 killed or seriously injured ( KSI) casualties, a decline of 1% compared to the year ending June 2022

133,443 casualties of all severities, a decline of 3% compared to the year ending June 2022

Considering the four main road user groups and demographics, the statistics show in Great Britain the year ending June 2023, compared to the year ending June 2022:

the biggest estimated percentage change for fatalities was pedal cyclists, which showed a decline of 22%

pedal cyclists had the biggest estimated percentage change for all casualties, showing a decline of 8%

77% of fatalities and 62% of casualties of all severities were male

Chart 1: Reported road KSI (adjusted) casualties, Great Britain, the year ending June 2013 to the year ending June 2023 (provisional)

Things you need to know

Provisional figures

Figures in this release are provisional and are based on data supplied by police forces by November 2023. A small amount of missing data has been estimated. Figures will change following updates from the police and the end of year validation process. Further details are given in the background information section.

Severity adjustment

The figures in this release for injured casualties are based on adjusting figures reported by the police to take account of changes in the reporting of injury severity by some police forces in recent years. These adjusted figures can reliably be used to compare trends over time across the country. More details can be found in our severity adjustments guidance.

Data coverage

There is no obligation for people to report all personal injury collisions to the police. These figures, therefore, do not represent the full range of all collisions or casualties in Great Britain. All collisions reported by the police and that occurred on a public highway involving at least one motor vehicle, horse rider or pedal cyclist, and where at least one person was injured, are included in these statistics. More information on STATS19, how road traffic casualty data is collected and how these figures are produced can be found in the accompanying guidance.

Overall casualties

Casualties by severity

Casualties are broken down into fatalities (people killed in road collisions), and those injured (further split into seriously and slightly injured based on type of injury sustained). Killed and seriously injured casualties are commonly grouped together as 'KSIs'.

It has long been known that non-fatal (and particularly slight) casualties are under-reported to the police, though we believe that the trends shown are likely to reflect genuine changes. Further information is available in the quality section below.

Chart 2 and Table 1 show the trend in road casualties by severity over the last decade. Trends in road casualties are affected by a wide range of factors, with 2020 and 2021 being impacted by COVID-19. There is an increase in casualty numbers between 2021 and 2022 - this is due to the impact of national restrictions on 2021 casualty numbers. In the decade prior to the pandemic in 2020, fatalities had been generally stable. The year ending June 2023 broadly shows a return to pre-pandemic trends.

Casualty counts are also impacted by traffic levels with casualty trends following a broadly similar pattern to motor traffic (in terms of billion vehicle miles) during periods of national COVID-19 lockdown. Trends in casualty rates are further explored in the next section. In the year ending June 2023, there were 332 billion vehicle miles travelled, an increase of 2% compared to the year ending June 2022.

In reported road collisions in Great Britain in the year ending June 2023 there were an estimated:

1,633 fatalities, a decline of 9% compared to the year ending June 2022

29,429 KSI casualties, a decline of 1% compared to the year ending June 2022

133,443 casualties of all severities, a decline of 3% compared to the year ending June 2022

Chart 2: Reported road casualties by severity and all road traffic (billion vehicles miles), Great Britain, the year ending June 2013 to the year ending June 2023 (provisional) RAS9001

Table 1: Reported road casualties by severity, Great Britain, the year ending June 2023 (provisional) compared with the year ending June 2022 and the year ending June 2013 RAS9001

Trends in casualty rates

Chart 3 and Table 2 show the trend in road casualty rates over the last decade. The patterns in casualty numbers shown above largely reflect changes in traffic patterns, therefore overall casualty rates have remained broadly stable over recent years. This indicates that the reductions in casualties have been associated with reductions in traffic, largely during periods of COVID-19 lockdown. Over the past decade, casualty rates in general fell steadily prior to 2020, with larger reductions in injured casualties than fatalities. This was a period where vehicle traffic increased steadily.

In reported road collisions in Great Britain in the year ending June 2023, there were an estimated:

5 fatalities per billion vehicle miles travelled, a decline of 11% compared to the year ending June 2022

89 KSI casualties per billion vehicle miles travelled, a decline of 4% compared to the year ending June 2022

402 casualties of all severities per billion vehicle miles travelled, a decline of 5% compared to the year ending June 2022

Although, there was a decrease in the year ending June 2022 to the year ending June 2023, the latest year matched levels broadly seen in earlier years.
Chart 3: Reported road casualty rates per billion vehicle miles by severity, Great Britain, the year ending June 2013 to the year ending June 2023 (provisional)

Table 2: Reported road casualty rates per billion vehicle miles by severity, Great Britain, the year ending June 2023 (provisional) compared to the year ending June 2022 and the year ending June 2013
Casualties by road user type

The 4 main road user types (car occupants, pedestrians, motorcyclists and pedal cyclists) are used in the charts below to show comparisons with the year ending June 2022.

