- Conditions of entry and exit of vehicles and road users to the road network
- Funding and resource allocation
- Institutional management functions
- Monitoring and evaluation
- Multi-sectoral co-ordination
- Planning, design, operation and use of the road network
- Recovery and rehabilitation of crash victims from the road network
- Research and development and knowledge transfer
- The evolution of road safety management for results
- The road safety management system
- The road safety management system
In good practice road safety management, 'results focus' is the overarching institutional management function . It determines the country's level of ambition for road safety and takes into account the interventions and institutional arrangements which need to be put in place in order to realise it.
Results focus involves:
- Appraising current road safety performance through high-level strategic review
- Adopting a far-reaching road safety vision or goal for the longer term
- Analysing what could be achieved in the shorter term and proposing targets
- Agreeing targets across the road safety partnership and ensuring stakeholder accountability for results
All other management functions influence this activity. In the absence of a clear focus on results, all other institutional functions and related interventions can lack cohesion and direction and the efficiency and effectiveness of safety programmes can be undermined  .
Countries have become progressively more ambitious in terms of the results desired culminating in safe system approaches which today represents the new performance frontier for road safety management requiring ambitious long term goals and interim targets, exacting intervention strategies and strengthened institutional management systems.
Appraising current road safety performance through high-level strategic review
OECD  Recommendation:
Countries experiencing difficulty in improving their road safety performance should as a matter of urgency conduct high-level reviews of their safety management capacity and prepare long-term investment strategies and related programs and projects to overcome revealed capacity weaknesses.
The first recommended step when formulating new long term goals, interim targets, strategies and programmes is a systematic country capacity review of the road safety management system. The aim is to achieve a clear overview of country organizational needs to understand present road safety performance - what is working and where there is room for improvement - and to specify or better specify challenging but achievable road safety outcomes in the national road safety strategy.
The process of appraising current road safety performance involves high-level multi-sectoral strategic examination of a range of activity and involve senior management from the key governmental agencies - Transport, Police, Health, Justice and Education, who may not all be actively engaged as yet (the WHO called on the health sector to engage more actively) - as well as all other stakeholders who are able to contribute to the delivery of road safety results.
What public health can do
- Include road safety in health promotion and disease prevention activities
- Set goals for the elimination of unacceptable health losses arising from road traffic crashes
- Systematically collect health-related data on the magnitude, characteristics and consequences of road traffic crashes
- Support research on risk factors and on the development, implementation, monitoring and evaluation of effective interventions, including improved care
- Promote capacity building in all areas of road safety and the management of survivors of road traffic c crashes
- Translate effective science-based information into policies and practices that protect vehicle occupants and
- vulnerable road users.
- Strengthen pre-hospital and hospital care as well as rehabilitation services for all trauma victims
- Develop trauma care skills of medical personnel at the primary, district and tertiary health care levels
- Promote the further integration of health and safety concerns into transport policies and develop methods to
- facilitate this, such as integrated assessments
- Campaign for greater attention to road safety, based on the known health impact and costs
World Report on Road Traffic Injury Prevention, 2004 
The World Bank has developed a 'state of the art framework' which its uses routinely for systematically assessing the performance of a country's road safety management system. The framework has been tested in low, middle and high income countries . Checklists are used by safety management experts to assess country capacity across good practice dimensions of institutional management functions, interventions and results  .
A recent independent review of road safety in Sweden highlighted the highly advanced nature of its road safety management system when benchmarked internationally, but still found that it required considerable strengthening to ensure the achievement of its ambitious goal of death and serious injury elimination .
Overview - Independent review of road safety in Sweden
- Sweden is a world leader in road safety performance having achieved continuous improvement towards one of the lowest death rates globally.Sweden works to highly ambitious long term and interim road safety goals and has developed innovative strategies and solutions which have inspired and engaged national stakeholders as well as road safety professionals worldwide.
- The review acknowledged, at its outset, that Sweden's road safety management system is in a highly advanced phase of development when compared internationally. The higher the level of ambition, however, the more robust the road safety management system is required to be. Sweden has embarked upon a bold path and Vision Zero demands a new level of high performance and responsibility which needs to be shared by both the providers and the users of the system. Based on national and international good practice and information provided by senior management of stakeholders in Sweden, this independent review has identified some scope for future action.
