ANALYSIS
With assaults on NHS personnel at an all-time high in England, what can be done to stem the tide of violence? Alistair Kleebauer reports
‘It is a shame more hasn’t been done to protect front line staff’ Physical assaults on NHS staff in England have reached their highest since national data was first collected a decade ago – up to 68,683 in 2013/14. In comparison, the figure in the first year of collecting data (2004/05) was 60,385, with the lowest figure being in 2008/09 when it was 54,758. Although the number of criminal sanctions following assaults has risen by 13.1 per cent – from 1,458 in 2012/13 to 1,649 in 2013/14 – a jump in the number of assaults by 8.7 per cent in the same period will be disheartening for nurses and other healthcare workers, and poses a challenge to employers and the government alike. NHS Protect, which provides guidance on NHS security in England,
released the figures and its head of external engagement and services Richard Hampton said: ‘No NHS staff should be physically assaulted and we encourage staff who are victims of violence to press charges against assailants.’ He added that employers must do all they can to support staff in preventing incidents and pursuing offenders. Amai Gold, a staff nurse working in emergency care in the West Midlands who has been attacked on seven different occasions, is angered by the figures. ‘It is a shame that more hasn’t been done to protect nurses and front line staff,’ she says. Ms Gold was stabbed with a needle in 2004 and has also been punched
Health bodies with the most assaults in 2013/14 Declared total staff
Assaults per 1,000 staff
Calderstones Partnership NHS Foundation Trust
1,088
1,098
Coventry and Warwickshire Partnership NHS Trust
4,916
517
Northumberland, Tyne and Wear NHS Foundation Trust
6,464
516
Hertfordshire Partnership University NHS Foundation Trust
2,653
390
Sheffield Health and Social Care NHS Foundation Trust
3,180
359
Leeds and York Partnership NHS Foundation Trust
3,864
330
Norfolk and Suffolk NHS Foundation Trust
3,888
314
Bradford District Care Trust
2,989
308
Cornwall Partnership NHS Foundation Trust
1,914
304
Southern Health NHS Foundation Trust
8,996
304
Declared total staff is health body declaration of total staff in March Physical assault statistics are validated by NHS Protect
in the face, hit in the shoulder and subjected to racial abuse. She says that staff who are assaulted are often not supported by their colleagues or managers. Her experiences, which she describes as ‘stressful’, reveal the psychological strain that assaults put nurses under. She says has lost two stone in weight, which she attributes to the attacks. Assaults on staff at Calderstones Partnership NHS Foundation Trust in Lancashire in 2013/14 were higher than the actual number of staff employed, at 1,195 and 1,088 respectively. The trust has the highest number of assaults per 1,000 staff of all health bodies in England. The trust supports patients, most of whom have a learning disability, in low and medium secure settings, with some patients presenting with ‘complex and enduring behaviours’, according to director of quality and nursing John Smith.
Induction programme
Mr Smith says all staff take part in a thorough induction programme. The ‘trust’s reported figures have plateaued over the previous two to three years against a background of a significant national rise, particularly outside the NHS where secure services are more common’. He says: ‘Our nursing staff are trained to manage clinical and personal safety risks and we adhere to safe staffing levels to ensure our ward environments have more than the required numbers of appropriately trained staff present and working with the people in our care at all times.’
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JIM VARNEY
ANALYSIS
Average number of assaults by type of organisation in 2013/14 Mental health Ambulance Acute trusts Primary care
201/1,000 45/1,000 20/1,000 20/1,000
Source: NHS Protect
occupational therapist can provide further support if an assaulted staff member wants it. North East London NHS Foundation Trust provides mental health and community services to a population of around 1.5 million people with 6,000 staff, yet had a relatively low number of reported assaults per 1,000 staff (33).
