YOU ****ING ****!!! – abuse in the NHS

When I started writing the draft for this blog, the first sentence I wrote was this:

“As a paramedic, being exposed to physical and verbal abuse is almost a daily occurrence”.

Then I stopped. I thought about how sad it is that this is true. But it is true.

I’ve certainly been on the receiving end. I’ve been shouted at more times than I care to remember, I’ve been sworn at and called every name under the sun and I’ve been threatened. Though I’ve never experienced serious physical harm, I’ve been spat at, pinched, scratched, swung at, bitten, I’ve had to restrain people and I’ve had bodily fluids flung at me (probably the one that annoyed me the most). If you’re reading this and you work for an ambulance service  (or generally for the NHS (or the police)) then this will sound all too familiar.

The most up to date figures I could find were the 2013-2014 number of reported physical assaults on NHS staff. These showed that there were 68,683 physical assaults on NHS staff that year, 1868 of those directed at members of the ambulance service. This is compared to 55,993 is 2007-2008, so we can see which way the trend is going. Figures for incidents of abusive and threatening behaviour towards NHS staff are not collected centrally, but it’s accepted that they will be significantly higher.If you’re interested, you can see the numbers here and can also look up the figures for each individual Trust.

All NHS staff are encouraged to report any act of physical or verbal abuse. Unfortunately the case has got so bad that staff often don’t report incidents, because they are so used to abuse/abuse is seen as part of the job (NHS Security Management Service). It’s a sorry old world when the very staff whose job it is to care for people are so used to being abused that they see it as part of their job.

So, is this just a part of the job that is to be expected and put up with?

The Health and Safety Executive (HSE) don’t think so (neither do I):

‘Health and social care employees should not accept incidents of violent or aggressive behaviour as a normal part of the job. They have a right to expect a safe and secure workplace.’

They also provide a list of those that are at an increased risk of being exposed to physical or verbal abuse:

  • working alone; 
  • working after normal working hours; 
  • working and travelling in the community; 
  • handling valuables or medication; 
  • providing or withholding a service; 
  • exercising authority; 
  • working with people who are emotionally or mentally unstable; 
  • working with people who are under the influence of drink or drugs; 
  • working with people under stress.


So, as a paramedic I can tick all of those!

I’ve been in situations that have made me feel very uncomfortable and frightened for my own safety. Working as a single responder on a car, at night, in a high crime or isolated area, with very little information and potentially unstable patients, you feel vulnerable.

The NHS recognise that lone workers and workers in the community are at increased risk and particularly vulnerable. In order to help reduce this risk, NHS employers have a duty to make sure we are trained in conflict resolution and personal safety training. I  recently taught a conflict resolution training session to a group of staff, I will leave it up to my colleagues in the ambulance service to decide how effective they feel the training is. The NHS Counter Fraud and Security Management Service produced this guide to help lone workers in the NHS.

Unfortunately the result of physical and verbal abuse doesn’t just stop after the incident. I know colleagues who have gone off sick with stress and anxiety after being threatened, shouted at, trapped, and physically assaulted.

The NHS has a zero tolerance policy on abuse of NHS staff. Last year, one ambulance Trust Security Manager called for magistrates to hand down the most severe sentences possible  for assault to make ambulance staff feel more protected. According to this BBC report the maximum sentence for common assault is six months’ imprisonment, while assault occasioning actual bodily harm or making threats to kill can incur prison sentences of up to five years and 10 years respectively.


If you’re interested in reading more about this subject, NHS Protect are the overarching organisation which covers violence, aggression and look at security across the NHS. You can find their website by clicking here.

Or you can check out the Health & Safety Executive information by clicking here. 

Stay safe out there!



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