- Achievement of the long term goal of death and serious injury elimination influences management functions and interventions in ways that differ profoundly from typical targeted approaches of the past. It requires both a shift to a more protective system (separating dangerous mixed road use as, for example, is being done with median barriers, better speed management, more crash protective roads and vehicles, good recovery and rehabilitation mechanisms) as well as achieving higher levels of user compliance with the design parameters set for the system in terms of speed and use of safety equipment.
- Sweden is in the 'establishment' phase of its journey towards Vision Zero. The next challenge, in view of Sweden's highly ambitious goal, is to achieve rapid 'growth' in the delivery of accountable, well-orchestrated, and effective Vision Zero activity. This is expected to include the continuation and deepening of essential long term work either underway or envisaged, as well as sharper multi-sectoral focus on interim goals to prevent death and disability in the short term. Short term gains can be expected from conventional interventions derived from national and international best practice, while improvement of the protective features of the network and the vehicle fleet will bring big benefits in the longer term.The new interim target(s) to 2020, and the related strategy and programme will establish the next phase of 'growth' for Vision Zero.
Source: Breen, Howard & Bliss, 2008 .
Adopting a far-reaching road safety vision or goal
OECD  Recommendation:
Adopt a highly ambitious vision for road safety
All countries are advised to adopt and promote a level of ambition that seeks in the long term to eliminate death and serious injury arising from use of the road transport system. Adopting this ambition will alter the community's view of the inevitability of road trauma, alter institutional and societal responsibilities and accountability and change the way in which road safety interventions are shaped.
This is an aspirational vision in that achievement will require interventions that are some steps removed from prevailing best practice and will require the development of altogether new, more effective interventions. Part of its value lies in driving innovation. The long term vision needs to be complemented with interim targets for specific planning periods up to a decade or so.
European countries are increasingly adopting long term visions or goals for road safety e.g Vision Zero and Sustainable Safety. Experience indicates that complacency about death and injury in society can be shaken and sights raised by adopting a vision or philosophy for road safety which can relate to the general public . Far reaching visions of total road safety promote a level of ambition that goes beyond incremental performance gains and the implicit acceptance of death and injury that will be determined by the rate of improvement shown by the best performing countries. These desired longer term results, together with interim targets, underpin the national road safety strategy and help to create a sympathetic climate for the introduction of effective interventions .
Vision Zero is presented as a long-term, objective for a traffic system where the amount of biomechanical energy to which people can be exposed without sustaining serious injury is the basic design parameter. Sweden has set a new performance frontier for road safety management and the adoption of a long term goal for eliminating death and serious injuries, supplemented by a range of interim casualty reduction targets, is strongly recommended by the OECD . As with the Sustainable Safety strategy being implemented in the Netherlands which has a similar safe system strategy, Parliamentary scrutiny and approval stimulated public debate and prepared the way for future successful work . The Nordic countries have all adopted a policy based on the Vision Zero strategy. Switzerland's Via Secura theme and the Safe System concept adopted in the Australia States are also derived from the Vision Zero philosophy.
These long-term goals and strategies for a Safe System require fundamental and wide-scale re-working of various aspects of the design and operation of the national traffic system, to achieve better interface between human, vehicle and road environment as outlined in OECD Towards Zero: Achieving Ambitious Road Safety Targets through a Safe System Approach .
Analyzing what could be achieved in the medium term
This entails analysis by a high-level expert group of the identification of the most important road casualty problems throughout the road traffic system on the basis of data analysis, survey and research. It involves survey of the current safety performance of different aspects of the traffic system, analysis of information on the effectiveness of different countermeasures in achieving road safety outcomes, socio-economic appraisals and the identification of useful implementation tools . This analytical activity usually involves a high-level multi-sectoral group supported by advisory groups comprising in-house, external research expertise and sometimes technical experts from abroad.
- Use of a sound methodology
Effective national target-setting requires a sound statistically based methodology to set credible casualty reduction targets. Several countries have used models which provide a powerful means of organizing available knowledge and thinking systematically about the future development of road transport and its safety     . The model used for the development of the New Zealand 2010 targets can be used to determine what target is achievable with given amounts and types of interventions and to determine the amounts and types of intervention needed to achieve a given target .
- Forecasting future trends on the basis of past performance
The starting point is analysis of past and current safety performance and on the basis of this forecasting what may be realistically achieved in future with additional efforts. The first stage of the forecasting process consists of developing statistical models that explain past changes in the casualty numbers for different user groups with reference to measures of the changing exposure to risk of these groups, including the amount of motor traffic and the average distances walked and cycled per person per year; and available information about the effectiveness at the national level of measures that have influenced casualty numbers substantially .
