The recent publication of the NHS Staff Survey painted a stark picture of the kind of environment that ambulance staff are currently working in, but it also provides much food for thought as to how we may be able to approach subtler contributing factors to violence against ambulance staff.
As part of the annual NHS Staff Survey which gathers views and experiences from staff regarding their overall wellbeing within the NHS, the feedback of almost 25,000 NHS ambulance personnel was dutifully recorded.
From this data it was found that within the last 12 months 52.8% of staff in patient-facing roles experienced musculoskeletal problems as a result of work; 52.2% of ambulance staff have felt unwell as a result of work-related stress; and 60.8% have experienced bullying, harassment or abuse from patients and service users.
Of vital importance is the statistic that 52% of ambulance staff with frequent face-to-face contact with patients and the public have experienced violence within the last year.
This is significantly higher than the 34% cited by Matt Hancock in his letter to staff on staff violence and significantly higher than the national average in the NHS of 21%.
Assaults can have a catastrophic effect on staff, not only from the physical impact of the injury, but also the long-term effect of the psychological impact. Unsurprisingly, people get traumatised, and it can take many months to recover.
It’s not just physical violence — the verbal abuse inflicted on call takers, dispatchers and other staff working in contact centres is often unseen and under reported.
This can have similar effects on staff as a physical assault and should be viewed as equally unacceptable The pressure ambulance services are under cannot be ignored as a key factor of violence against staff.
Previous research by UNISON on violence against staff in the wider NHS found that NHS trusts struggling to meet their performance targets were likely to have much higher increases in violence against staff and that NHS trusts struggling with huge financial deficits also witnessed a big rise in the number of reported attacks on staff.
It’s no coincidence that in trusts where pressure seems most extreme — where there are huge financial deficits or serious struggles to meet waiting time targets — there have been the steepest rise in the number of attacks.
Staff shortages, increased workloads and longer waiting times can all lead to growing frustration and more potentially volatile situations.
There have indeed been some very positive steps taken to address this serious issue.
The Assaults on Emergency Workers (Offences) Act 2018 came into force in November 2018 and was a very welcome development, while the recent joint agreement, which involves NHS England and Improvement and other stakeholders, has underpinned the provisions in the 2018 Act and sets out the standards which victims of these crimes can expect.
The commitment to violence reduction a laid out by the NHS Long Term/10 Year Plan, published in January 2019, is also undoubtedly a step in the right direction.
Furthermore, the piloting of body worn cameras in the ambulance services has also had a positive impact.
The work done by NEAS in this area, and particularly their commitment to involving staff and trade unions in the project, is definitely an approach UNISON would like to see replicated across all services introducing body worn cameras.
However, the introduction of new technology and legislation is not an instant solution to the problem and can never be fully effective in efforts to reduce violence and aggression against staff without a fundamental change in how our services are funded from a political level in the face of such clear links between burdens caused by financial deficit and abuse of staff.
Additionally, we can’t help but bemoan that as of April 2017 NHS Protect, the national organisation that was responsible for setting the violence reduction strategy in England, no longer exists.
NHS Protect had wide-ranging responsibilities which played a key role in the fight against violence, from setting the violence and aggression standards contained in the standard NHS Contract to producing annual violence and aggression data.
In their absence ambulance trusts have been left with the difficult task of managing the violence and aggression risk but without the leadership and strategic oversight that comes from a national body.
The safety of ambulance staff needs to be paramount in the NHS and it can never be acceptable to feel that regular assaults or abuse are simply ‘part of the job’.
This needs to be heard loud and clear from NHS staff and, whilst the NHS Staff goes some way to showing this within its data, uniting the voices of NHS staff across the UK to ensure that this data is acknowledged by those with the power to make positive changes is a role that UNISON takes pride in.
As these cases continue to rise it would appear to be more vital than ever that you ensure your voice is heard in this.