News Roundup [abridged Versions Appear In The Paper Journal]

Attacks on NHS staff increasing, MPs say

BMJ 2003; 327 doi: (Published 24 July 2003) Cite this as: BMJ 2003;327:182
  1. Owen Dyer
  1. London

    The British government is failing to meet self imposed targets on reducing attacks on NHS staff, a report published this week by the Parliamentary committee has said.

    The House of Commons Public Accounts Committee said that the number of reported incidents is “clearly going in the wrong direction,” with nurses at particularly high risk.

    According to the British crime survey 2000, nurses run a 5% risk of being violently assaulted at work in a given year, compared with 1.2% for the average worker. The risk for other healthcare workers, including doctors, is 1.4%.

    The Department of Health set targets in 1999 for reducing incidents of violence against staff by 20% by 2001 and 30% by 2003. Instead, 2000-1, 84 214 incidents of violence and aggression against NHS staff were reported, an increase of 30% over 1998-9. This increase has continued, with 95 501 reported incidents in 2001-2. Only a fifth of NHS trusts achieved the 2001 target.

    The Department of Health, however, told the Public Accounts Committee that it is far from clear whether these figures represent a real rise in attacks or are due to a greater willingness on the part of staff to report incidents. At the time the targets were set, the Department of Health also launched other initiatives, such as the “zero tolerance zone” website, to encourage staff to come forward. Moreover, verbal abuse is increasingly considered to be a form of assault and is reported as such.

    Incidents involving serious physical abuse, which by law have to be reported to the Health and Safety Executive if they result in more than three days off work, appear to be coming down. The number of serious injuries to NHS staff due to violence at work is also falling, from 82 in 2001 to 64 in 2002.

    The Public Accounts Committee recommended that trusts adopt the European Commission's standard definition of workplace violence, which is “any incident where staff are abused, threatened or assaulted in circumstances related to their work, involving an explicit or implicit challenge to their safety, well being or health.” The Department of Health also promised to do more to evaluate the costs to the NHS of violence against staff, and particularly, via exit interviews, to find if violence was instrumental in driving people to leave the NHS.

    The report also urges the Department of Health to assess the effectiveness of various deterrent measures, such as withholding treatment from violent patients or bringing in police or security guards. Although such measures are known to reassure staff, there is still no empirical evidence to show that they deter offenders.

    The report, A Safer Place to Work: Protecting NHS Hospital and Ambulance Staff from Violence and Aggression, is available at

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