New guidance published today aims to tackle violence in mental health, ambulance, community and primary care settings, where staff are most at risk of attack. It is the next stage in the Government's drive to make the NHS a zero tolerance zone for violence. The guidance will lead to more staff who work away from the office having pagers and phones to keep in touch with colleagues, better staff training and tough action against patients who threaten staff.
Launching the guidance at the headquarters of the London Ambulance Service Mr Denham said:
"The Government is determined to make life safer for all staff who work in the NHS. Millions of patients benefit from the care of NHS staff every year. Shockingly, every year thousands of NHS staff are the targets of violence, and some suffer serious injury. Many more suffer fear and anxiety because of the threat of violence. When staff are attacked, other patients suffer and resources for patient care are wasted.
"Violence, and the threat of violence, put people off working in the NHS, and make others give up. This is unacceptable. When I launched the zero tolerance campaign last year, I announced our targets for reducing incidents of violence against NHS staff by 20 per cent by 2001 and by 30 per cent by 2003.
"The guidance published today is aimed at helping staff who are most at risk of violence and abuse. We cannot promise that there will never be any violent incidents, but the risks can be reduced. This applies equally whether staff are working alone in the community, in mental health or in A&E Departments. The bottom line is that staff working in the NHS and Primary Care must know that their safety comes first".
A survey carried out in September 1998 revealed that in the region of 65,000 violent incidents take place against NHS staff each year. Some staff are more at risk than others. The survey found:
- 3 incidents every month per thousand staff working in acute Trusts
- 7 incidents every month per thousand staff working for ambulance services
- 14 incidents every month per thousand staff working for community Trusts
- 24 incidents every month per thousand staff working with people with mental illness or learning difficulties.
The guidance includes some good practice examples of NHS organisations which have established initiatives to combat violence against staff:
Tees and NE Yorkshire NHS Trust : The Trust has introduced the Alpha Numeric paging system to help protect staff who make home calls to patients and who work out of office hours. The low cost paging system ensures that staff can log their appointments and that managers and colleagues know where they are and can contact them at all times. The system can also be used to send a message to a group of staff simultaneously.
Newcastle City Health NHS Trust : All staff are given personal security awareness training. Staff who work away from home are given emergency alarms which send signals to a 24 hour security company linked to the local police. Staff who regularly visit patients' homes or who work with people with mental illness are given specific training to help them calm down potentially violent situations and break free and escape from physical attack. Premises are equipped with panic buttons. Personal alarms are issued to any member of staff who want them.
NE Ambulances Service NHS Trust : This Trust has developed a training programme run by operational staff for operational staff. Staff are taught how to spot potentially dangerous situations, to diffuse potential violent situations and to encourage co-operation from abusive or potentially violent people. They are also taught self-defence techniques aimed at ensuring that they can escape from an attack an summon help.
North Staffordshire Hospital NHS Trust : The Trust has pioneered a wide range of initiatives aimed at combating violence against staff. They include a 'safety first' conference which discussed ways in which to improve protection for staff and training programmes for medical staff, including a 'strangers on the ward' course to help staff challenge strangers on NHS premises.
Blackburn, Hyndburn and Ribble Valley Healthcare NHS Trust : The Trust has worked with the police and magistrates to ensure that adequate action is taken against offenders who abuse or attack its staff. After low-level incidents, the Chief Executive writes to perpetrators warning them that their behaviour will not be tolerated and that any further incident will result in more serious action. Magistrates have amended sentencing guidelines so that the fact that the attack has taken place in an NHS setting is viewed as an aggravating factor.
The new guidance materials issued to the NHS today are:
- Managing Violence in the Community
- Managing Violence in Mental Health
- Managing Violence in Ambulance Trusts
- Primary Care - Preventing Violence and Abuse to GPÆs and their staff; and
- Case Studies and Examples of Good Practice Part II.