- Identifying the potential for further improvements
The forecasting process produces a wide range of results reflecting different scenarios about the future development of road transport and road safety measures. Scenario planning and computer modelling is often used to predict possible outcomes. Assessment of future long-term casualty, traffic and demographic trends is also necessary to understand underlying factors which may influence achievement of future results.
Working papers analysing a range of countermeasures in terms of their cost-effectiveness and public acceptability are developed to inform target-setting and strategy development (e.g.   . These working papers are typically published at the same time of the road safety strategy. Information is derived from surveys, practical trials or from national or overseas experience of successful implementation effectiveness of policies. During the last forty years a substantial international knowledge base of effective interventions has grown up to inform national policymaking and road safety planning  . At the same time, exacting safe system strategies and innovative intervention which take better account of human limitations are being used increasingly and with some good results  .
Socio-economic appraisals need to be carried out to determine the best use of public resource to meet the objectives. Selecting measures and ensuring that maximum returns are realized entails the benefits of road safety measures needed to reach safety targets to be quantified and ranked, using cost-effectiveness, multi-criteria analysis and cost-benefit analysis or a combination of these methods.
Cost-effectiveness analysis In cost-effectiveness analyses the costs of a measure are set against its effects. The measure's effects are not expressed in monetary terms. Starting from a given safety target and budget, this method identifies the path which will produce the highest casualty savings. Policy measures are ranked according to their estimated cost-effectiveness ratios. Cost-effectiveness analysis is widespread in OECD countries (e.g. Finland, the Netherlands, and the United States). An ETSC review in 2003 identified a variety of cost-effective measures which could be adopted by the European Union .
Multi-criteria analysis is a qualitative method which is more complex than other appraisal options. It assesses the impact of a measure against a wide range of general objectives. Value scales and weighting schemes are used to indicate a value trade-off between criteria and objectives. Such analyses are also commonly used in OECD countries.
Cost-benefit analysis in an essential road safety resource allocation tool in best practice countries. The result is obtained by comparing crash and injury costs with benefits of avoiding the crash and injury. Avoiding such crash and injury costs represents the economic benefit of road safety measures. The benefit-cost ratio represents the economic advantage of the safety measures . Cost-benefit analysis requires the valuation of lives saved and injuries avoided. Some best practice countries adopt values of statistical life, based on estimates of peoples' "willingness to pay" for small reductions in risk. Others adopt a "gross output" or "human capital" approach which values the loss of current resources and losses in future output, and sometimes adds a significant sum to account for related "pain, grief and suffering". Other measures can also be used, such as those based on the values revealed in "court awards" to surviving dependents. Given the limited availability of robust data, cost benefit analysis is not yet used widely, but it is the preferred tool of road safety professionals. In the absence of such data, cost-effectiveness can be used to select and rank the most effective measures, once a target has been set.
Public opinion survey data Covering representative samples of road user opinion are helpful in establishing levels of understanding and support for different interventions. These can often be used to place the contributions of narrowly focused lobbies into an appropriate context  . Most road safety lead agencies put in place public opinion tracking, usually with an outside agency to monitor the public acceptability of different measures. The European Social Attitudes to Road Risk in Europe (SARTRE) survey is a cross national study of attitudes to road safety. In it, about 1000 driving license holders per country are questioned about their opinions on road safety measures, danger perception in traffic, about road accident causes, their own behaviour and that of other road users, and about their experiences with police surveillance  .
Setting targets by mutual consent across the road safety partnership
Set interim targets to move systematically towards the vision
Ambitious, achievable and empirically-derived road safety targets should be adopted by all countries to drive improved performance and accountability. These targets should be developed by using a methodology that links interventions and institutional outputs with intermediate and final outcomes to develop achievable targets for different intervention options.
Exceptional efforts will be required in most OECD and ITF countries to achieve the road safety targets set by Transport Ministers in 2002 - 50% reduction in deaths between 2000 and 2012, or similar ambitious targets. Accordingly, it is recommended that targets based on expected outcomes from specified interventions now be established, as a means to move more systematically towards the level of ambition established by the targets set in 2002.
An effective process depends upon effective governmental lead agency direction and coordination, good in-house support, technical support from independent experts and consultation with a wide range of stakeholders to identify a system-wide programme of effective and implementable intervention .
In good practice, target-setting is the responsibility of the lead agency and the coordinating body since the realization of outcome targets is a multi-sectoral shared responsibility across Government.
