500 recruits!

The Bespoke Study has been recruiting cyclists attending the Royal London Hospital with cycling related injuries since April 2016. Cyclists have been recruited from Emergency Department, Outpatient Clinics, Inpatient wards and over the telephone. The aim of the study is to explore the epidemiology of cycling crashes presenting to Barts Health NHS Trust.

We have now successfully recruited 500 cyclists to the study! We would like to thank all of our cyclists who have been involved and all the staff who have helped us in the Emergency Department and across the hospital in both clinics and on the wards. We really couldn’t have done it without your support!

We are continuing to recruit until September 2017, to allow for 18 months of data collection. To keep up to date on our progress follow us on twitter: @bsp0ke.

How can you get involved?

If you would like to get involved in our research please report your cycling hazards and incidents to http://www.bikemaps.org/ or download the FREE app onto your phone “BikeMaps”.

Thank you so much for your ongoing support! Happy cycling!!


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BikeMaps comes to London!

What is BikeMaps and how does it work?

BikeMaps.org is a crowd sourced incident reporting tool. You can log the location of a collision, near miss, hazard or theft on a BikeMaps webmap or through our mobile apps. Once the location is chosen, you will anonymously answer a series of questions about the incident and about you and your riding habits. This should only take a couple of minutes.



Where did the BikeMaps idea come from?

Dr. Trisalyn Nelson had the idea for BikeMaps.org after a near miss on her bike to work. Trisalyn, now at Arizona State University, specializes in spatial analysis, GIScience, and the emerging field of volunteered geographic information. She had the idea for a web-map to collect locations where people had a frustrating experience on their bike. Upon discussing her idea with public health researchers who study bike safety, she discovered that there was a great need for the data that BikeMaps.org could supply.

Why are you collecting this information?

It’s estimated that only 30% of all bike collisions are captured by official data – police reports or insurance claims. In addition, there was a need to collect data on falls as well as collisions not involving a motor vehicle. Near miss reports are also rarely collected, yet can serve as additional data points to proactively highlight problem locations. All of this data is valuable to a wide range of audiences from cities planning safer infrastructure to health researchers studying activity.

What will you do with the data?

The data collected in London will be shared with the Bespoke team. In other locations we have shared the data or analysis with municipalities to assist them with planning. We have graduate students who use the data for graduate research in the fields of Geography and Public Health.

How can the public monitor areas of interest to them?

You can outline a “riding area”, which is a geographic area of interest. First you will need to create an account. Once the account is made, a polygon shape will be visible, which you will use to create your area. You may create more than one area. Once you have an area defined, you will receive notifications whenever someone reports something within that area. Please note that you do not have to have an account to report an incident nor will having an account identify you if you report an incident. Notifications will appear under the bell on the website or as push notifications on the mobile apps.

What other research studies have you been involved in?

Prior to BikeMaps.org, Trisalyn and her research team at the University of Victoria were involved in a wide range of studies involving patterns of data over space and time. These included grizzly bear habitat in Alberta, crime, biodiversity, the mountain pine beetle epidemic in Canada’s boreal forest, and wildfire. Our team member, Dr. Meghan Winters is an assistant professor at Simon Fraser University (British Columbia) whose research has included public bike share, cycling safety, and how the built environment affects the health and mobility of older adults.

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Trauma Symposium Poster

The Bespoke team were honoured to be asked to display a poster at the Pan London Major Trauma System symposium which took place yesterday at the Royal Geographical Society(http://www.c4ts.qmul.ac.uk/london-trauma-system/trauma-care).

The first Pan London Major Trauma System symposium: ‘Sharing trauma innovation from London and the South East’ included presentations covering a wide range of topics by some brilliant speakers including Traumatic Brain injuries, Managing MSK trauma and ideas on how New York manages their trauma, which were all topics of interest to the Bespoke Team.

The poster outlined our protocol for our observational, prospective cohort study exploring the epidemiology of cycling crashes presenting to the Royal London Hospital. The poster included our objectives, inclusion/exclusion criteria, data collection methods, Public and patient involvement and our current recruitment data.

We would like to say a big thank you to the Centre for Trauma Sciences and the London Major Trauma System for giving us the opportunity in being involved in such a fantastic day!


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Barts’ Bike Service Success!!

Over the last couple of months we have supported several free bike servicing events at Whipps Cross Hospital, Barts Hospital and Newham Hospital for all Barts Staff. This was organised by the Barts Sustainability team, and we had an excellent mechanic from Dr Bike sorting out all sorts of bike problems as well as completing secure bike marking for Barts Staff. We wanted to get out to as many sites as possible- to ensure everyone had a chance to get their bike ready for winter cycling!

image1 image2

All events were a success, with a steady stream of cyclists keen to get their bike checked – hats off to those who waited in a cold queue for their bike service! It’s great to see the huge number of cyclists working within Barts Health NHS Trust. We will be looking to host similar events at the beginning of next year so keep an eye out for posters!!

If you are interested in supporting our study please let us know about any cycling near misses/collisions you have. Simply send us a screenshot of your map location using a pin to identify the specific geo-location, with a brief description of the event to twitter or instagram, or drop us an e-mail! Happy cycling!!!