While provisional statistics for the 4 main road user types are likely to give a reasonable indication of trends, figures for other road user types can be impacted by classification issues, as explained in the quality section below. Therefore, these figures should be interpreted with caution.

'Other vehicle occupants' include e-scooters, which account for much of the increase in casualties for this road user category compared to 2019 figures. A provisional annual update on e-scooter casualties for the year ending June 2023, which are not explicitly covered in this release, is available in the e-scooter factsheet.

Fatalities by road user type

Chart 4 and Table 3 shows fatalities for the year ending June 2023 for the 4 main road user types: car occupants, pedestrians, motorcyclists and pedal cyclists.

In the year ending June 2023, 45% of fatalities were car occupants, 24% were pedestrians, 20% were motorcyclists and 5% were pedal cyclists. Of these 4 road user types, compared to the year ending June 2022:

the biggest percentage change was for pedal cyclist fatalities, which showed a decline of 22%

car occupant fatalities showed a decline of 8%

motorcyclist fatalities showed a decline of 9%

pedestrian fatalities showed a decline of 7%

Chart 4: Reported road fatalities by road user type, Great Britain, the year ending June 2023 (provisional) compared with the year ending June 2022 RAS9001

Table 3: Reported road fatalities by road user type, Great Britain, the year ending June 2023 (provisional) compared with the year ending June 2022 and the year ending June 2013 RAS9001

All casualties by road user type

Chart 5 and Table 4 shows overall casualties figures split into the 4 main road user types: car occupants, pedestrians, motorcyclists and pedal cyclists.

In the year ending June 2023, 55% of casualties were car occupants, 14% were pedestrians, 13% were motorcyclists and 11% were pedal cyclists. Of these 4 road user types, compared to the year ending June 2022:

the biggest percentage change was for pedal cyclists, which showed a decline of 8%

there was also a decrease for car occupants and motorcyclists casualties, but pedestrians casualty numbers were broadly unchanged

Chart 5: Reported road casualties by road user type, Great Britain, the year ending June 2023 (provisional) compared with the year ending June 2022 RAS9001

Table 4: Reported road casualties by road user type, Great Britain, the year ending June 2023 (provisional) compared with the year ending June 2022 and the year ending June 2013 RAS9001

Casualties by age and sex

Chart 6 shows fatalities and all casualties split by both sex and age group.

Overall, in the year ending June 2023:

77% of fatalities and 62% of casualties of all severities were male

4% of fatalities and 10% of casualties were aged 16 years old and under

22% of fatalities and 29% of casualties were aged 17 to 29 years old

24% of fatalities and 8% of casualties were aged 70 years old and over

Chart 6: Reported road fatalities and all casualties by age group and sex, Great Britain, the year ending June 2013 to the year ending June 2023 (provisional)

Fatalities by age and sex

Overall, 77% of fatalities were male in the year ending June 2023.

In the year ending June 2023 the age group with the most male fatalities was 30 to 49 year olds with 364 fatalities, a decline of 14% compared to the year ending June 2022. For females the age group with the most fatalities in the year ending June 2023 was 70 year olds and over with 142 fatalities, an increase of 2% compared to the year ending June 2022.

The largest reductions are seen in males and females in the 17 to 29 age groups when compared to the year ending June 2022, and to the year ending June 2013.

As the numbers in each group are small, there can be large fluctuations when comparing between years, as shown in Chart 6 and Table 5.
Table 5: Reported road fatalities by age group and sex in Great Britain, the year ending June 2023 (provisional) compared with the year ending June 2022 and the year ending June 2013
All casualties by age and sex

Overall, 62% of casualties of all severities were male in the year ending June 2023.

In the year ending June 2023 the age group with the most male casualties of all severities was 30 to 49 year olds with 27,203 casualties. For females the 30 to 49 year old age group also had the most casualties of all severities in the year ending June 2023 with 16,077 casualties.

Compared to the year ending June 2022 there was a larger fall in male casualties than female casualties, as shown in Table 6.
Table 6: Reported road casualties by age group and sex in Great Britain, the year ending June 2023 (provisional) compared with the year ending June 2022 and the year ending June 2013
Background quality information

Detailed guidance on road casualty statistics is given on our guidance page. A full list of the definitions used in this publication can be found in our notes and definitions documentation.

