The get-tough approach in the NHS

The Institute of Conflict Management (ICM) has been established since 1997 working with all sectors that face the problem of work related violence. During this time the ICM has been aware of the plight of workers within the NHS and agrees that it is totally unacceptable for doctors and nurses to be subjected to verbal abuse and violence whilst treating patients.
    
All efforts to eliminate and/or reduce the risk and impact of violence must be applauded. Managing people who are violent and/or aggressive comes with its own challenges and is a difficult and multi faceted process.

Coping with violent situations
Managing risks, personal safety and in particular challenging/aggressive behaviour requires contingency planning and skilled professional management in an attempt to resolve such situations safely, with minimal risks to all parties involved and limited disruption within work settings and to the organisation. To prepare employees of the organisation/profession to cope with such situations is not in question; considerations for staff development and training receive a specific mention under health and safety legislation — Health & Safety at Work Act 1974 Section 2 (2) (C).
    
Following the Launch of the National Conflict Resolution Syllabus in 2003, the ICM voiced some concerns about the effect this would have on existing training programmes and how this syllabus compared to other initiatives. As a result the CFSMS and ICM engaged in discussions and we continue to be available to consultation on future developments.

Deterrents
Although not directly consulted on the get-tough approach, the ICM agrees that the reporting of incidents, effective deterrents such as tougher sentencing and victim support all form a valuable part of an organisation’s overall strategy for preventing and managing work related violence. An effective strategy that also promotes an anti work related violence culture and combines this with a logical and systematic procedure for risk assessments, reporting of incidents, post incident counselling and relevant training, and, where possible, the use of technology, can all help to reduce incidents of work related violence. These are all issues that are highlighted time and again as effective measures with which to deal with violence and abuse to staff in the NHS, but all too often become lost in the wider priorities of an organisation, especially where budgetary constraints are an issue.
    
At a recent All Party Parliamentary Group Meeting in Westminster on preventing and managing work related violence, for which the ICM acts as the Secretariat, a number of speakers from a variety of industries were invited to speak. It was clear from the discussions that took place at the meeting, that there is a common theme across all sectors, and that there are common solutions. The National Occupational Standards-“Prevention and Management of Work-related Violence” (NOS – PMWRV/revised 2007), do in fact address those very themes and can be used in most, if not all, industries.
    
It was the ICM that applied for funding from the Health and Safety Executive to develop these NOS-PMWRV, which should be the first reference point for all organisations that have a need to protect their staff from violence at work. Whilst the ICM has developed several other initiatives to assist organisations, staff and trainers in this specialist area, it is the NOS-PMWRV which informs all of the ICM’s work. These are now freely available from the ENTO (www.ento.co.uk ) and offer all sectors, not just the NHS, the tools to ensure effective management processes and measures are in place.

Foundation award
The ICM has developed training from these standards entitled the Foundation Award for Managing Work-related Violence, which is based upon the first four units of the National Occupational Standards and covers:

• Assessing the risk of violence to your workers
• Ensure your actions contribute to a positive and safe working environment
• Protect yourself from the risk of violence at work
• Respond to work related violence incidents.  

The Award has been taken up by a number of organisations and has been piloted successfully by the Fife Fire and Rescue Service as part of the Scottish Executive campaign in partnership with the Scottish Trade Union Congress (STUC) to protect staff that serve the public from the risk of violence from customers or clients.

Physical Skills Tutor
More recently, the ICM has launched a Physical Skills Tutor Award whereby trainers in this subject are registered to the ICM having submitted a comprehensive portfolio of their expertise, demonstrated their knowledge to a panel of experts, and committed to continuous professional development throughout the period of their registration by attending two workshops per year. The ICM has also collated and risk assessed a comprehensive ‘catalogue’ of physical skills for industries to refer to and which will assist them in selecting a syllabus skill base that is appropriate and safe. The ICM is hereby filling a gap which many industries have either shied away from or have not focused their attention on effectively.
      
The ICM will continue to provide guidance and set standards for all sectors, including health and social care. It is imperative that the issue of violence at work remains at the top of the government agenda, and that standards are reviewed as good practice are identified and shared across all industry sectors, from which we can continue to develop further national standards and foster joined-up thinking across all government departments, industries and organisations.
    
The Institute of Conflict Management provides the context and the forum for all those with an interest in preventing work related violence to be involved in future development of working practice, training and other appropriate initiatives.

The ICM
To summarise, the ICM:

• is represented on the Health and Safety Executive’s Partnership on Work Related Violence
• is engaged in discussions with the Department of Health, Commission for Social Care Inspection, Department for Children, Schools and Families, on the issue of guidance on the use of physical intervention skills and training in vulnerable settings
• acts as the secretariat for the All Party Parliamentary Group on Preventing work related Violence and Bullying at Westminster
• is involved in the review of the National Occupational Standards “Managing Work-related Violence”
• is applying for QCA recognition as an Awarding Body
• is developing a website as a resource for information and debate for all matters relating to work related violence and conflict – www.conflictmanagement.org
• has developed a recognised scheme (ICM Quality Award Scheme) to ensure organisations that train in preventing and managing work-related violence and allied courses have the capability to design and deliver relevant and quality training
• has Codes of Practices and other standards to which all members have to abide
• has The Foundation Award which is now available, with further qualifications development underway
• has the UK’s first Physical Skills Tutor Award for trainers involved in the design and delivery of training programmes to manage physically challenging behaviours

For more information
ICM- 840 Melton Road, Thurmaston Leicester, LE4 8BN, Tel: 0116 2691049,
E-mail: conflictmanagement@associationhq.org.uk ,
Web: www.conflictmanagement.org
    
Further information about the National Occupational Standards can be obtained from the ENTO at www.ento.co.uk