Twitter: @bsp0ke

Email: bespoke@bartshealth.nhs.uk

Facebook: The Bespoke Study

Instagram: Bespoke Study

Website: www.bespokestudy.co.uk

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5 minutes with Tim Harris, Professor of Emergency Medicine

stafftimharrisTell us about your day to day work at the Royal London Hospital/Barts health NHS Trust?

It is a huge privilege to work at QMUL and BH. I work as part of a world class team in a world class health care facility. No day is remotely similar – keeps the brain fresh I hope. I work in research and teaching as well as the clinical side and enjoy each part of my work. I work in the ED and pre-hospital arena (with paramedics in a HEMS service based near Cambridge), so I am involved in the care of injured cyclists each day. I also previously worked in ICU – and I miss it very much but there are just not enough hours of the day. Job variety is hugely important in this field – it helps in maintaining perspective and balance.

What led you to develop the Bespoke study? 

We need to better understand cycle injuries and how/why they occur, and how they affect people. Hospital statistics are surprisingly inaccurate – indeed the coding of illness remains a highly variable. We hope that this will change in the future. Thus to really understand a specific set of injuries or disease processes health care researchers usually need to create specific databases. Bepsoke will provide a huge amount of data into a multitude of factors which surround cycling injuries. We obviously hope that this will improve safety for cyclists.

Do you cycle yourself?

After a night shift I was cycling home and fell asleep. I woke up under the wheels of a large 4 wheel drive. That unnerved me. I also was unlucky enough to have two bikes stolen (locked and security coded). The near miss and the lack of any perceived interest for the law enforcement in their recovery means I do not cycle now. I did actually find my last bike but the elderly man using it looked like his need was greater than mine so I did not try to claim it! I guess that says a lot about how untrendy my bikes were. I take the tube to work now and run home. I still think cycling is the fastest and best way to travel in London so hopefully I will again in the future.

What kind of cycling injuries have you managed previously?

Over the past 25 year I have been involved in a huge range of cycling injuries. I tend to be much more involved in critical illness these days

What can Londons cyclists do to help?

We are trying to capture the location of cyclists near misses and collisions across London. Please upload a screenshot of your map location with a brief description of the event to our twitter/instagram or facebook and #crashitmapit


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New York Inspiration

The Bespoke Study was designed with careful consideration of previous research relating to traffic safety, and ways to make the roads safer for all road users. This is an example of another study that has successfully used data collection to highlight urban “hotpots” to help make recommendations for improving the safety on the streets of New York.

“A community traffic safety analysis of pedestrian and bicycle injuries based on the catchment area of a trauma center” Slaughter et al (2014)

An epidemiological study took place in New York investigating the characteristics of pedestrian and cyclists’ collisions with motor vehicles within New York City’s high density hub between December 2008 and June 2011. The primary objectives were to map crash locations and identify hotspots within this injury cluster. The secondary objective was to quantify differences in injury severity based on road type and user behaviours.

The data was collected from pedestrians and cyclists struck by motor vehicles and brought to Bellevue Hospital in New York City. ISS (Injury severity score) and collisions locations were extracted from the database. A total of 1457 patients were enrolled, with collision locations known for 97.5%. Geomaps were then created to identify “hotspots” areas where higher volumes of crashed occurred.

The results demonstrated pedestrians crossing avenues had higher ISS’s than those crossing streets and were more likely to die.  This demonstrated that the wider avenues resulted in more serious injuries than the narrower streets. Pedestrians who were crossing mid-block had higher ISS’s than those crossing with a signal at a crosswalk. The geo-map data showed that hotspots of pedestrian collisions were detected in mid-town Manhattan whereas cyclists’ hot spots were detected in tunnel portals and bridges; spatial analysis demonstrated showed these were not random events. These results could then be taken forward to help make changes to road layouts, town planning and prevention strategies.

The Bespoke Study is collecting data of cyclists’ near misses, slight incidents and serious incidents across London between April 2016 – September 2017. This data is collected via cyclists attending the Royal London Hospital who are recruited to the study, and also cyclists reporting to the website Collideoscope.

What can you do to help?

We need all cyclists in London to be actively using Collideoscope to report near misses, slight and serious incidents so we are able to collect data on where cycling incidents are happening. Is it vital that we collect data covering the whole injury pyramid – from the near misses to the more serious incidents… all reports are vital!

Massive thanks to all those who have reported so far!


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Start cycling!

In response to a lack of physical activity in the UK, Public Health England have developed The Physical Activity tool. This combines data of physical activity and related risk factors such as obesity and diabetes. The tool compares local data to national data to develop better understanding and therefore promotion of physical activity, such as walking and cycling.

Physical inactivity contributes to 1 in 6 deaths in the UK, there have been slow improvements over the past few years but the UK remains behind many other countries including the USA.

Physical inactivity costs the NHS approximately £0.9 billion per year

Physical activity reduces risk of multiple diseases such as cardiovascular disease, coronary heart disease, stroke, diabetes, obesity, osteoporosis, colon/breast cancer as well as improving mental health.

Completing 30 minutes of moderate physical activity can make a big difference to health and well-being

Table showing overview of physical activity

Table showing overview of physical activity

  • In London 57.8% of adults complete 150 minutes of physical activity per week, this is better than the national benchmark
  • In London 5.4% of adults cycle at least 3 times a week
  • In London 14.7% of adults cycle at least once per month, this is less than the national benchmark

Physical activity should be encouraged as part of everyday life to improve health and mental well-being, reduce risk factors for disease as well as promote a healthier and more active community. Public Health England has developed the Everybody active, everyday framework to help all sectors to promote physical activity, such as cycling.. We need more people to start!