Star wards
The ten health bodies with the highest highest number of assaults per 1,000 number of assaults per 1,000 staff are all staff (516), although of the 80,000 people it sees each year with mental mental health services. Last month the health issues, less than 500 have been National Institute for Health and Care involved in violent incidents with staff, Excellence released a draft guideline according to the trust’s chief executive on the management of violent and John Lawlor. aggressive behaviour in people with Mr Lawlor says the use of the word mental health problems when they are ‘assault’ may give a false impression as being treated in the NHS. a ‘significant number’ of incidents relate It recommends recognising how to staff trying each patient’s mental to stop patients health problem might ‘THESE FIGURES MAY BE THE self-harming. affect their behaviour TIP OF A BIGGER ICEBERG’ He says: (for example, taking ‘Patients have perhaps been trying account of their diagnosis, the severity to self-harm because of their own of their illness and their past history distress. Our staff have tried to prevent of violence or aggression) and it also that and, as part of the distress, the calls on providers to train staff so they patient reacts and staff get hurt. are able to recognise early signs of agitation and anger, can use techniques None of which is any excuse.’ All staff undertake prevention for distraction and calming, and find and management of violence and ways to encourage relaxation. aggression training, which is common Northumberland, Tyne and Wear in mental health trusts and, if there is NHS Foundation Trust is one of the an incident, staff also have a review largest mental health and disability meeting. Colleagues and/or an trusts in England and had the third
Its interim director of nursing for clinical effectiveness Susan Smyth admits to being ‘quite surprised’ by the figure, but is confident it provides an accurate reflection of staff experience because the trust has ‘a strong reporting culture’ and she sees all violent incident reports. She points to a ‘star wards’ programme, which provides activities for patients, as one explanation for the low number of reported incidents. Staff and patients take part in sporting activities together, such as games of football or basketball, or it can be ‘something as small as a board game or a game of cards’. However, RCN executive director of nursing and service delivery Janet Davies suggests the national assault figures ‘may be the tip of an even larger iceberg’ and the college’s senior employment relations adviser Kim Sunley says staffing and skill-mix pressures can increase the likelihood of violent incidents. Communication, including the importance of reporting all incidents, can also be a valuable tool in combating the number of assaults, adds Ms Sunley. ‘It is important for employers to speak to staff and the trade unions. The staff know what the problems are and what the pinch points are’ NS
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With assaults on NHS personnel at an all-time high in England, what can be done to stem the tide of violence? Alistair Kleebauer reports
‘It is a shame more hasn’t been done to protect front line staff’ Physical assaults on NHS staff in England have reached their highest since national data was first collected a decade ago – up to 68,683 in 2013/14. In comparison, the figure in the first year of collecting data (2004/05) was 60,385, with the lowest figure being in 2008/09 when it was 54,758. Although the number of criminal sanctions following assaults has risen by 13.1 per cent – from 1,458 in 2012/13 to 1,649 in 2013/14 – a jump in the number of assaults by 8.7 per cent in the same period will be disheartening for nurses and other healthcare workers, and poses a challenge to employers and the government alike. NHS Protect, which provides guidance on NHS security in England,
released the figures and its head of external engagement and services Richard Hampton said: ‘No NHS staff should be physically assaulted and we encourage staff who are victims of violence to press charges against assailants.’ He added that employers must do all they can to support staff in preventing incidents and pursuing offenders. Amai Gold, a staff nurse working in emergency care in the West Midlands who has been attacked on seven different occasions, is angered by the figures. ‘It is a shame that more hasn’t been done to protect nurses and front line staff,’ she says. Ms Gold was stabbed with a needle in 2004 and has also been punched
Health bodies with the most assaults in 2013/14 Declared total staff
Assaults per 1,000 staff
Calderstones Partnership NHS Foundation Trust
1,088
1,098
Coventry and Warwickshire Partnership NHS Trust
4,916
517
Northumberland, Tyne and Wear NHS Foundation Trust
6,464
516
Hertfordshire Partnership University NHS Foundation Trust
2,653
390
Sheffield Health and Social Care NHS Foundation Trust
3,180
359
Leeds and York Partnership NHS Foundation Trust
3,864
330
Norfolk and Suffolk NHS Foundation Trust
3,888
314
Bradford District Care Trust
2,989
308
Cornwall Partnership NHS Foundation Trust
1,914
304
Southern Health NHS Foundation Trust
8,996
304
Declared total staff is health body declaration of total staff in March Physical assault statistics are validated by NHS Protect
in the face, hit in the shoulder and subjected to racial abuse. She says that staff who are assaulted are often not supported by their colleagues or managers. Her experiences, which she describes as ‘stressful’, reveal the psychological strain that assaults put nurses under. She says has lost two stone in weight, which she attributes to the attacks. Assaults on staff at Calderstones Partnership NHS Foundation Trust in Lancashire in 2013/14 were higher than the actual number of staff employed, at 1,195 and 1,088 respectively. The trust has the highest number of assaults per 1,000 staff of all health bodies in England. The trust supports patients, most of whom have a learning disability, in low and medium secure settings, with some patients presenting with ‘complex and enduring behaviours’, according to director of quality and nursing John Smith.
