Background
The NHS Constitution sets out the rights and responsibilities of patients, the public and staff to ensure the NHS operates fairly and effectively. The staff pledges define what the NHS expects from staff and what staff can expect from NHS employers. One of the pledges is to provide support and opportunities for staff to maintain their health, wellbeing and safety. Patients and the public have the right to be cared for in a safe and secure environment and the responsibility to treat NHS staff and other patients with respect.
Health and social care employees have had a consistently higher risk of violence at work than other occupational groups in recent years. Incidents may be underreported due to a lack of confidence in the reporting process or an acceptance that it is part of the job. The first NHS violence reduction strategy was launched in 2018, aiming to protect the NHS workforce from violence and aggression from patients, their families and the public. It also set out to provide mental health support for staff who are victims of violence and ensure quick and effective punishment for offenders.
Physical violence at work
The NHS Staff Survey asks respondents whether they have experienced physical violence at work from patients, their relatives or the public in the past 12 months. It also asks whether they have experienced violence from managers or other colleagues. Between 2015 and 2020, the percentage of respondents who said they had experienced physical violence from managers or other colleagues at least once in the past 12 months decreased from 2.5% to 1.8%, before increasing again to 2.5% in 2022. In terms of patient-related incidents of violence, the proportion of respondents who said they had experienced it at least once in the past 12 months wavered around 14-15% between 2015 and 2022, resting at 14.7% in 2022.
Staff in ambulance trusts remain by far the most likely to face violence from patients and the public, with 31% of respondents in 2022 saying they had experienced at least one incident in the past 12 months. This compares with 7% of staff in community trusts and 5% of staff in acute specialist trusts. Staff in mental health/learning disability trusts reported the most violence from managers or colleagues, at 3.3% in 2022.
While a higher percentage of staff in ambulance trusts report at least one incident of violence from patients and the public, those in mental health and learning disability trusts are more likely to experience multiple incidents of violence. In 2022, 2.1% of respondents in mental health and learning disability trusts said they had experienced violence from patients and the public more than 10 times in the past 12 months.
The Urgent and Emergency Care Survey asks respondents if they felt threatened by other patients or visitors while they were in A&E. The percentage of respondents who replied that they ‘definitely’ or ‘to some extent’ felt threatened decreased from 11% in 2003 to 7% in 2014. Due to changes to the survey methodology, results pre- and post-2016 are not comparable.
The percentage of respondents who ‘definitely’ or ‘to some extent’ felt threatened by other patients or visitors decreased slightly from 8.1% in 2016 to 7.6% 2020. The Care Quality Commission describes a significant decrease in those who ‘definitely’ felt threatened, from 2.4% in 2016 to 2.1% in 2020.
About this data
NHS Staff Survey data:
This indicator uses data from the NHS Staff Survey. The scores were calculated as the percentage of respondents who gave a specific answer to a question, or a defined set of responses to a series of questions. The responses for each respondent were summarised for each organisation using a weighting procedure. In order to make NHS organisations’ scores comparable, individuals’ scores were weighted so that the occupational group profile of the organisation reflected that of a typical organisation of its type. It should be noted that results for surveys up until 2020 were not weighted. For comparisons between scores over time, scores from previous years were re-calculated where necessary to enable fair historical comparisons.
For more information, please see the NHS Staff Survey – Basic guide for 2022 results and the Technical Guide to the 2022 Staff Survey Data.
Care Quality Commission data:
For the 2022 Urgent and Emergency Care Survey, two weights have been applied to the survey results data:
- a trust weight to ensure that each trust contributes equally to the England average, and
- a population weight, to make sure each trust’s results are representative of their own sample and do not over-represent particular groups, such as older respondents.
A combination of the two weights results in one single weighting, which has been applied to enable comparisons between years.
Results prior to 2016 are not comparable due to a change to the sample month, which had previously been in winter, and the inclusion of type 3 departments (such as minor injuries units or urgent care centres).
For more information please see the Urgent and Emergency Care Survey 2022: Quality and Methodology Report.