Make a change and start cycling!

Wednesday 14th September is National Cycle to Work day!

Check their website for more information and tips https://www.cycletoworkday.org/

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5 minutes with Manoj Ramachandran, Orthopaedic Consultant

Can you tell us about your day to day work at the Royal London Hospital/Barts Health NHS Trust?manojrcropoutsid

I’m mainly a children and young adult trauma and orthopaedic consultant surgeon, looking after injuries and chronic conditions of bones and joints in these age groups. On top of that, I head up a research team in orthopaedics that is focused on innovative clinical and translational research projects in all kinds of important subject areas, from common injuries to medical devices to digital health.

What led you to develop the Bespoke study?

It was on the back of the numbers of cycling related injuries that we were seeing at the Royal London Hospital on a background of the high-profile deaths reported in the media. I wanted to really take a granular look at the mass of injuries that presented to our Emergency Department, including minor injuries, to really understand what patterns and types of injuries we were seeing, how and why they had happened, and what the effect on an individual patient was in the short-, medium- and long-term.

Do you cycle yourself?

Yes, I love cycling but I stopped cycling as a commuter in London around twelve years ago when I was knocked off my bike a few weeks before my wedding and suffered some facial injuries. I have got back on my bike since but not for commuting. I don’t want in any way to discourage cycling as I think it’s an amazingly healthy activity and we should all be out there on our bikes but I just want to understand why we are seeing so many injuries clinically and to help in the process to make cycling safer and prevent injuries in the first place.

What kind of cycling injuries have you managed previously?

All kinds from minor to severe in children and young adults. These have ranged from simple bruises to severe life threatening injuries brought in by the London Air Ambulance. I’m positive that if we understand how these injuries are happening in incredible quantitative detail we can really start to make cycling completely safe.

What can London’s cyclists do to help?

Please please please report any cycling incidents at http://www.collideoscope.org.uk/  these can be near misses, minor or major incidents. It will really help us build a picture of where problems are happening in London.

And finally, please spread the word to everyone you know who cycles and help us build a robust study!

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5 minutes with Chris Bridle, Oral & Maxillofacial surgeon

chris bridle
Can you tell us about your day to day work at the Royal London Hospital for Barts Health NHS Trust?
I am a Consultant Oral & Maxillofacial Surgeon at Barts Health NHS Trust. I have been working in the trust for the last 13 years and was appointed as a Consultant 8 years ago with an interest in facial trauma. In my years as a consultant my primary focus has been dealing with patients who have sustained injuries to their face from a variety of different accidents, assaults and mishaps. My week is based around the assessment and treatment of these patients such that we run an all-day trauma clinic at the beginning of the week and then schedule the surgery for our two all-day operating lists on Tuesday and Wednesday. Over the years I have noticed an increase in the number of cycling related injuries. This is undoubtedly due to the increased popularity of cycling in London as a means of getting about the city but also the increased popularity of the sport itself. The impact of facial injuries on people’s lives can be profound and I am passionate about encouraging prevention as well as treating those unfortunate to be the victims of facial trauma.

Do you cycle yourself?

I was a very keen cyclist as a teenager and younger adult years. As a kid my main mode of transport was my Raleigh Racing bike rather than the dad taxi. Many a weekend during my junior training I would spend on the mountain bike, riding through the North Yorkshire Moors. More recently I have tried the delights of the ‘Boris’ bikes as means of getting around and with a young son we often get out on our bikes around the parks of South London.

What kind of cycling injuries do you manage?
We see on a weekly basis a number of patients who have been involved in some form of bicycle related accidents. This includes bicycle riders and pedestrians who have stepped out in front of cyclists. The main type of injury is soft tissue injury where the rider hits the floor and sustains nasty grazes and ‘road rash’. These are really important to treat well as any dirt left in the wound will tattoo the face with an unsightly scar. The other types of injury are those to the bony facial skeleton where fractures of the lower jaw, cheek bone, eye socket and skull are not uncommon. In those riders wearing helmets we see more lower facial injuries compared to those not wearing helmets who show a wider range of facial injuries.

What can Londons cyclists do to help?
From our experience dealing with facial injuries amongst the cycling community, the biggest piece of advice is to be vigilant and aware of everything around you

Please make your crash count by reporting any near misses and incidents to http://collideoscope.org.uk/ and help build a map of collision hotspots in London

Happy & safe cycling!

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NipNip Bike Service Success!!!

We hosted our NipNip FREE bike servicing afternoon on Wednesday, which was a huge success! One of the talented NipNip bike mechanics serviced bikes from 3-7pm outside the Royal London Hospital, managing to service 40 bikes in total – an incredible 10 per hour! We were really encouraged by the amount of cyclists turning out to ensure their bikes were road safe. We also had The Met police attending to complete bike markings to aid bike security. The Leigh Day Cycling Team were also here to help, and share their cycling knowledge with fellow cyclists which was an added bonus!

We used this opportunity to tell people about the Bespoke Study and promote cyclists to help the study by reporting their cycling near misses/incidents to http://collideosco.pe/ to help us see what’s happening on the London roads.