Quality and methodology

Quality

Road casualty statistics have been assessed as National Statistics, indicating compliance with the Code of Practice for Statistics. Full details of the quality of these statistics are available in the background quality report.

There are several important areas which users of the statistics should be aware of which are listed below.

Provisional figures

These provisional mid-year figures are the first national statistics published on the number of road casualties in Great Britain during the year ending June 2023. They will be followed by the provisional annual estimates for the whole of 2023 published in May 2024. Final annual figures are scheduled for publication in September 2024.

These are provisional estimates which have not been validated in detail and include imputation for missing data. Missing data for Avon and Somerset, North Yorkshire and Wiltshire police forces has been imputed for some months where data was not supplied or not considered to be complete. Overall the imputed data accounts for 2% of casualties and 2% of fatalities. There may be some duplicates, as some casualties might have been logged twice or more, these will be deleted following end of year validation. The potential of duplicate records is relatively small and therefore this publication provides a good picture of the road safety landscape especially at high aggregation.

Unexpected issues with data collection were encountered for Staffordshire Police. This means the reliability and accuracy of the recorded road collisions in this region cannot be guaranteed as some collisions may have been misrecorded or not recorded at all. This is unlikely to noticeably impact on the overall Great Britain road collision trends, but caution should be applied when considering geographical breakdowns by police force area RAS9002.

Provisional results for some road user types can be impacted by misclassified vehicle types. Misclassified vehicle types are reported back to the police who will return a designated vehicle type where notified. Vehicles are matched to the Driver and Vehicle Licensing Agency database and where there is a good body type match, vehicle type may be reclassified.

These factors are unlikely to affect the high-level national trends shown, but will have a bigger impact on figures for individual police force areas.

Traffic figures and casualty rates

Road traffic figures for 2023 are available for this release, therefore the casualty rates have been produced using the data published by the Road Traffic Statistics team TRA2501. The quarterly traffic data does not include pedal cyclists therefore an estimate has been made based on annual figures and added to the totals.

Under-reporting

Comparisons of road collision reports with death registrations show that very few, if any, road collision fatalities are not reported to the police. However, a considerable proportion of non-fatal casualties are not known to the police, as hospital, survey and compensation claims data all indicate a higher number of casualties than those recorded in police collision data. More information on the coherence of the police reported data with alternative sources can be found in our comparison to other sources of information on road casualties.

Changes in reporting systems used by police forces

From 2016 onwards, figures on the severity of injury have been affected by a large number of police forces changing their reporting systems. It is likely that the recording of injury severity is more accurate for forces using these new reporting systems.

The Office for National Statistics (ONS) Methodology Advisory Service have completed analysis to quantify the effect of the introduction of new injury based reporting systems on the number of slight and serious injuries reported to the police, and to estimate the level of slight and serious injuries as if all police forces were using injury-based reporting systems.

For more information, please see our guide to severity adjustments.

Online self-reporting

Online self-reporting is part of a wider project for digital public contact known as Single Online Home. It is funded by the Home Office to allow people involved in road traffic collisions to report the collision to the police online should they choose to do so, rather than having to physically report it at a police station.

The principle of online reporting is to make it easier for members of the public to report collisions. It is expected that the introduction of online reporting will affect the number of non-fatal (and particularly slight) casualties reported and therefore impact the total for Great Britain, as the public will have more reporting options available to them.

See our analysis of the impact of online self reporting for more details.

User engagement, developments and STATS19 review

Details of users and uses of road casualty statistics and response to recent user feedback is available from our user engagement page.

The STATS19 system which provides the majority of statistics for this publication is periodically reviewed to keep up with changes in technology, to make improvements to completeness and accuracy, and to reduce the reporting burden. Key recommendations of the latest review, carried out in 2018, can be found in the full STATS19 review report.

National Statistics and pre-release access

These statistics were designated as National Statistics in July 2009. The continued designation was confirmed in July 2013. National Statistics are produced to high professional standards set out in the Code of Practice for Statistics. They undergo regular quality assurance reviews to ensure they meet customer needs. More information can be found on our national statistics status webpage.

Details of Ministers and officials who receive pre-release access to these statistics up to 24 hours before release can be found in our pre-release access list.

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Reported road casualties in Great Britain, provisional estimates: year ending June 2023

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About this release This release provides an estimate of the number of personal injury road traffic casualties in Great Britain that were reported by the police in the year ending June 2023 using the STATS19 reporting system. These figures are provisional as they will change following the end of year validation process.