With violence against NHS staff continuing to rise, Alex Jay, chief executive of Little Green Button, argues the real issue isn’t just funding but policy gaps.
The latest annual NHS staff survey revealed that nearly one in seven of its staff members were physically assaulted last year – a three-year high – while incidents of discrimination and sexual misconduct have also risen.
Many point to funding pressures as a key driver of this rise, and it certainly plays a role. Chronic underfunding and workforce shortages are widely documented by bodies such as the Nuffield Trust and The King’s Fund – pressures that are linked to overcrowding, longer waiting times, and staff burnout. In turn, this leads to a higher risk of patient frustration and aggression, increasing pressure on team members who remain, while trusts struggle with the high costs of replacing those choosing to leave.
But on top of this, funding pressures are also limiting investment in a huge range of tools and infrastructure specifically designed to keep staff safe. Budgets are undoubtedly under strain, but failing to invest in measures that prevent harm is proving a false economy, with the cost of claims, staff turnover, and absences rising alongside assault levels.
In fact, the Health and Safety Executive (HSE) estimates that work-related injuries causing absences of seven days or more cost £7,500 per case. Compensation awards for workplace assault can range anywhere between £1,000 and more than £25,000. Then, if staff leave, replacing them can cost an average of £6,125, according to the Chartered Institute of Personnel and Development (CIPD).
All of this adds up, with a report looking at the cost of abuse within the NHS showing that the health organisation has paid out £20.7 million in staff assault claims during the last five years, across a total of 1,017 claims since 2019.
Yet, despite there clearly being a financial argument for doing more, there is no unified strategy to prevent it.
A fragmented approach
There are some trusts that have taken proactive steps to protect staff, recognising the benefits of investing in preventative safety technology.
Just this March, for example, four hospitals in Greater Manchester introduced body-worn cameras to help prevent the abuse of frontline staff. It follows a trial at Fairfield General Hospital in Bury last year, in which Julie Newton, a lead nurse in Fairfield’s Emergency Department, said the tech has helped them “create a safer, more respectful environment so we can focus on delivering the best possible care to those who need us”.
In other parts of the UK, trusts and agencies are also investing in improved access control and security systems.
The problem is that despite the clear potential benefits of protection tech – which can reduce incidents, improve staff retention, and ultimately cost far less than replacing workers and responding to violence – action in other parts of the NHS is lacking.
It has almost become a postcode lottery – there are doctors’ surgeries in one county with robust safety measures, while a neighbouring surgery might have none. Staff face the same risks, but the resources, technology, and training available to them vary widely depending on location.
That’s not a question of policy absence; it’s a question of enforcement and prioritisation.
Technology can help, but only if it’s fit for purpose
The answer here is not simply to “invest in tech”. Panic alarms, body-worn cameras, and reporting tools can all make a huge difference, but they need to be tested and effective. I’ve seen alarms bought cheaply just to tick a box – but they don’t work, staff aren’t protected, and the risk remains.
That being said, the cost of prevention can indeed be relatively small if done right. Some preventative measures can cost as little as £30 per person per year, while the financial impact of an incident is in the tens of thousands of pounds.
The main point here, however, is that without a unified national standard or enforced baseline for staff protection, essentially, we’re left with a fragmented NHS. Standards exist, but there’s no policing, no enforcement, and no consistency. Even when a national standard is introduced, people move on, or budgets aren’t applied properly, so the benefits are limited.
What’s really needed is a clear national baseline for staff protection – enforcement of existing standards, investment in fit-for-purpose technology. Everyone should have the same minimum duty of care and safety for their staff.
That’s the only way to move away from a fragmented system where some staff are protected, and others are left exposed. Without it, the cycle of violence, staff turnover, and rising costs will only continue to rise.
