Unreported violent incidents compromise security

In 2006/7 there were 55,709 physical assaults against NHS staff1. This equates to an average of 43 assaults per 1000 staff. The apparent downward trend in the level of violence towards health workers is not the picture painted by the Royal College of Nursing, which reported that more than one third of nurses working alone have been assaulted or harassed in the last two years.  Research involving GPs indicates similar levels of violence. The anecdotal evidence seems to suggest that there is a high level of non-reporting of incidents despite a legal requirement to do so.

RELUCTANCE TO REPORT INCIDENTS
According to research conducted by Mori for the NHS Counter Fraud and Security Management Service (SMS), two-thirds of those physically abused do not report the attacks2. A similar finding was recorded by The Health Commission's National NHS Staff Survey 2006.
    
There are many possible reasons as to why this is. However both studies conclude that a majority of healthcare workers consider abuse and threats as an occupational hazard and/or they didn’t think any action will be taken.

In his speech to the Labour Party conference last autumn, Health Secretary, Alan Johnson challenged this perception by saying, “Anybody who abuses our staff must face tough action and the possibility of jail.” However criminal prosecutions are still rare. A BBC Panorama investigation found that less than two per cent of all attacks result in prosecutions.
    
The introduction of Security Management Directors has raised the profile of security management within NHS bodies and provides focus at Board level. But frontline workers are still waiting to see if this gesture results in changes that better secure their safety.

BEYOND COMPLIANCE REQUIREMENTS
All employers have a legal duty to protect their staff from work-related violence and aggression. Secondary legislation requires NHS bodies to monitor and ensure compliance with the Directions on Violence and Aggression (2003) Amended (2006) set out by the Secretary of State. In particular employers must ensure that all NHS staff are informed of the content of these directions and what is required from them to ensure compliance.
    
Despite increased publicity, some staff still do not understand why they must report violent incidents or even know how to do it. Management needs to reinforce the message that reporting is about more than compliance. Lessons learnt from security incidents inform future preventative measures to protect them.

SOUND POLICY & PROCEDURE MANAGEMENT
There is no point creating safer working procedures and policies if they are a well kept secret. The onus is on employers to ensure that policies and procedures are circulated to all staff in a clear and consistent manner. Automated software is now available to make this task manageable without a high administrative burden. Employees will begin to see that reporting incidents makes a difference when procedures are updated immediately as a result of lessons learned during incident investigations. NETconsent, leading procedure and policy management software vendor, also recommends randomly testing sample groups of employees to ensure they understand published procedures. In this way line managers can more readily spot gaps in knowledge or potential issues with the practical application of amended procedures.
    
“Once staff understand the importance of reporting all incidents of violence and abuse and know how to set about it, they are more inclined to complete the process correctly” says Robin Saunders, Managing Director of NETconsent. “Automating the procedure and policy management lifecycle is a cost-effective method to guarantee employees, bank and agency staff read key information, understand it, and accept their responsibilities.”
In the short term any increase in the level of incident reporting might result in unwanted headline statistics. However achieving a more accurate picture of violence towards staff will ultimately enable NHS bodies to mitigate risks more effectively and to instigate appropriate control measures. This will better protect NHS staff and lead to a reduction in the cost of these attacks, which is estimated to have cost the health service more than £100 million in 2005-2006 when extra security, absenteeism, training and legal bills are taken into account.

1 NHS SMS Physical Assault Statistics 2005/06
2 Violence towards NHS staff from the public, Research conducted for the NHS Counter Fraud and Security Management Service ©MORI/20533

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