Physical assaults on NHS staff increased by nearly 10% last year, with nurses reporting that staffing pressures have contributed to the rise in incidents.
New figures obtained via a Freedom of Information request reveal a worrying leap in attacks on health workers, with the biggest increase seen in the acute sector where assaults were up by 21%.
“Staff shortages are harming patient care and helping to create a hostile environment”
The data was obtained by the Health Service Journal (HSJ) on behalf of health union Unison, which warned that staffing shortages were adding to a “hostile environment”.
Freedom of Information requests were submitted to all 244 trusts in England, with responses received from 181. The results were revealed today at the union’s health conference in Brighton.
The trusts who responded reported a total of 56,435 physical assaults on staff on 2016-17 – a 9.7% increase on the 51,447 reported the previous year.
If those figures were extrapolated to cover the whole of the NHS in England, the number of reported violent incidents in 2016-17 is likely to be closer to 75,000 – the equivalent of 200 every day, according to report authors.
When measured per 1,000 staff – and taking into account increases in the NHS workforce – the rise in reported assaults was still up 6% on the 2015-16 figures.
“This desperate situation is only set to worsen as the squeeze on resources gets tighter”
The figures – which form the basis of a wider report on the issue of violence against staff – suggest that trusts struggling to meet performance targets were likely to fare particularly badly, as were those struggling with financial deficits.
Alongside the data analysis, Unison also spoke to a number of NHS staff about their experiences on the frontline.
One nurse described how she was regularly on the receiving end of abuse and had been slapped by patients. She recently witnessed a colleague being punched in the face.
She said the growing number of patients with dementia and delusions were part of the reason for the increasing number of assaults, and staffing shortages were makings things worse.
Another nurse, who works in an acute admissions unit, told Unison he had witnessed a colleague being threatened with a knife and seen a patient hurl a chair through a window.
He said he was regularly scratched and even bitten by dementia patients and also described a distressing situation where it took four staff to restrain a patient in order to give essential treatment.
Unison said it asked HSJ to carry out the research because it was concerned that, since the abolition of NHS Protect, data on assaults was not being looked into properly.
The body, which used to be responsible for collating data on assaults and taking action to prosecute offenders, was scrapped last year.
Unison’s head of health Sara Gorton called for the decision to axe NHS Protect to be reversed.
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“Across the entire NHS, staff shortages are harming patient care and helping to create a hostile environment where health workers are increasingly at risk of being assaulted,” she said.
“It’s no accident that trusts where the pressures seem the most extreme – where there are huge financial deficits or where it’s a struggle to meet growing demands on services – have seen the steepest rise in the number of attacks,” she said. “This desperate situation is only set to worsen as the squeeze on resources gets tighter.
“Now that there is no NHS or government organisation collecting data on assaults nationally, the picture is growing increasingly unclear. The safety of staff, who care for us when we are sick or injured, and their patients should be paramount,” she added.
Although the figures show staff working in mental health were seven and a half times more likely to be attacked, there was a smaller increase of 5% in the number of attacks.
It suggests the sector may be having some success in preventing a difficult situation getting any worse, suggest the report authors.
- Staff survey shows rise in stress levels, staffing concerns and attacks
- A&E nursing staff ‘resigned to being abused by patients’
- Violent attacks on mental health staff rising with shortages
For example, Mersey Care NHS Foundation Trust’s “No Force First” approach – which includes the ambitious goal of eliminating the use of restrictive interventions – has helped improve the experiences of patients and create a safer environment for staff.
The report also features a number of case studies on the action being taken to counter violence by other types of trusts.
For example, Guys and St Thomas’ NHS Foundation Trust has trialled video-recording bodycams for accident and emergency staff and found they had a “very positive effect”.
Its multi-faceted approach has also included giving staff training on conflict resolution, providing lone worker alarms to community staff and liaising more closely with community psychiatric nursing colleagues and GPs, who may have useful knowledge of patients.
Danny Mortimer, chief executive of NHS Employers, said: “All NHS workers should feel able to perform their vital jobs without the fear of violence. The NHS has a zero-tolerance attitude towards violence and can pursue legal action against offenders whenever appropriate.
“It is also the case that there must be improved support to services and teams where there are clinical conditions affecting patient behaviour,” he said. ”Organisations are also taking measures to prevent violence and in particular ensure that staffing levels reduce risk to our people.”
More news from the Unison annual health conference:
- Safe staffing studies ‘needed to reveal scale of problem’ in community
- Unison starts NHS pay consultation with call to accept deal
- Healthcare staff to press government and trusts for ‘vital’ CPD funds
- NHS spending millions on private staff outsourcing, claims union