We would like to thank NipNip, the Met Police and the Leigh Day Cycling Team for their support in making it such a fantastic day! We hope to hold further servicing dates so keep an eye on our Twitter or website!

Blog pic




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NipNip FREE Bike Servicing Event – Wednesday 27th July 3-7pm at The Royal London Hospital

We are excited to have the NipNip Bike Servicing Team visiting us at The Royal London Hospital on Wednesday 27th July 3 – 7pm. The NipNip team are a fantastic Bike servicing company which started in 2013 as a small, family-run business, and is now one of London’s fastest growing cycle repair and servicing business. For further info please visit: https://www.nipnip.co.uk.

At Bespoke we are keen to get the London roads as safe as possible for cyclists, and this includes having bikes which are serviced and road-worthy. The Bespoke team are encouraging cyclists to drop in and have a FREE bike service!!


  • full safety check
  • frames and forks wiped down and checked for alignment
  • wheels and tyres inspected for wear
  • wheels trued and spokes tensioned
  • chain checked and lubricated
  • gears and brakes adjusted

In addition to the FREE bike services, the Police will also be attending to do Bike Markings – so you can get your bike safe and secure all at once! Please spread the word to all of your cycling friends!

Look forward to seeing you and your bike!!


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Questions, questions, questions..

We have had lots of queries regarding how our questions were formulated and exactly what we are asking of the cyclists in The Bespoke Study. Our research approach is committed to being questioning and neutral in order to allow for unbiased evidence to be collected. There are some amazing benefits from cycling and as health care professionals we are keen to promote it across the UK; the ultimate aim of the study is to make London roads safer for all cyclists.

We ask over 40 questions in the Bespoke Study, all of which were formulated and reviewed in collaboration with the public at our launch event in October 2014. Subsequently these questions have been reviewed by a smaller panel of cyclists. This panel is our public representation in the study delivery; each panellist comes from a different cycling background. Read more about them on the Get Involved page. Our panel have played a vital role in ensuring we are asking cycling specific questions that cyclists have indicated they wanted us to investigate.

Forms from the Bespoke Study

Forms from the Bespoke Study

First questions

Cyclists are approached at the hospital, after having an incident, to see if they are happy to take part in the study. They are then asked about the circumstances of the event such as the time and location (including the type of road), road conditions and for a full description of the event. We also ask if anyone else was involved in the incident. Further information about injuries and medication use is collected from both the medical records and the cyclist themselves. We aim to satisfy the World Health Organisation injury data set requirements with our line of questioning so that we are able to provide a robust description of the crash.

We then ask our cyclists more specifically about their cycling history and habits, which does include whether they use a helmet, reflective clothing or lights. We are interested in their main reason to travel by bike, amount of journeys completed per week and if they have had any previous cycling training. Cyclists we spoke to felt that these questions were important in understanding all of the circumstances around a collision.

Second questions

At discharge from hospital or 28 days following the incident (whichever comes first) we ask about the cyclist’s physical and mental well-being after the incident. This includes how they are managing with daily activities, work and social life. We are keen to find out how they are recovering and if they have managed to return to cycling. The assessments used are standard clinical or research measures such as the Barthel index, EQ5D and the SF36.

Final questions

Six weeks after the incident we check up on how the cyclist is managing with their injuries. We ask about their day to day activities and are keen to find out about the physical, social and emotional impact of the incident. At this stage we ask again whether they have returned to cycling or not, if they haven’t we are keen to explore the reasons behind this.

These questions will give us a huge amount of relevant information on the where, what and why surrounding cycling collisions in London. So far we have had a really positive response from our patients who are keen to be a part of The Bespoke Study.

Please follow our progress online or get in touch if you would like further information.

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Bespoke Relaunch


Rowanne and I joined The Bespoke study at the beginning of April and are excited to be working on promotion of the study and data collection within the hospital. If you head over to the Project Team page you can find out a bit more about each of us.

There has been a huge amount of progress over the past couple of months which we are keen to update you all on!

We have a few plans up our sleeves in order to try and promote the study further and need your help, please follow us on twitter @Bsp0ke or give us a like on Facebook The Bespoke Study


Recruitment to the study has begun within The Royal London Hospital and we have had a fantastic start, capturing 27 participants in the first two weeks!

We are collecting a variety of information about the incident including what happened, where it happened and when it happened. We are also asking cycling specific questions, such as use of cycling safety equipment, electronic use and about any previous cycling training. Following the incident we keep in contact with our participants to keep an eye on how the incident has affected their overall health including family, work, social and cycling life.

This information will help us to learn more about the impacts of cycling incidents, large or small, and ultimately improve cycling conditions and safety across London.


We need as many cyclists as possible to get on board and start logging any cycling incidents on our fantastic web based app Collideoscope.

Collideoscope has had a fantastic start to the year with 333 new reports so far! On the website you can log details about either a near miss or a collision, and then this information is forwarded to the local highways department as well as directly to our researchers.  Collideoscope also highlights in real-time, danger hotspots in London so cyclists can plan a safer route.

So what are you waiting for? Whether you’re commuting to work, or planning a cycling day out in our great capital, visit www.collideosco.pe  today!

Happy cycling!

Chloe and Ro


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Safer Lorry Scheme = Safer Cycling?


What is the Safer Lorry Scheme?

