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'Zero tolerance of violence against NHS staff should be more than a politician’s mantra'


A story about a trust’s fresh approach to trying to reduce violence against its staff has really grabbed my attention this month.

Featuring North Tees and Hartlepool Foundation Trust, the story has also been at the top of the ‘most popular’ articles list on the Nursing Times website for the past week and it’s been a hit on social media too.

Children of frontline workers at the trust are making a plea to patients and relatives to let staff do their job without fear of abuse. Inspired by a similar campaign by London Underground, the initiative will see photographs of the youngsters being displayed around the trust ready for the winter, when activity is expected to increase and tempers also tend to fray.

“I’ve not seen the North Tees approach of emotionally targetting patients before”

I’ve read and written about moves like beefing up security and pinning cameras to staff uniforms many times, but I’ve not seen the North Tees approach of emotionally targeting patients before.

It reminded me that one of the very first big stories I covered when I became a health journalist was the launch in October 1999 of a ‘zero tolerance’ campaign to combat violence against NHS staff.

The health service in England has maintained that policy ever since, but with seemingly little action to back it up. In fact, NHS Protect, the body that had responsibility for tackling violence towards staff was shut down this time last year.

While its anti-fraud and corruption responsibility went to a new government arms’-length body – the NHS Counter Fraud Authority, NHS Protect’s other key role of promoting the protection of staff and collecting official figures on assaults appeared to vanish, and just when it was needed most.

According to figures published in April this year by Unison and Health Service Journal, physical assaults on NHS staff rose by nearly 10% in 2016-17 compared with 2015-16. The data, collected from 181 NHS organisations that responded to a Freedom of Information request, also indicated that the biggest increase in reported attacks was in the acute sector.

Meanwhile, the last NHS staff survey found more than 15% of NHS staff have experienced violence from patients, their relatives or the public in the last 12 months – the highest figure for five years.

The underlying causes of these worrying increases are, of course, hard to tackle. These include increasing demand for services, staff shortages, the public’s ongoing obsession with the bright lights of A&E and its desire to get completely plastered on a Saturday night.

However, this autumn has seen a flurry of developments at the other end of the issue, addressing response rather than prevention.

In September, a new law came into effect in England and Wales that doubled the maximum prison term from six to 12 months for anyone who attacks NHS staff in the course of their duties.

And, at the end of October, health and social care secretary Matt Hancock revealed a new NHS violence reduction strategy, which includes measures designed to better protect staff.

The strategy should see the NHS working with the police and Crown Prosecution Service to help victims give evidence and get prosecutions in the quickest and most efficient way.

The Care Quality Commission will also assess violence as part of its inspection regime and improved staff training has been promised on responding to violence, including circumstances involving people with dementia or mental illness.

“A zero-tolerance approach should be exactly what it describes”

It is good that action like this is being taken nationally, but its impact – or lack thereof – must also be measured. A zero-tolerance approach should be exactly what it describes; it should not be a half-baked mantra to be trotted out by periodically by politicians when they want to look like they are taking action.

The fact that I’ve been writing about this topic for nearly 20 years is testament to just how little success the approach has had so far.

At a local level, I hope that the North Tees initiative proves successful and that other trusts look at trying something similar.

I’ll leave the last words to Julie Gillon, chief executive at North Tees and Hartlepool, who said: “I hope this campaign acts as a reminder to members of the public that staff work incredibly hard and it is completely unacceptable for them to be subject to any form of violence or aggression.”


Readers' comments (2)

  • What about patients with dementia and mental health issues? Attacked regularly by these but nothing is done because “it’s their condition”

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  • Anonymous - they just put in behaviour based safety, zero tolerance and huddles which many whisper cause and contribute towards under reporting, concentrate on staff, undermine H&S or contribute to fear based cultures. But hey what do nurses know. The gov in my view are a part of this prob, which many feel are causing harm on staff. They listen to directors, ceos and academics but not nurses.

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