Violence prevention and safety

The primary aim of the violence prevention programme is to embed a culture where our NHS colleagues feel supported, safe and secure at work.

The NHS Long Term Plan and the NHS People Promise both demonstrate a commitment to the health and wellbeing of NHS colleagues, recognising the negative impact that poor staff health and wellbeing can have on patient care. Violence and abuse toward NHS colleagues is one of the many factors that can have a devastating and lasting impact on health and wellbeing. Therefore, a fundamental part of our partnership work around health and wellbeing is focused on the prevention and reduction of violence and abuse toward NHS colleagues.

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 Exceutive (February 2022)

The 2021 NHS Staff survey, of which there were nearly 600,000 responses from 220 NHS trusts, found that:

  • 14.3% of NHS staff 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. In the ambulance sector, our paramedics have experienced a much higher volume of abuse (31.4%).
  • The impact on staff is significant, with violent attacks contributing to 46.8% of staff feeling unwell as a result of work-related stress in the last 12 months, with 31.1% said thinking about leaving the organisation.

Violence Prevention and Reduction Standard and accompanying guidance

In January 2021, NHS England and NHS Improvement in conjunction with the Social Partnership Forum published the new national Violence Prevention and Reduction Standard, which complements existing health and safety legislation. Employers, including NHS organisation, have a general duty of care to protect staff from threats and violence at work.  The standard delivers a risk-based framework that supports a safe and secure working environment for NHS staff, safeguarding them against abuse, aggression, and violence.

In addition to this Standard, we will be publishing a National Violence Prevention and Reduction Guidance document which will further support Trusts in working through the Standard’s aims and requirements.  This is due to be published in Spring 2022.

Violence prevention reduction and public health course

We are pleased to be funding 50 places for NHS staff on the CPD Violence prevention, reduction and public health online course with Liverpool John Moore University. The course is aimed at NHS colleagues who currently have a role within aggression and violence management in security and or clinical settings in the NHS.

The programme aims to provide learners with the public health skills and knowledge to devise, plan and implement a violence reduction project in the workplace or community. Learners will also develop their ability to strengthen the capability of front-line staff through a combination of taught sessions, action learning, and project implementation and evaluation.

Candidates will need to submit a 1000-word essay and have line managers approval when applying for the course. One place per ICS will be offered.

There are two online CPD courses available both awarding 30 credits – one at Level 6 and the other at Level 7. For more information on the courses and how to apply, click below:

If you have any questions relating to the course, please contact:

Work without fear campaign – Association of Ambulance Chief Executives

Working together with the Association of Ambulance Chief Executives (AACE), a national communications campaign is being developed in response to the rising levels of aggression, verbal and physical assaults against NHS ambulance staff in control rooms and on the frontline when caring for patients.

This campaign #WorkWithoutFear will launch in early Spring 2022 with a PR campaign, posters, video and social media assets for use by communications teams in ambulance trusts across the country.

Our key objective is to portray ordinary people doing an extraordinary job. All the examples you see are based on real-life case studies that have been collected from staff in NHS ambulance trusts in England over the past three months.

Hear real life stories from Ambulance colleagues and find out how you can support the campaign here.

Supporting staff working within the Ambulance Sector

NHS England and NHS Improvement have now 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.

Working in partnership with the association of Ambulance Chief Executives (AACE), NHS E&I have also supported the development of a national Ambulance Violence Prevention Hub to facilitate shared learning and improve coordination of activity.

National violence data collection

NHS organisations have a duty, as far as it is reasonably practical, to protect the health, safety, and welfare of staff under the 1974 Health and Safety at Work Act. This includes the prevention of risk and harm, in which incident recording and data collection is a part of.  Since NHS Protect was disbanded in 2016, there has been no national data collection, relating to violence, abuse and aggression, against our NHS colleagues. There is, however, national data collection within the ambulance sector.

NHS E&I are now working with a number of NHS trusts to establish a consistent, coherent approach to inform evidence-based solutions for collecting data on violence, with an aim to ultimately improve data collection across all trusts and analyse data fields to ensure alignments to the NHS Violence Prevention and Reduction Standard.

A further project is being undertaken to explore what data, evidence and research is currently available, through an open source, desk-top exercise.  This will examine incidents against our NHS colleagues, causation, themes and trends, and sectors and staff groups most at risk.

Further resources

Case studies

Body worn cameras pilot: North East Ambulance Service NHS Foundation Trust successfully piloted body worn cameras with their ambulance crews in 2018. The Trust worked in partnership with trade unions to implement the pilot. Due to the successful launch, NEAS expanded the pilot and there are now in excess of 100 ambulance staff using the devices.

NHS England and NHS Improvement have invested £2.1 million in a national body worn camera pilot to run in 2021-22. An independent evaluation has been commissioned to support future plans.

All 10 ambulance trusts have signed up to this commitment and will pilot their cameras from April 2021 onwards.

De-escalation training: The RAND corporation conducted a study focused on individual skills-based training to help reduce workplace violence and assessed whether de-escalation training is effective in managing violence towards NHS staff, benefits and key methods used to provide training, key types of training and its content, and factors of success in deploying training.

The study found that training may help staff manage patient violence and aggression although de-escalation training may not in itself reduce the number of violent or aggressive incidents.

Therefore, we are reviewing and assessing existing training and the evidence base in order to devise a validated de-escalation training for recommended use across the whole system.

The RAND report can be read here.

For more information please email the Violence Prevention and Reduction team at