The Safer Lorry Scheme was introduced on 1st September 2015 and legally requires heavy goods vehicles (HGVs) over 3.5 tonnes gross vehicle weight driving in London to have side guards and extended view mirrors to protect cyclists and pedestrians.

Here is what the equipment looks like:HGV1



Under the London scheme, most vehicles that are currently exempt from national legislation for basic safety equipment will have to be retrofitted, including construction vehicles. The scheme will operate across London, 24 hours a day, seven days a week, covering the same area as the Low Emission Zone. The scheme will be enforced by the Metropolitan Police, City of London Police and the Driver and Vehicle Standards Agency. Penalties range from £50 Fixed Penalty Notice to a potential £1000 fine.

 Will it work?

There are some apprehensions about tHGV Boxhe scheme. The increasing number of mirrors for drivers to check might be over-whelming, and a possible distraction from looking at the road itself. Can it ever be made safe for vulnerable road users to share road-space with such large vehicles? Should cyclists have to take a greater responsibility in avoiding lorry blind spots? Would a blanket ban on HGVs at certain times be more effective?

Without research into the circumstances surrounding cyclist-HGV encounters, it is difficult to answer these questions. Unfortunately, we rarely have the cyclists’ side of events to examine the circumstances leading to collisions – either because the cyclist has not survived or detailed collision data is not recorded from those at the scene of the crash. Furthermore, many cyclists experience close calls with HGVs but manage to avoid an actual collision. Data on these will also help us to predict how to protect cyclists.

Time will tell if the new safer lorry scheme reduces the number of deaths and serious injuries to cyclists in London – hopefully it will have an impact. The Bespoke study will gather data on injured cyclists who present to the Royal London Hospital, and aim to find out about the circumstances leading to collisions between cyclists and HGVs as well as all other incidents. Cyclists who report their near misses or collisions via the collideosco.pe web-app will also help to build a picture of danger hotspots and patterns in circumstances leading to such incidents. It is envisioned these findings will help to shape future transport planning and road safety initiatives.

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Five minutes with Alex Dowsett

Alex Dowsett

Following his time trial gold medal at the 2014 Commonwealth Games, Alex Dowsett subsequently took on the UCI Hour Record, which he smashed in May this year despite a training setback after a fractured collarbone. Dowsett went on to take his first stage race victory at the Bayern-Rundfahrt in Germany after winning the time trial stage. He began the 2015 Tour de France with his Movistar team, but unfortunately had to withdraw following a crash in the early stages. His recent success at the road Cycling World Championships in Virginia saw him celebrate a bronze medal in the team time trial.

Alex has supported the Bespoke study’s crowd-sourcing Collideoscope app since its launch. Speaking to the London Evening Standard in October 2014:
“I got involved because I have had some near misses on the road myself. It’s a good tool to advise doctors of the most likely injuries cyclists are likely to get.”

We caught up with Alex to find out his priorities for the coming months and some advice on avoiding crashes, recovering from injury and how he would like to see cycling made safer.

What have been your highs and lows of 2015, and what are your priorities for the next few months?

Highs would be achieving a bronze medal in the world team time trial championships recently, there’s something pretty special about working together with your teammates and achieving a target set out then sharing a podium with them. The next month will mostly be R&R; it’s the end of the season so some time off the bike, living like a normal human being and enjoying myself is on the cards. After that, start knuckling back down and looking ahead to next season.

You have had a few crashes this year, have you fully recovered from your injuries?

There are always crashes and the injuries sustained do vary. This year I had no muscular injuries fortunately as the major crash in the Tour de France caused a deep cut to my elbow that required stitches twice over. However I have to have on-going treatment on my back, I’ve broken 2 ribs, a collarbone, shoulder blade and elbow all on my right side and it has taken its toll so physios and osteopaths keep working on it to keep me on the straight and narrow!

How often do you experience ‘near misses’ whilst out training – is there a way to avoid them?

I’d say once a week there is a real near miss. I’ve learnt through time on the roads to see when there is a potential hazard coming before it happens, things like looking into a driver’s eyes to see if they’ve seen you before they pull out and taking evasive action before the inevitable. My mum got unlucky with a car towing a caravan overtaking her and the driver not realising the length of the caravan before he finished his overtaking manoeuvre and ran her off the road, subsequently breaking her shoulder in a very complicated way. Had it been me in mum’s position maybe I could have avoided the accident I don’t know – I would rather me be in mum’s position than her as I would’ve stood a better chance in that scenario I feel.

There are often a high number of cyclists in close proximity on common commuter routes and a lot of ‘bike vs bike’ collisions/near misses get reported on Collideoscope. Can you offer any advice to cyclists?

It’s not a race; in a peloton we are all travelling on the same route whereas cyclists in front of you on the way to work may turn off at any second. If you are overlapping your front wheel with their rear wheel and they turn off unexpectedly you’ll be on the floor before you know it, and with the added risk of cars behind you also. Just take a little extra care, give a little more space and be ready for some unexpected manoeuvres!

What do you think would make the roads in London safer for cyclists?Quote box

I think clearly separated cycle paths and car/bus roads would massively reduce the amount of incidents. The cycle paths have to be good enough that cyclists want to use them, i.e. flowing well and not interrupted abruptly. But then also the car congestion in London is always high so these cycle lanes can’t make London more congested either; it is a tricky situation where too many people using different forms of transport need to use the same routes which really aren’t big enough for everyone to fit. So I guess patience, courtesy and understanding are needed by all parties on the road – drivers and cyclists alike.

