Violence Prevention and Reduction National Webinar

Escalating Threats to NHS Safety

Violence and aggression directed at NHS staff have intensified in recent years, with reported physical assaults climbing steadily. Data from the 2024 NHS Staff Survey showed that 14.38% of respondents experienced at least one incident of physical violence from patients, relatives, or the public—up from 13.88% the previous year—equating to over 100,000 workers affected annually. Ambulance services report the highest exposure, with 38% of frontline staff encountering physical violence and 22,536 incidents of violence and abuse across UK ambulance trusts in 2024-25, a 15% increase year-on-year.

Emergency departments bear a heavy burden: Freedom of Information data revealed incidents nearly doubled from 2,093 in 2019 to 4,054 in 2024 across sampled trusts, with some hospitals experiencing rises over 500%. Broader figures indicate around 285 daily reported violent incidents in hospitals during 2024-25, contributing to more than 295,000 recorded cases over three years. These attacks range from spitting and punching to threats with weapons, exacerbating staff burnout and sickness absence already elevated at 5.3%.

In response, NHS England refreshed its Violence Prevention and Reduction (VPR) Standard in December 2024, updating the 2021 version in collaboration with trade unions and employers. The new framework promotes a public health, trauma-informed approach to address root causes of distress, incorporates a red-amber-green rating system for self-assessment, and includes tools to track progress. Trusts have since appointed dedicated leads, developed local action plans, and piloted measures like body-worn cameras in ambulances. Oversight groups formed in 2025 coordinate efforts across stakeholders to implement recommendations from earlier reviews.

Non-obvious tensions persist: many incidents go unreported—only 76% in ambulance services—and disproportionately affect staff from black and minority ethnic backgrounds, who face higher rates of racist abuse. Balancing strict sanctions against patients with the need for clinically compassionate responses creates trade-offs, particularly in mental health and emergency settings where challenging behaviour often stems from underlying conditions. Inaction risks further eroding staff retention, already strained by recruitment drops, and undermining public trust in an overstretched system.

The stakes are concrete: persistent violence drives up sickness absence, mental health-related leave, and potential litigation costs, while failures to curb it could worsen staffing shortages and delay care for millions.