Induction programme
Mr Smith says all staff take part in a thorough induction programme. The ‘trust’s reported figures have plateaued over the previous two to three years against a background of a significant national rise, particularly outside the NHS where secure services are more common’. He says: ‘Our nursing staff are trained to manage clinical and personal safety risks and we adhere to safe staffing levels to ensure our ward environments have more than the required numbers of appropriately trained staff present and working with the people in our care at all times.’
14 december 3 :: vol 29 no 14 :: 2014 NURSING STANDARD Downloaded from RCNi.com by ${individualUser.displayName} on Nov 23, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
JIM VARNEY
ANALYSIS
Average number of assaults by type of organisation in 2013/14 Mental health Ambulance Acute trusts Primary care
201/1,000 45/1,000 20/1,000 20/1,000
Source: NHS Protect
occupational therapist can provide further support if an assaulted staff member wants it. North East London NHS Foundation Trust provides mental health and community services to a population of around 1.5 million people with 6,000 staff, yet had a relatively low number of reported assaults per 1,000 staff (33).
Star wards
The ten health bodies with the highest highest number of assaults per 1,000 number of assaults per 1,000 staff are all staff (516), although of the 80,000 people it sees each year with mental mental health services. Last month the health issues, less than 500 have been National Institute for Health and Care involved in violent incidents with staff, Excellence released a draft guideline according to the trust’s chief executive on the management of violent and John Lawlor. aggressive behaviour in people with Mr Lawlor says the use of the word mental health problems when they are ‘assault’ may give a false impression as being treated in the NHS. a ‘significant number’ of incidents relate It recommends recognising how to staff trying each patient’s mental to stop patients health problem might ‘THESE FIGURES MAY BE THE self-harming. affect their behaviour TIP OF A BIGGER ICEBERG’ He says: (for example, taking ‘Patients have perhaps been trying account of their diagnosis, the severity to self-harm because of their own of their illness and their past history distress. Our staff have tried to prevent of violence or aggression) and it also that and, as part of the distress, the calls on providers to train staff so they patient reacts and staff get hurt. are able to recognise early signs of agitation and anger, can use techniques None of which is any excuse.’ All staff undertake prevention for distraction and calming, and find and management of violence and ways to encourage relaxation. aggression training, which is common Northumberland, Tyne and Wear in mental health trusts and, if there is NHS Foundation Trust is one of the an incident, staff also have a review largest mental health and disability meeting. Colleagues and/or an trusts in England and had the third
Its interim director of nursing for clinical effectiveness Susan Smyth admits to being ‘quite surprised’ by the figure, but is confident it provides an accurate reflection of staff experience because the trust has ‘a strong reporting culture’ and she sees all violent incident reports. She points to a ‘star wards’ programme, which provides activities for patients, as one explanation for the low number of reported incidents. Staff and patients take part in sporting activities together, such as games of football or basketball, or it can be ‘something as small as a board game or a game of cards’. However, RCN executive director of nursing and service delivery Janet Davies suggests the national assault figures ‘may be the tip of an even larger iceberg’ and the college’s senior employment relations adviser Kim Sunley says staffing and skill-mix pressures can increase the likelihood of violent incidents. Communication, including the importance of reporting all incidents, can also be a valuable tool in combating the number of assaults, adds Ms Sunley. ‘It is important for employers to speak to staff and the trade unions. The staff know what the problems are and what the pinch points are’ NS
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