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A Critical Eye on Cycling Literature

Accident Analysis & PreventionExposure measurement in bicycle safety analysis: A review of the literature

This recently published journal article has sparked some attention due to its controversial ‘headline’ that wearing visible clothing and a helmet do not reduce cyclists’ risk of being involved in a crash. However, a more in-depth look at the review of 20 papers, all published in peer-reviewed journals, reveals some interesting insight into cycle safety research. This blog summarises the key findings of the review, then critiques its weaknesses.


In setting the scene for their paper the authors – a group of researchers based at the University of Brussels – summarise the benefits of cycling; reduced traffic congestion, cleaner air and an active lifestyle. As is now a major concern here in the UK, safboxety must be improved to shift populations from ‘passive’ to ‘active’ transportation. To create safer cycling environments, we need to understand where, when and under what circumstances collisions occur. The review article focuses on identifying studies which report exposure data to help to better interpret the relative risk of being involved in a cycling incident. The authors’ initial literature search brought 1578 hits; 20 papers were retained for further analysis. Those which looked only at cycling for leisure or sport were excluded.

Key Findings

Gender Differences

Studies which included gender analysis were contradictory. Generally more cycle commuters were male and they had a higher incident rate than women, however one study reported the opposite. For cyclists over 50 years old, incident rate increased with age. This might be related to factors such as balance or spatial awareness as people get older, but needs further investigation.

Environmental Factors

Three prospective studies indicated that having good cycle infrastructure was not enough to ensure cyclist safety, especially if it was not well-maintained. There were more traumatic events on residential streets and bike lanes, but exposure was not measured – so, for example, there might be more crashes on residential streets simply because more cyclists ride there compared to busy main roads.

Behavioural Factors

Two studies reported that wearing visible clothing, having more cycling experience, or wearing a helmet did not reduce relative risk of being involved in a crash. However, four studies reported that wearing protective clothing reduced accident severity. This suggests that protective wear might not prevent a cycling incident occurring, but it might reduce the severity of injuries sustained – further research is needed to clarify this relationship.

Further research

The authors suggest a more detailed description of injury severity is required and note that little research has been carried out on the quality and presence of bicycle-specific infrastructure related to accident exposure. They recommend prospective study designs – those that take a group of subjects and monitor them over a period of time – as these will collect more accurate data on accident characteristics compared to retrospective studies which risk losing detail.


The article was not a systematic review and no statistical techniques were used to combine results of the included studies. This reduces its rigour, i.e. we cannot be certain the results are accurate or precise or that all parameters have been controlled for. Although it addressed a focussed question, there was no exclusion of studies based on their design and there was a large variety in the methodology and outcomes used. This makes comparisons difficult and results from different studies were inconsistent. Although four different databases were searched, it is not clear whether the search was exhaustive and the authors excluded articles not published in English. Finally, the findings might not be generalisable to the population of London or the UK as the studies were carried out in Canada, Australia and Belgium.

The article analysed here demonstrates that there is still much to learn about how to make cycling safer. The Bespoke study will go some way to filling the gaps on how, where and when collisions occur for cyclists in London through collecting data on injury severity, circumstances, location and infrastructure at the earliest opportunity following a crash. The data will hopefully help to improve understanding of how to prevent them in the future.


Van Parijs, J., Int Panis, L., Meeusen, R., de Geus, B. (2015) Exposure measurement in bicycle safety analysis: A review of the literature. Accident Analysis and Prevention, 84, pp 9-19.


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July in Numbers!

Thank you to everyone who logged a near miss or incident on Collideoscope last month. The following describes some of the patterns observed in reports sent to Bespoke about London-wide incidents – no statistical analysis has been carried out but we wanted to share some of the useful trends Collideoscope might help to identify.
Throughout July, Bespoke received a total of 42 reports logging incidents across 13 different London Boroughs and comprising 40 near misses and two serious incidents. This compares to 33 reports in June, and just four in May. Each of these reports was also sent to the relevant Highways Department.
The majority of incidents in July were reported by cyclists (83%), with five pedestrians (12%) and two drivers (5%) also contributing. Over half the incidents could be described as ‘bike vs car’, but others included ‘bike vs van’, ‘bike vs HGV’ and ‘bike vs pedestrian’. There were three separate reports of cyclists colliding with, or nearly colliding with, pedestrians due to jumping a red light. Out of the 42 incidents, 16 (38%) happened on a Wednesday and just six (14%) on weekend days. The time of day incidents occurred varied widely between 6am and 11pm, but ‘peak’ times were 8-10am and 6-7pm.
The Bespoke team have mixed emotions over the rising number of reports we receive. It is sad to hear about crashes and even near misses – as these can be as distressing as an actual crash. However, we hope the increase in incidents logged on Collideoscope represents a decline in the number left unreported, rather than an increase in their occurrence. July also saw fewer serious and slight incidents reported compared to June and the numbers coincide with an increase in cyclists on our roads during the warm (and mostly dry) summer months.
We hope you find this information useful and interesting. Thank you again and please continue to log all your cycling near misses and crashes on Collideoscope.

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Bespoke Update!

