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Patient aggression up by a fifth despite trust’s interventions

Published on: 16 May 2023

A hospital trust, which has already implemented a series of safety measures to protect employees, has reported a 17 per cent rise in incidents of abuse against staff by patients and the public in the last year.

Data from the Oxford University Hospital’s clinical incident system, shared with HSJ, shows there were 1,181 cases of violence and aggression against staff in 2022, up from 1,003 in 2021 (see chart below).

Before late 2021, the monthly incident rate very rarely hit 100, while since January 2022 it has topped 100 in seven months, including 162 and 131 incidents respectively in January and February this year.

The ongoing growth is despite the trust launching a campaign, called “No Excuses”, in January 2022, in response to cases doubling between 2020 and 2021 from 531 to 1,003. Measures include bodyworn cameras, and safety devices with alarms and positioning technology for lone workers. 

The trust said it plans to launch a second phase of the No Excuses campaign in the coming weeks, with a focus on staff stories. 

In an example shared in board papers from March, a band five nurse describes how they were “attacked” and “pushed on to the floor” by a patient waiting for a mental health bed who was “very erratic and jumbled”. The nurse reported the incident to the police.

As part of the campaign, the trust also established an internal working group for staff to discuss their experiences of abusive and aggressive behaviour, as well as in-team support. 

The trust’s emergency department matron has begun writing a letter to all patients who have been violent or aggressive, which asks them to “act in a more understanding and appropriate manner towards the staff who are trying to care for you” if they attend the ED again. 

It has also developed a “quality priority” for 2022-23 to “understand the scale of and contributory factors to violence and abuse, implemented interventions and reduce the frequency of these incidents and the impact they have on both patients and staff”. 

Paula Gardner, interim chief nursing officer at OUH, told HSJ that the trust knows “this is an ongoing issue” and “will continue to do all we can to support and care for our colleagues”. 

“The wellbeing and safety of our staff is of paramount importance to us, and forms a significant part of our People Plan 2022-2025,” she added. “Following a significant increase in reports of abusive and aggressive behaviour last year, we put several actions into place to tackle this.”

In the build-up to the nursing strikes last month, the trust said its staff had been verbally abused when contacting some patients to postpone their appointments.

NHS Staff Survey 2022 results show 14.7 per cent of staff had experienced physical violence from patients or members of the public in the last 12 months, while 27.8 per cent said they had suffered harassment, bullying or abuse from patients of members of the public.