Workplace violence

NHS staff and other healthcare workers have a right to expect a safe and secure workplace. However, recent reports indicate that these staff can be as much as 4 times more likely to experience work-related violence and aggression than other workers.

The National Audit Office report ‘A Safer Place to work – Protecting the NHS Hospital and Ambulance Staff from Violence and Aggression’ [150KB] was published in March 2003. It found that nurses and other NHS staff who have direct interaction with the public, for example, ambulance and accident and emergency staff, and staff who work in acute mental health units, have a higher risk of exposure to violence and aggression.

The negative consequences of violence are also well documented. It has been estimated that stress and violence together possibly account for approximately 30% of the overall costs of ill-health and accidents.

Verbal abuse and threats are the most common types of incidents. The majority of activities which trigger violence episodes involve employee interaction with people from all sections of society, many of whom are needy and vulnerable. Complications can arise, some cases can be predicable, others can not.

Employers must assess the risk of verbal and physical violence to their employees and take appropriate steps to deal with it.

These steps might include:

• providing suitable training and information;
• improving the design of the working environment (such as providing physical security measures); and
• making changes to aspects of the staff roles.

Recording incidents of verbal abuse and physical violence can help employers check for patterns and so help to predict the type of incidents that could occur. Employers must notify their health and safety enforcing authority if any act of non-consensual physical violence done to a person at work results in their death, serious injury or incapacity for normal work for three or more days.

HSE carry out periodic inspections of NHS Trusts to review the arrangements in place to deal with workplace violence.

There are a number of other strategic interventions underway to tackle this problem across England, Scotland and Wales

• England the NHS Counterfraud and Security Management Service
  are leading a programme of work which has developed from the Zero Tolerance Campaign.
• Wales the Welsh Assembly [470KB]
  have launched the All Wales NHS Violence and Aggression Training Passport and Information Scheme.
• Scotland a Zero Tolerance Campaign
  is being coordinated by the Scottish Executive.

Research

• Research projects related to violence in healthcare