It might have been a while since our last update but the Bespoke team has been busy working towards finalising the details of the study, ready to start recruiting participants.

As the Bespoke study co-ordinator I started in this new and exciting role at the beginning of July. This means the study now has a full time researcher dedicated to its promotion and development. You can read more about me on the Project Team page.

The study protocol and documents have all been completed and sent to the governance teams. Following a few minor changes we are are now ready for submission to Ethics. If all continues to go to plan, the first participants will start being enrolled onto the study in the next 4-6 weeks.

Collideoscope continues to attract regular hits with people recording their near miss and collision data. Of course, promotion of this is ongoing and we are excited to forge new relationships with like-minded groups who can help to promote the site. Collideoscope will help to provide valuable data on cycling incidents which do not present to hospital. You can report yours via the ‘Report your Crash’ link.

Happy cycling and stay safe!

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Bespoke study partners collideosco.pe (@Collideoscp) receive funding from DFT

From time to time the Bespoke Study team will host posts by our collaborators. One of the vital relationships the Bespoke study team has is with Ben and Neil from www.collideosco.pe . Their project which is a central part of the Bespoke study has gone from strength to strength. So it was great to hear that they have been successful in a competition for research funding from the Department for Transport.   Here’s more from the collideosco.pe Facebook page post on the project.


Collideoscope: 5 months and counting

Day 148… it’s hard to believe almost 5 months have passed since we applied a final coat of polish to www.collideosco.pe in time for the Bespoke Study launch event in London with Alex Dowsett.

Where did the time go? Here’s a quick update on what’s been going on since then…

Thanks for reporting Contribute

Since last October over 7,400 different people have stopped by the site, and we’ve forwarded over 600 reports to local authorities across the UK – 176 incidents and 429 near misses, in case you were wondering.

We’re always conflicted over the reports we receive: sad to hear about incidents, relieved for people’s near-misses, but ultimately glad they are being collated onto a map and shared publicly.   As such, many thanks to all who have taken the time to contribute.

Impact and response

The site has attracted a mixed response from local authorities, with some responding positively to incident reports – see below – while others have been slightly bemused by the site’s purpose or value of the reports we are forwarding in relation to cycling near-misses.


We don’t know for sure, but suspect the dataset being created will help identify locations where it is only good fortune that, on a number of occasions, has prevented more serious incidents. Continuing to collate minor incident and near miss data over a longer period of time is key to demonstrating whether our hunch is right (or not!), and helping local authorities to respond to any patterns that emerge.

Thanks to the Department for Transport for research fundingDfT Logo (cropped)

To help us investigate this further, and work more closely with local authorities in England, we applied successfully to the Department for Transport’s first ever Transport-Technology Research Innovations Grant (T-TRIG) competition earlier this year. The grant-funding is time-limited, and we are using it for a number of specific initiatives that we will be working on over the next few weeks:

  • Working with a small number of local authorities to create a more actionable and informative set of ‘batched’ notifications that we can send out on a monthly basis.
  • Openly releasing anonymised incident report data from the first 6 months since the Collideoscope site went live (many thanks to the nice people at SOCRATA who are supporting us with this).
  • Working with local police forces to explore whether Collideoscope incident reports could be enhanced to allow them to double-up as official Police reports.
  • Doing some comparative analysis to understand whether Collideoscope is filling gaps in the official STATS19 collision reporting data in the areas we have sufficient data (London mainly!).

Staying in touch

Aside from getting cracking on the to-do list above, we’ll be aiming to keep this new blog up to date. We’re planning to share our work in progress and seek feedback on the enhancements we make to the site.

Hopefully that will allow us some time to hit the road and enjoy the promised Spring weather! Cycle safely, and don’t hesitate to drop us a line or use Facebook / Twitter to send us any thoughts and ideas you have for how we could improve the tools in the future.

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Bespoke Team wins Health Hero award

Following a fairly quiet, wintery January, this week saw the arrival of the much anticipated Barts Health Heroes awards evening. The Barts Health Heroes awards were launched on 1 October 2012 as an opportunity to reward and recognise those staff who demonstrate the values of Barts Health in their daily working lives and create a culture where the values become central to all that they do. This year there were 517 nominations received– 392 for individuals and 125 for teams who embody Barts Health values in their day to day work.

Barts Charity, which generously sponsors the Barts Health Heroes Awards, once again recognised staff who have been exceptional in supporting the Charity over the last 12 months through two awards – The Best Fundraiser Awards (for staff who have raised the most money for the Charity over the last year) and The Best Ambassador Awards (for the individual and the team who have been the most active in supporting and promoting the Charity over the last year). The Bespoke team attended the ceremony following our nomination for the Best Ambassador Award, as well as the PI of the team, Manoj Ramachandran being nominated for the Best Fundraiser Award. The ceremony got off to a great start, with both the Bespoke team and Mr Ramachandran winning the awards in their respective categories!


The evening definitely did not disappoint. Apart from the great atmosphere and hospitality of the hosts, it was lovely to celebrate so many teams and individuals who have worked so hard in doing the best for their patients and colleagues. Thank you so much to Barts Charity, and specifically Belinda Dee who has supported us continuously since the inception of the project. We are definitely feeling encouraged to carry on our effort to push forward the Bespoke Study, with the ultimate goal of making London’s streets safer for cyclists.

