Promoting partnership working in the NHS

The violence reduction – creating a culture of safety sub group

Violence reduction subgroup (VRS)

The national SPF set up the violence reduction subgroup in 2019 as a subgroup of the Workforce Issues Group.

Read the VRS terms of reference, revised in June 2021. 

NHS violence prevention and reduction work programme

The subgroup is engaging with the Violence Prevention and Reduction Team at NHS England and NHS Improvement (NHSEI) to support the delivery of their work programme. The work programme includes:

  • NHS Violence Prevention and Reduction Standard (see below). Work is underway to identify an integrated care system in each of the seven regions to pilot use of the Standard across their systems.  
  • Body worn cameras – £8.4m investment in a national body worn camera pilot will run in 2021-22 with an independent evaluation to be commissioned to support future plans. 
  • Training programmes for de-escalation – developing and supporting the roll out of nationally accredited safety training programme for NHS Staff in relation to de-escalation, where appropriate and necessary. 
  • National staff safety campaign – working in collaboration with the Association of Ambulance Chief Executives on the campaign. 
  • Diploma/degree – working with Salisbury Hospital Trust to identify a higher education provider to develop and deliver an accredited training programme for violence prevention and reduction lead practitioners and other health care staff with related roles at a diploma/degree level. 
  • Engagement – connecting with Public Health England’s Violence Prevention Network and the Home Office’s Violence Reduction Units to develop and embed a public health approach to violence prevention. 
  • Violence data collection – progressing a data collection pilot across ten hospital trusts to better understand the scale and nature of violence against staff and to inform a national data collection approach. 
  • Physical environment toolkit – to develop a safer by design physical environment toolkit. 
  • Joint Agreement Assaults Against Emergency Workers (see below) – to undertake an annual review of the Joint Agreement. 

NHS Staff Survey

The 2020 NHS Staff Survey found that:

  • Almost one in seven (14.5 per cent) of all staff responding to the Survey 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 within ambulance trusts continue to report far higher levels of violence - 33.4 per cent more than double the national average.
  • A similar picture is reported for staff experiencing bullying, harassment or abuse from patients, service users, their relatives or other members of the public over the past 12 months. The national average is 26.7 per cent, but almost double again for staff in ambulance trust at 46.7 per cent.
  • Reporting of violence overall at work has remained fairly static over the last five years at 72 per cent, although higher in mental health and learning disability and community trusts at 90 per cent. Reporting within the ambulance sector has risen to 72 per cent from 63.8 per cent in 2016.

Case studies

In January 2021, NHSEI published the national Violence Prevention and Reduction Standard, which complements existing health and safety legislation.

Employers (including NHS employers) 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. 

The Standard was developed in partnership with the national SPF. It was endorsed by the SPF on 15 December 2020.

You can read the NHS Violence Prevention and Reduction Standard on NHSEI’s website.

Following the enactment of the Assaults on Emergency Workers (Offences) Act 2018 on 13 November 2018 the Crown Prosecution Service (CPS) led the development of a Joint Agreement. The Joint Agreement on Offences Against Emergency Workers was published in January 2020. NHSEI represented the NHS in collaboration with stakeholders. The Joint Agreement provides a framework to ensure more effective investigations and prosecution of cases, where emergency workers are the victim of a crime, particularly in applying the provisions of the 2018 Act, and sets out the standards which victims of these crimes can expect. Equally it underpins the provisions outlined within the 2018 Act.

The definition of an emergency worker in the 2018 Act, goes beyond specific titles and jobs, and extends to persons whose roles brings them within the definition, for the NHS this is:

  • A person employed for the purposes of providing or engaged to provide NHS health services – and whose general activities in doing so involve face to face interaction with (i) individuals receiving the services or (ii) with other members of the public.
  • A person employed for the purposes of providing or engaged to provide services in the support of the provision of NHS health services – and whose general activities in doing so involve face to face interaction with (i) individuals receiving the services or (ii) with other members of the public.

For localised support, any member of NHS staff who are the victim of a crime, should contact their accredited security management specialist or violence reduction lead.