Promoting partnership working in the NHS

The violence reduction – creating a culture of safety sub group

Creating a Culture of Safety sub group

This sub group was set up in 2019 as an action from the Workforce Issues Group (WIG). The aim of the sub group is to take forward actions in partnership to support NHSE/I in the development of the NHS violence reduction strategy.

The 2018 NHS staff survey results highlighted the need for action to prevent and tackle violence and abuse against staff from patients and the public by creating a culture of safety. SPF partners are contributing to the development of the tackling violence strategy and related work.

The sub group is chaired by Harprit Hockley, Organisational Development Lead, NHSE/I and Alan Lofthouse, National Officer, UNISON and includes members from the WIG.

The subgroup’s Terms of Reference were agreed in September 2019.

Case studies

On 2 January 2021 NHS England and NHS Improvement published the first national Violence Prevention and Reduction Standard for NHS organisations.

The new standard 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 has been developed in partnership with the Social Partnership Forum and its subgroups, including trade unions and the Workforce Issues and Violence Reduction Groups. It was endorsed by the Social Partnership Forum on 15 December 2020.

Key areas for NHS organisations under the Violence Prevention and Reduction Standard, assessment indicators include:

  • board accountability
  • workforce and workplace risk assessments
  • workforce engagement
  • training
  • supporting roles
  • learning outcomes from management reviews
  • audit and assurance.  

Read the Violence Prevention and Reduction Standard and find more information on the NHS England and NHS Improvement 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. NHS England and NHS Improvement (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.

Data provided by the CPS shows they prosecuted more than 50 assaults a day in the first year of legislation, making attacks on emergency workers a specific offence.

Between November 2018 and 2019, almost 20,000 offences were charged under the Assaults on Emergency Workers (Offences) Act, three quarters of which were assault by beating.

The CPS data is based on the number of offences charged, rather than individual defendants. Ministry of Justice figures for 2018, based on the first cases to go through the courts, show a conviction rate of 90 per cent.

The Joint Agreement is an intrinsic part of the violence reduction programme as cited in the Long Term Plan where it states “we will not tolerate violence against NHS staff and, where justified, will always seek to prosecute incidents of verbal and physical abuse”.

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.