Fiona, Bespoke Team Researcher 27/02/2015

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Leigh Day partners with Bespoke for safer cycling

Leigh Day

We are delighted to welcome our new partners, Leigh Day, as supporters of the Bespoke study. We first met representatives from Leigh Day at our public meeting on the 7th October, and it wasn’t long before they made it clear that they felt they could offer us a perfect fit as a partner for the project. When we spoke to them about how they became so involved in cycling as a firm, they explained that this had been driven primarily by the large number of employees across all levels of seniority who were cyclists themselves.

As well as employees having plenty of personal experience of cycling as a way to get around, Leigh Day represent British Cycling’s members and have done since 1999, making them experts in cycling and cycling injury. Their input will be extremely valuable as Bespoke evolves and develops, and we very much look forward to meeting more representatives across the firm.

Adrian Jewitt, Associate Director of Marketing and Business Development said:

“Leigh Day is the UK’s top law firm for injured cyclists, with offices neighbouring Barts in Smithfields. We deal with thousands of claims for cycling injuries every year, some of them catastrophic and life changing. Despite the cases we deal with, our staff are committed cyclists themselves covering thousands of miles commuting, for fun, and for fundraising.

Our team is acutely aware of the importance of making the roads in our cities as safe as possible for cyclists. Many of the crashes and collisions that happen in the UK are preventable, and systematic failures such as lack of safety mirrors on lorries and HGVs must be tackled. And cyclists’ safety needs to be a primary consideration in road design.

But effective change to make London safer for cyclists needs to be driven by London’s planners and policy makers, and in turn they require data. The researchers in the Bespoke project are committed to gathering high quality information about bicycle related injuries and then use this data to work with key stakeholders to improve London for cyclists. As a law firm who deal with the aftermath of bicycle crashes, we share their goal to prevent cycle-related traumatic injury and encourage cycling for all, and that’s why we are delighted to support this research.

We believe our knowledge of the factors affecting our clients, and the impact of their injuries on their lives means we can make a real contribution to the research goals, and shape policy in favour of more, and safer cycling, for us as cyclists ourselves and our clients’.”

To find out more about Leigh Day you can visit their website – http://www.leighday.co.uk/. We recommend checking out their cycling section which is a good resource for interesting facts and information, including common causes of cycling injury, types of injury and research on the benefits of cycling.

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“I don’t want to cycle! So why should I support Bespoke?”

I recently posted this on Twitter:

The image comes from a report published by British Cycling supported by Leigh Day. Leigh Day, our new partner, act for British Cycling’s 100,000 members offering specialist legal advice, and have a large contingent of cyclists across the firm.

This is my most popular Tweet to date with a staggering (wait for it…) 34 retweets and 14 favourites. Not bad, given my modest 123 followers. But more importantly, it has opened up discussions about the overall relevance of cycling, and why people should support Bespoke.

The Bespoke team is largely comprised of healthcare professionals. As you would expect, they are invested in better healthcare and injury prevention. The Bespoke team are people who cycle and who are passionate about cycling, driven by our own, personal experiences. Our colleagues, friends and families cycle, and we have all been or know someone who has been seriously injured on their bike. Some of us have friends, or friends of friends, who have tragically passed away. Sadly, most cyclists in London will tell you the same thing, and for the cycling community, this creates an obvious link to Bespoke.

So what if you’re not a cyclist, and you don’t want to cycle? Unfortunately, if you live in London, there will be very few degrees of separation between you and an injured cyclist. More importantly, the implications of wider spread, safer cycling have positive impacts on society as a whole, and I would challenge any well-informed person to argue against this. But Bespoke is not about arguments, or dictating actions or thoughts. Ultimately, it is about giving people freedom, by removing the fear of injury from cycling, which will help to make cycling fun and accessible to all.

What is essential for Bespoke is that we remain entirely agnostic and neutral in our approach, less we unintentionally bias our findings. We will not enter into any debate or argument, or make judgements about who is to blame. Singling out cyclists, HGVs, helmets, headphones, reflective gear, pedestrians, motorists, traffic lights, road layout, alcohol etc is counterproductive… because the factors are numerous, interlinking, complex and poorly understood.

What we will do is invite cyclists, pedestrians and motorists to voice their opinions, share their experiences and challenge our study, to ensure we produce the most accurate information, data and insights possible. The new evidence Bespoke will generate will help transport planners, local councils and healthcare leaders make better, more informed decisions about safety interventions, investment and cycling as a whole.

In the short term, our biggest challenge is to overcome the emotions which have built up over the last few years to form a melting pot of frustration, anger and confusion, from all sides and in all directions. And I can empathise with nearly all of these sides. The positive aspect of this is, that people care and are engaged, which only reinforces the view that the potential for change is great.

On this note I deliver my final comment – an appeal, to everyone, to suspend their emotions, and instead focus this energy towards making the Bespoke project as effective as it can be. We have already involved the cycling community at our public meeting earlier this month, but we need continued input with all road users recording near misses and cycle-related minor injuries on the Collideosco.pe app (past and present). For those with strong views, we welcome their thoughts on our study documents and patient questionnaires – are we asking the right questions to get valuable insights about cycling injury? And finally, because we are 100% reliant on charitable donations, to complete our study we need financial support too. We only hope that everyone, not just cyclists, can realise the value of this investment.

Belinda Dee

Director of Development, Barts Charity



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