Partnered Content

Assaults on NHS staff

NHE talks to Richard Hampton, head of local support and development services at NHS Protect, about the most recent figures on assaults on NHS staff, which show a clear increase in reported incidents.

Figures submitted by 425 health bodies employing over a million staff and contractors show a 3.3% rise in total reported assaults on NHS staff, from 57,830 in 2010/11 to 59,744 in 2011/12.

The number of assaults involving medical factors showed a particularly large rise – from 39,770 in 2010/11 to 46,265 in 2011/12, a 16.3% rise.

NHS Protect’s Richard Hampton told NHE: “The trend over the past five years has been that there’s increased reporting.

“There are nearly 60,000 physical assaults a year, which really reinforces the message that it’s unacceptable that staff face these situations, and also the importance of the work we do with trusts to understand why incidents occur in the first place and to try to address the causes.”

Hampton suggested the rise in assaults could be attributable to increased awareness among NHS staff, rather than it necessarily suggesting a big jump in physical assaults. This is backed up by the NHS Staff Survey, which suggests nearly 30% of physical assaults go unreported. He explained: “The NHS Staff Survey does ask questions about whether staff are reporting incidents of violence, and whether they’re confident that NHS trusts are taking action to support those reports.”

Asked for his analysis of underlying trends in the data, he said: “We’ve seen a decrease in the number of assaults reported by primary care trusts, yet an increase in those reported by acute/foundation trusts. That’s a reflection of the changing NHS. As the NHS is reorganising, a lot of those services previously delivered by PCTs are now being delivered by acute trusts.”

NHS Protect offers support and guidance to local security management specialists employed by the trusts, which are trained and accredited in protecting property and staff.

Frontline staff are getting conflict resolution training, Hampton said: “That’s a large element of the effort to try to prevent incidents.

“That training gives staff the ability to identify potentially violent situations and provides them with skills to try to de-escalate those situations before they do turn violent.

“Where prevention unfortunately hasn’t worked, we have signed a tripartite memorandum of understanding with ACPO and the CPS, highlighting the importance of taking action against those people who feel they can assault NHS staff – where that is possible. That distinction is quite important.

“Where medical factors contribute to an assault, it’s not always possible to take action against the offender. It’s not a complete bar; there are situations where it actually helps an assailant come to terms with their actions, if action is taken.”

Although in fraud cases NHS Protect has an important investigatory role, when it comes to assaults the situation is different. Hampton said: “It’s important that action is taken by the police.

“We do have a legal protection unit within NHS Protect where, if a trust comes to us and for whatever reason the police or CPS have declined to take action, and we still think there’s a prima facie case, we do have the ability to take a private prosecution against the assailant.

“On the back of the national MoU with ACPO and CPS, we’re trying to translate that into local agreements between individual trusts and their local police to reinforce that message that action should be taken where appropriate.”

The jump in assaults involving medical factors is clearly a concern, and new guidance is being produced, ‘The Prevention and Management of Challenging Behaviour’. Hampton told us: “We formed an expert reference group of people who face these situations, professionals in the field, and we hope to identify what challenging behaviour is – and that can be behaviour which can result from a range of clinical conditions, dementia, delirium, mental health, disabilities – and to provide practical strategies not only to help identify and assess those behaviours, but prevent and manage them.

“It’s incredibly important that every incident, whether it be down to a medical condition or not, is recorded.

“For the member of staff who is suffering the injury and the distress, there’s no demarcation for them between whether or not it was an intentional act. Trusts and employers must take action.”

Advice for health bodies

• Take advantage of the joint working agreement with ACPO and the CPS and use existing guidance to pursue local arrangements building on this national agreement – to ensure criminal assaults are identified and do not go unpunished.

• Ensure staff are trained to use available powers to respond decisively to low-level nuisance behaviour before it escalates into violence against staff (powers under the Criminal Justice and Immigration Act).

• Seek advice from the enhanced network of NHS Protect’s Area Security Management Specialists (ASMSs). They give guidance to Local Security Management Specialists (LSMSs) and assist in assessing risks of violence, addressing these through prevention work and pursuing legal action when assaults do occur.

Tell us what you think – have your say below, or email us directly at [email protected]