More than 8,800 serious industrial injuries to nurses, midwives, and healthcare assistants have been reported at NHS organisations over the past three years, figures released exclusively to Nursing Times show.
The figures, obtained under the Freedom of Information Act, reveal for the first time a complete record of work-related injuries, dangerous occurrences, and diseases reported to the Health and Safety Executive by the NHS between 2008 and 2011.
Of the 20,547 work-related injuries reported to the executive by NHS organisations, 8,828 were to nurses, nursing auxiliaries and assistants, and midwives. Among the injuries they suffered were 2,057 sprained backs, 300 broken arms or legs, 50 fractured skulls, five amputated fingers, and one loss of sight.
These were just the accidents classed as “reportable” by the HSE - meaning they caused major injury, left a person unfit for work for more than three days, or resulted in a death not caused by medical accident.
They are likely to represent just a fraction of the industrial accidents suffered in the NHS by nurses. The HSE estimates that, across all industries, 43 per cent of the injuries it should have been told about went unreported in 2009-10.
The figures do offer some cause for optimism. The annual number of injuries to nurses, midwives, and healthcare assistants in the less serious “over-three-day” category has fallen 18 per cent over the past three years, from 2,823 in 2008-09 to 2,325 in 2010-11.
However, the annual reported number of major injuries to these workers has barely altered over the same period. It rose from 417 in 2008-09 to 429 in 2009-10, before falling slightly to 404 last year.
Unions warned that the fall in “over three day” injuries might be due in part to “aggressive” drives by NHS organisations to cut sickness absence.
Unison assistant national officer Robert Baughan told Nursing Times: “We are hearing some branches pointing to areas of good practice, but there are also examples of draconian approaches, which could be putting pressure on staff to return to work before they’re ready.”
Royal College of Nursing employment relations officer Nicola Lee said a number of NHS employers were now “taking a much more aggressive approach to absence management”.
“Of course that would discourage somebody from taking as much time as perhaps they might need,” she said. “But for a major incident, if you’re put in hospital by somebody assaulting you, you can’t hide that,” she said.
Between 2006 and 2010 the HSE-reported rate of over-three-day injuries to all health workers also fell, from 522.9 to 462.3 per 100,000 employees, while the rate of major injuries rose from 76.8 to 85.1.
But Ms Lee added there were also many trusts taking health and safety responsibilities more seriously, and it was possible the decline in reported injuries was due in part to initiatives like mandatory manual handling training.
The figures released to Nursing Times show that in the past two years physical assault rose to replace handling accidents as the second biggest cause of major injuries to nursing staff and midwives, after slips and trips.
Unite national officer for health Fiona Farmer said the rise was “to be deplored”. She added: “An increased security presence in hospitals may, unfortunately, be the answer, which obviously takes money away from providing frontline care.”
NHS Employers director Dean Royles said assaults against staff continued to be “a real concern” but employers were “working with staff to ensure that support is in place”. He added that the NHS Staff Survey showed “modest but promising improvements” in reporting of incidents of physical violence, and confidence that employers would take effective action.
In addition to injuries, the NHS reported 855 dangerous occurrences to the HSE between 2008-09 and 2010-11, of which 585 were classed as the release of “a biological agent likely to cause human infection or illness”.
A spokeswoman for the executive said it believed the “vast majority” of occurrences reported in this category were needlestick injuries. In most cases, needlestick injuries are only reportable to the HSE when an employee is injured with a sharp contaminated with a blood-borne virus, such as hepatitis B or C, or HIV, HSE guidance states.
Injury in the NHS: The major hazards for nurses
While this remains the leading cause of injuries to nursing staff and midwives, numbers reported have dropped 26% over the past three years. An HSE spokeswoman said the “downward trend of over-three-day injuries” relating to musculoskeletal disorder was “encouraging”. She added: “Many trusts have adopted the use of electric profiling beds which greatly help reduce injury as a result of manual handling”.
Slips and Trips
These were the leading cause of the most serious category of injuries to nursing staff and midwives in each of the past three years, although numbers dropped in 2010-11. The HSE said it was currently investigating the causes of a “significant increase” in major injuries of this kind to health and social care workers. Its website, http://www.hse.gov.uk/shatteredlives gives health sector-specific guidance to prevent slips and trips.
The number of major injuries caused by physical assault to nursing staff and midwives rose from 50 in 2008-09 to 63 in each of the following two years. Unison assistant national officer Robert Baughan said examples of good practice included improved risk assessment and ensuring patients with records of poor conduct were treated in environments which did not leave staff vulnerable to assault.
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