Long term goals and challenging but achievable interim targets
It is recognized good practice that national road safety strategies include achievable performance targets for the interim, with their achievability being determined by both the country's institutional management capacity and the technical performance boundaries of the interventions implemented. However, longer-term ambition can go beyond what can be achieved with current and projected means, and in leading countries the goal of eliminating deaths and serious injuries has been set and requires a shift to the safe system approach to bring the road system into line with the safety performance expectations for other modes of transport.  .
Empirically derived targets
In good practice, the interim targets proposed by the lead agency and/or the coordination body are based on research and analysis of how targets can be reached. These are then submitted for Ministerial/Cabinet approval and Parliament. The activity is driven by the lead agency which reviews safety performance, identifies priorities, and organizes the other key government stakeholders to consider and approve proposed outcomes. An achievable but challenging target requires a sound relationship to be established between targets and measures and the ownership and commitment of all the affected stakeholders. A strong alliance between political leadership and professional management is crucial.
Establishing mechanisms to ensure stakeholder accountability for results
Public service targets and agreements are typically the means by which governments and agencies demonstrate their role and accountability for road safety responsibilities.
Examples of lead agency annual performance agreements
Victoria: The roles and responsibilities of VicRoads, Victoria Police and the Transport Accidents Commission are set out in the road safety strategy, annual plans and performance agreements. The Chief Executive of VicRoads has reducing road crash death and injury as a formal criterion in the performance-driven employment remuneration package. Reducing road casualties by 20% by 2007 as targeted in the national strategy Arrive Alive! is one of four policing performance targets in Victoria Police's published plan for 2003/4. Accountability for local road safety activity is established through a combination of funding mechanisms and performance indicators. Specifically allocated funding is made available to Community Road Safety Councils for targeted road safety activity and VicRoads works to specific performance targets associated with this program, the results of which are published annually.
New Zealand: Since 1989, public finance law in New Zealand has required all government agencies to prepare annual corporate management information, which includes performance targets, objectives and scope of activities17. The road safety targets which each National Road Safety Committee member has signed up to and the systematic follow through which is conducted to determine the success or failure of specific actions are the cornerstone of New Zealand's road safety performance assessment regime. The lead agency for road safety has to submit an Annual Performance Agreement with the Ministry of Transport covering road safety activity for the next twelve months18.
Sweden: The Swedish Road Administration's (the lead agency) responsibilities for road safety are set out every year in performance agreements in its Annual Report. The SRA target is to contribute to a reduction in the number of deaths and serious injuries and the number of deaths in road traffic is to be no more than 270 in 2007. Annual goals are specified in performance agreements. For example in 2003, the specified goal was to implement cost-effective road safety measures on the state road network so that the number of deaths is reduced. Measures that aim to improve traffic safety of children are to be prioritized. The outputs and contributions of other key stakeholders are based on formal Declarations of Intent.
Britain: The Department for Transport's Public Service Agreement target is to reduce the number of people killed or seriously injured in Great Britain in road accidents by 40%, and the number of children killed or seriously injured by 50% by 2010 compared with 1994-98, tackling, at the same time, the significantly higher incidence in disadvantaged communities. The Department's Highways Agency also has a specific Public Service Agreement target to reduce casualties on national roads and has produced a 5 year road safety plan
Bliss and Breen, 2008 
Police performance management framework in New Zealand
To encourage and promote good quality service delivery and to maximise the effect of enforcement on meeting the 2010 road safety targets New Zealand Police work within a performance management framework.
The performance framework considers both outcomes (aims and objectives) and outputs (enforcement) and has been put in place to promote the effectiveness and efficiency of the enforcement delivered in order to maximise the effect on the desired outcomes.
Outcomes include road deaths, serious injuries and crashes as well as other intermediate outcomes relating to driver behaviour. Some examples of the behavioural outcomes that might be influenced by enforcement include mean speeds and the percentage of offenders driving in excess of 10 kph above the limit. These outcomes often relate to 2010 road safety targets.
Outputs include strategic offences per hour delivered (for speed, drink driving, restraints and visible road safety) and these are generally referred to as productivity measures and intended to maximise the efficiency of enforcement. Other quality-focused outputs are intended to maximise the effectiveness of Police enforcement by targeting particular behaviours. These outputs include the percentage of tickets issued in the lowest speed band above the 10 kph tolerance and the percentage of visible road safety offences that relate to manner of driving and driver duties and obligations (eg crossing the centre line, failing to give way).