Violence prevention and reduction

The violence prevention and reduction programme aims to support NHS organisations and systems to embed a culture where our NHS colleagues feel supported, safe and secure at work.

The NHS Long Term Plan, NHS People Plan and NHS People Promise demonstrate a commitment to support the health and wellbeing of NHS colleagues, recognising the negative impact that poor staff health and wellbeing can have on patient care. More recently, the NHS EDI Improvement Plan further demonstrates our commitment to supporting the NHS workforce.

Violence and abuse toward NHS colleagues is one of the many factors that can have a devastating and lasting impact on health and wellbeing.

The 2023 NHS Staff Survey outlined that:

  • 13.7% of NHS staff who completed the survey have self-reported that they have experienced at least one incident of physical violence from patients, service users, relatives or other members of the public in the last 12 months
  • 27.6% of ambulance staff reported experiencing at least one incident of physical violence from patients, service users, relatives or other members of the public in the last 12 months
  • 25.15% of NHS staff who completed the survey experienced at least one incident of harassment, bullying or abuse in the last 12 months from patients/service users, their relatives or other members of the public which is lower than the previous years

“The vast majority of patients and the public show nothing but respect and thanks for the skilled care they receive, but the unacceptable actions of a small minority have a massive impact on the professional and personal lives of our  colleagues.”  Amanda Pritchard, NHS Chief Executive (February 2022)

Violence Prevention and Reduction Standard

In January 2021, NHS England published the Violence Prevention and Reduction Standard, which intends to complement existing health and safety legislation and support NHS organisations to address violence against NHS staff.   The Standard, which was developed in partnership with the Social Partnership Forum, delivers a risk-based framework that supports a safe and secure working environment for NHS staff, safeguarding them against violence and abuse.  To support organisations to use the Standard, we have also published some accompanying guidance notes.

Supporting the education and training of NHS staff

NHS England are committed to supporting colleagues in relevant security management and violence prevention roles to feel upskilled and able to do their job to the best of their abilities.  As such, an accredited educational pathway has been developed and made available, consisting of several qualifications ranging from Level 3 to Level 7.

This education pathway focusses on the public health approach of understanding the root causes of violence and abuse, before then taking appropriate steps to prevent and reduce violence against our staff.  The pathway supports attendees to move away from a zero tolerance approach and consider why incidents are occurring, for example due to individual-specific factors (such as trauma and distress) and structural, environmental, and societal factors (such as the impact of health inequalities).

The pathway has been developed and delivered by two key educational partners:

  • The Royal Society for Public Health – delivering the Level 3 and Level 4 training
  • Liverpool John Moore’s University – delivering the Level 7 training

A limited number of places have been funded by NHS England for colleagues who are based in roles considered to be exposed to a high level of risk to violence and abuse.  These include, but are not limited to, areas such as:

  • acute care
  • specialist secondary care
  • mental health
  • ambulance trusts

The pathway will be available for national roll-out late 2023.  You can register your interest in attending via The Royal Society for Public Health (RSPH) website.

Working with the ambulance sector

Piloting bodyworn cameras in ambulance trusts

NHS England has provided £8.4 million to all 11 Ambulance services for the procurement and evaluation of a three year body worn camera trial.  Alongside this dedicated funding, an independent national evaluation partner has been commissioned to draft the independent evaluation of the rollout, feeding data and information into the analysis and evaluation.  This will help determine if body worn cameras can help to reduce violence against NHS ambulance staff, and provide learning for other sectors around the implementation and operation of these cameras in NHS services.

Violence Prevention and Reduction Hub

NHS England has commissioned the Association of Ambulance Chief Executives (AACE) to deliver a new Violence Prevention and Reduction Hub, specifically designed for NHS ambulance services. Initially funded for two years until May 2024, and extended to March 2025, work on a series of workstreams to support the ambulance sector’s efforts to improve staff safety is underway. These include:

  • Data and information: Share best practice, expertise, and information about all aspects of violence prevention and reduction across the ambulance sector.
  • Education: Promote new and innovative ways to extend skills and knowledge across the sector to help combat the challenges of violence and abuse.
  • Collaboration: Facilitate a culture of collaborative working through several key workstreams assisting and supporting the ambulance sector, providing a consistent process when managing violence and aggression.

To learn more about this work on the Association of Ambulance Chief Executives website.

Work without fear – comms campaign

#WorkWithoutFear was developed in collaboration with the Association of Ambulance Chief Executives (AACE), as a national communications campaign in response to the rising levels of verbal and physical violence against NHS ambulance personnel working in Emergency Operations Centre (EOC) and on the frontline when caring for patients.

The key objective was to portray ordinary people doing an extraordinary job and highlight the profound impact that violence and abuse can have on the everyday lives of ambulance staff and encourage the minority to have respect for the people who are trying to help them, their friends, and families when they need it most.

All the assets were developed using real-life case studies from staff in NHS ambulance trusts in England and work is currently underway to develop further case studies for future promotion. Hear real life stories from Ambulance colleagues and find out how you can support the campaign on the Association of Ambulance Chief Executives website.

Understanding the impact of violence on our workforce

Since NHS Protect was disbanded in 2016, there has been no national data collection of incidents of violence and abuse towards our NHS colleagues.  In order to address this, NHS England are working in collaboration with a number of key partners and organisations to better understanding the nature, extent and impact of work-based violence, harassment and abuse to NHS staff across all healthcare settings, as well as identifying examples of good practice that can inform future interventions.

Further resources and useful links