Violence prevention and safety

The primary aim of the violence prevention and safety programme is to create cultures in which our NHS colleagues feel supported, safe and secure at work.

The programme aims to support NHS organisations to create compassionate workplace cultures, through the prevention of and response to incidents where staff feel threatened, vulnerable, unsafe, or are assaulted at work.

On 31 October 2018, the Secretary of State for Health launched the Violence Reduction Strategy and the government committed to tackling violence and abuse against NHS staff.  A private members bill received Royal Assent and became law in November 2018 which makes provision about offences against emergency workers. NHS England and NHS Improvement have continued to work in collaboration with the Police and Crown Prosecution Service and on 6 January 2020, a Joint Agreement for Emergency Workers was launched. This Joint Agreement ensures a more effective investigation process is followed when an assault takes place and that there is prosecution of cases where emergency workers are the victim of a crime.

Alongside the above, in January 2019, the NHS Long Term Plan emphasized that the violence against NHS staff would not be tolerated, and committed to fund up to £2 million a year from 2019/20 to reduce violence, bullying and harassment for our staff.

Despite this commitments to support our NHS colleagues, the 2020 NHS Staff Survey for England found that 14.5% of all staff responding said they had experienced at least one incident of physical violence from patients, service users, their relatives or other members of the public in the last 12 months. Staff working within our ambulance trusts report higher incidents of violence at 33.4% – more than double the national average.

If we break this information down into ethnicity, BAME staff reported higher than average incidence of violence within the sector, while reporting slightly lower experiences of harassment, bullying and abuse.

Violence Prevention and Reduction Standard

In January 2021, NHS England and NHS Improvement 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.

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