NHS: Violence Against NHS Staff

Question

Asked by

To ask His Majesty’s Government what steps they are taking to reduce violence against NHS staff.

My Lords, the department and NHS England are working with NHS employers and trade unions to prevent and reduce violence in the NHS by improving prevention, security, reporting and investigation, as well as enhancing training and post-incident support. As announced in the 10-year plan, the Government will strengthen existing measures by introducing this spring a new set of staff standards to ensure that NHS organisations are held to account for improvements.

I thank my noble friend the Minister for her, as ever, detailed and insightful response, but I am sure she is also aware that certain groups are disproportionately affected by violence in the workplace. Black and Asian nurses make up over 30% of the total number of registered nurses in England yet report higher exposure to both verbal and physical abuse than their white counterparts. How are the Government supporting NHS trusts to protect staff from all forms of violence and racism?

I agree with my noble friend that racism, violence and abuse in the NHS, and indeed anywhere, are quite unacceptable and there is clearly so much more that we have to do. The Government’s progress is about the establishment of the workforce race equality standard, which measures NHS organisations against nine indicators, including bullying and harassment. The report about the standard was published in June of last year. We also have the equality, diversity and inclusion improvement plan, which again identifies six high-impact areas for employers, and this is expected to be strengthened by the introduction of a new staff standard on tackling racism, which is due in April.

My Lords, the level of violence towards staff in healthcare settings which the Minister has just mentioned is unacceptable. The 2024 NHS staff survey found that violence had increased since 2023, with a quarter of the workplace reporting harassment. Given that staff safety is essential to the functioning of the NHS, what specific funding is being made available to trusts for preventive measures, such as de-escalation training, alongside direct protections such as increased security personnel?

The noble Baroness is right about the increase as reported in the staff survey, and it is indeed shocking and totally unacceptable. The reporting of incidents of physical violence has also increased and, while I do not want to see more violence, if it is there, we need to know about it. On funding and NHS organisations, it comes within their general budgets. We are guiding and supporting those organisations to ensure they use the money in the most appropriate and effective way.

My Lords, I have had reason to visit St Thomas’ Hospital on a number of occasions recently to visit the noble Baroness, Lady Fookes, and I assure the Chamber that she is progressing well and thanks everybody for their messages of support, which have come from all sides. Just across the river, I have witnessed on two occasions levels of violence against the staff which I have never witnessed in some of the toughest parts of London or other cities. Nobody who has not experienced what the staff in NHS hospitals have experienced can appreciate the threat that is regularly meted out, to the extent that, last week, I had to act as a witness on behalf of a member of staff at St Thomas’ because he was having to fight off somebody who was trying to beat him up in the hospital.

That is a terrible thing that the noble Lord reports, and I appreciate him drawing your Lordships’ House’s attention to it. I can only reiterate the unacceptability of growing violence, bullying and harassment towards staff. Our work is to retain, recruit and get the best out of staff—I know this is a matter of interest to noble Lords—but we cannot do that in this environment. It is absolutely key that staff do not just feel safer but are safer in the workplace.

My Lords, when working as a district nurse in 1981, I worked with an elderly male patient who had a rat in a cage as a pet. I made a rookie mistake that I would not make now: I said I was frightened of it. The next time I visited, when I drew back his bedclothes to give him a bed bath, the rat leapt out at me. I just draw attention to that, but can the Minister explain how and what statistics are kept on the sickness and absence of healthcare workers who work in the community as a result of physical and psychological aggression from patients?

Again, I am very sorry to hear of the experience that the noble Baroness had and should not have had. Sadly, I am sure that she was not—and is not—alone in having had such experiences. We have zero tolerance towards violence, bullying and intimidation, and I would regard that as being an instance of that. We need to improve our data and our recording. We are developing a common reporting framework for violence prevention and reduction which will support the adoption of more consistent approaches to dealing with it and improve comparability across not just systems but services. The noble Baroness’s point about community-based violence is as valid as points about hospital-based violence: violence is unacceptable wherever it is.

My Lords, I declare an interest as a lay member of the General Medical Council. I was very sorry to hear the example given by the noble Lord; unfortunately, we have all heard too many such examples. If a healthcare professional is the subject of violence in the workplace, the police may be required, sadly, to arrange for a forensic physician to examine the victim. That experience can be stressful and daunting for the member of staff in question. Can my noble friend the Minister outline what steps are being put in place to support those practitioners in such instances?

I think I understand my noble friend’s question; if I have misunderstood, I will gladly write to her. The point here, I think, is about not just practice but culture. We need to see good leadership. We need good organisational culture to improve staff engagement and staff responsibilities when faced with dealing with such incidents. Again, our NHS working cultures need to be more compassionate and more inclusive, and they need better support, including around occupational health and staff well-being. Practitioners are part of the solution, and of course we give them our full support.

My Lords, in advance of this Question, the Medical Defence Union wrote to a number of noble Lords, for which we are grateful. It outlined that if a healthcare professional is the subject of violence in the workplace, the police may be required to arrange for a forensic physician to examine the victim. This experience of course doubles the terrible experience that the individual has been through and is daunting for them. Can the Minister confirm what steps or guidance the department and NHS England, as long as it continues to exist, are putting in place to support medical staff in such instances?

I understand the point. All NHS staff have access, for example, to a helpline for support and to Practitioner Health for when they need more complex mental health support. Of course, anyone who is experiencing violence or abuse should report it to their line manager so that it can be properly investigated, including reporting it to the police. These are very difficult situations for the person who has suffered abuse and for members of the team who have to support them. I take the point about forensics; forensic investigation can worsen it, but it is also necessary to secure conviction where necessary.