ED Staff Face Weekly Violence or Aggression, Poll Finds

Around 3 in 4 UK emergency department (ED) staff said they experience or witness violence and aggression in their department on a daily or weekly basis. The findings came from a Royal College of Emergency Medicine (RCEM) survey of 2126 ED staff, conducted between 27 April and 31 May this year. Nearly all (96%) said they had experienced violence or aggression in their ED from patients or members of the public. For almost three quarters (73%), this experience was a weekly, or even daily, occurrence. Around two thirds (63%) said the incidents were of a discriminatory nature. One anonymous resident doctor told the survey: "Working in the ED, you brace yourself for a lot, but nothing truly prepares you for direct, hateful verbal abuse, especially when it's racially charged." Fewer than 1 in 20 (4%) members of staff surveyed said they always felt safe working in emergency departments, whilst 1 in 4 (27%) sometimes felt safe, and 57% felt safe most of the time. Figures released in March from the NHS staff survey of all staff found almost 1 in 7 had been physically attacked by a patient or the public in the last year — the highest rate for three years. Meanwhile, 1 in 10 said they had suffered discrimination. The new RCEM survey data is part of its Safe to Care campaign, which aims to highlight how “levels of violence towards NHS staff has become intolerable,” the RCEM said in a press release. Violence and Aggression ‘Normalised’ Violence was damaging staff wellbeing and impacting retention. Stress and anxiety affected 3 out of 4 (75%) ED staff in the short-term, with over 1 in 4 (28%) experiencing these long-term. Two in 5 (40%) experienced burnout, and 14% took time off work. Violence and aggression were described as being “normalised” by staff, despite the impacts on their wellbeing. If left to continue, the impact on the workforce could be “devastating” for emergency medicine, the RCEM said. It was an “appalling state of affairs” which was contributing towards many people seriously considering whether emergency medicine — or even healthcare in general — was for them, said Dr Ian Higginson, RCEM president, in a press release. Meanwhile, many staff said they had little confidence that reporting incidents would lead to action, with fewer than half (41%) of staff who made a report saying their trust took ‘meaningful action’. “No one should go to work fearing or, worse, expecting, to be attacked, intimidated or abused,” Higginson said. “Nor should they lack confidence that their employers have their backs, or that the judicial system will kick in.” Ensure Staff Are Safe Many survey respondents pointed out that long waiting times (90%), overcrowding (85%), staff shortages (66%), and corridor care (65%) were making the problem worse. Tackling these issues would create a calmer environment in EDs and provoke fewer incidents, the RCEM said. It called on the four UK governments to take immediate action so that ED staff feel safe, and are safe, to provide care. This should include eradicating long waits, crowding and corridor care, and strengthening security standards to prevent violence and abuse from occurring. For staff, it should include better training, reporting and follow-up, stronger links with the police, and improved organisational accountability to protect and support them. A Department of Health and Social Care spokesperson said that the government had recently introduced new NHS staff standards, which set out the steps that every NHS employer across the country must take to prevent and reduce violence and abuse against their staff. Rob Hicks is a retired National Health Service doctor. A well-known TV and radio broadcaster, he has written several books and has regularly contributed to national newspapers, magazines, and online publications. He is based in the United Kingdom.