More information For more information about violence in NHS workplaces and what you can do to combat it, contact UNISON's health care unit at Mabledon Place on 0845 355 0845.

Hospital police? UNISON has called for a police presence at the Queen Elizabeth hospital in King's Lynn after a series of violent assaults on frontline staff. Click here to read that story.

Zero tolerance zones launched to help combat the daily barrage of mental and physical abuse faced by frontline health workers

Violence in the NHS

Health staff have always provided front-line services but now they are finding themselves in a true battle zone: one paramedic found someone taking a chainsaw to his ambulance.

Violence against hospital staff, ambulance workers and community nurses has been on an alarming rise. Existing figures inevitably under-report and often exclude "routine" threats or insulting behaviour.

Four years ago, the Department of Health produced targets for reducing violence against staff. At the time trusts were recording a high level of incidents.

The continuing rise in numbers could be a good thing if it means that more staff are taking action when they have been assaulted or threatened. A recent UNISON survey suggests that more than 40 per cent of staff have been assaulted.

At Ealing Hospital, UNISON hit management objections when it tried to carry out a survey of abuse staff that staff working in A&E were having to endure.

The survey logged 50 incidents of verbal abuse and 36 of physical abuse. Participation in the survey was voluntary and some senior management took part.

UNISON Scotland published a survey showing a threefold increase in verbal and physical assualts from 1996.

Last year the DoH said it wanted incidents of violence reduced by 30 per cent by 2003.

To back up this aspiration, the government launched the NHS Zero Tolerance Zone crossing Whitehall boundaries by also involving the Home Office and the Lord Chancellor's department.

The initiative's goals include ensuring that staff report all violent incidents at work and emphasising that managers are responsible for providing safe working conditions for staff.

There was also an explicit statement that enduring violence and aggression is not part of the job and all violent incidents must be reported to the police.

These actions by government are encouraging and form a strong foundation for challenging violence in health service workplaces.

But it is action by UNISON - nationally, regionally and at branch level - that will really make a difference. Union support is vital if individuals are to challenge unacceptable.

UNISON ACTION • UNISON pressure helped launch the London Ambulance Service's high-profile Christmas publicity campaign challenging violence against staff. • In Merseyside, UNISON worked closely with management on an anti-violence campaign that was supported by stars from Channel 4's weekly soap Brookside. • UNISON successfully objected to a Broadmoor patient being admitted to an acute ward where he had previously stabbed a nurse who still worked there. • UNISON has negotiated successful policies on violence against staff with two ambulance trusts, Kent and Lincolnshire. The Kent policy has resulted in a follow-up health and safety document entitled "Procedure for managing violent or aggressive incidents". • UNISON worked closely with trust management at St George's Hospital, Tooting, London, to improve safety and security for nurses on the site. • UNISON has been heavily involved with the Department of Health in drawing up the NHS Zero Tolerance campaign and commenting on the materials. These can be accessed at www.nhs.uk/zerotolerance • UNISON in Scotland has drawn up a four-point plan for tackling violence against health care staff.

UNISON, UNISON Centre, 130 Euston Road, London NW1 2AY. Telephone: 0845 355 0845.
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