NHSE accused of cutting action to protect staff from violence

A union has accused NHS England of trying to save money at the expense of reducing violence against healthcare staff, as several national initiatives face the axe.

Despite growing concern about abuse and violence against staff, HSJ understands:

• An NHSE-funded pilot scheme to reduce violence against ambulance staff – who are at much higher risk of violence than others – is coming to an end, with no sign of ongoing help;
• Six other NHSE-funded violence reduction pilot schemes have come to an end or are ending, with the responsibility passing to integrated care boards and providers, and no confirmed future funding; and
• The NHSE team responsible for violence prevention and reduction has been reduced to just two people.

Speaking about the concerns, Unison deputy head of health Alan Lofthouse said: “Cost-saving measures at NHSE have put more responsibility for violence prevention and reduction on providers and ICBs.

“But Unison is concerned that resources are just as tight at local and regional levels, and national leadership is really needed.”

The union, which has led work over many years on reducing violence, also wants to see a tightening up of rules, by making it mandatory for providers to use NHSE’s “violence prevention and reduction” standard. This requires trusts to take a range of actions including risk assessments, communications, and investigating, monitoring and reporting incidents.

Instead, NHSE’s commitment to VPR appears to be faltering, with a reduction in the national team working on it.

One person involved in VPR told HSJ it had recently “gone off the radar” of NHSE. The source said: “Without a national steer, without people at a national level saying what needs to be done and what good violence reductions looks like, nothing happens.”

Mr Lofthouse also called for the introduction of a national data set on incidents of violence against staff. Since 2016, when the national agency NHS Protect was disbanded, there has been no central monitoring of their details and outcomes.

NHSE declined to directly address concerns about national funding for the schemes being axed, with a spokesman saying: “It is our priority to eliminate violence and abuse, with various programmes of work under way to do this”.

“NHSE significantly invested in prevention programmes over the last three years to inject increased support to kickstart this important work, and local areas are continuing to take forward this work with NHSE training initiatives, [with an] e-learning offer around violence prevention and reduction open to all ambulance staff.”

Last year Barking, Havering and Redbridge University Hospitals Trust CEO Matthew Trainer said it was introducing body cameras for staff in frailty units, and those in antenatal clinics with additional security, as violence and aggression against them was going “through the roof”. 

The national ambulance scheme funding which is coming to an end has been used by the Association of Ambulance Chief Executives to employ two members of staff whom it says have made “significant progress developing initiatives to keep the ambulance workforce safer”.

These include:

• “bespoke sector-wide restrictive interventions training”; 
• “a new data set that is now used as a foundational basis for interventions”;
• “our very high-profile Work Without Fear national awareness campaign”;
• and work spreading body-worn video cameras. 

AACE said it had been possible due to “funding from NHSE but regretfully this is coming to an end”.

NHS staff survey results show about a third of ambulance staff with frequent patient contact are assaulted each year; with some saying they are assaulted more than 10 times a year. The figure for NHS staff generally is 13.7 per cent. 

Of the six local pilots, Lancashire and South Cumbria ICB used the funding to employ specialist staff, create a violence data dashboard, examine which staff characteristics are disproportionaly affected, and to spread trauma-informed training. It was given an additional year’s funding (2024-25) but has not confirmed funding from April.

Sussex ICB developed its own VPR strategy, including using a trauma-informed approach, regular reporting to trust boards, leadership training, and communication guides for staff on VPR and domestic violence. Its compliance with the national standard has improved. It also does not have 2025-26 funding confirmed.