A critical report by the National Audit Office has prompted Health Minister John Hutton to announce tougher measures to counter violence against NHS staff. The NAO found that violence against doctors, nurses, ambulance crews and other health staff has risen 13% in the last two years. A much more serious problem is that it is estimated that the recorded figures under estimate the reality and that two in five incidents go un-reported. The NAO found that in 2001 – 2002 there were 95,500 incidents of violence. In the last eight months, following the introduction of tougher measures, there were only 50 prosecutions. The rise in violence continued despite the adoption by the NHS of a zero tolerance zone campaign.NHS Trusts are criticized for their response to the problem. Four fifths of Trusts failed to meet the Department of Health’s national improvement target of a 20% reduction by April 2002. Some Trusts do not provide adequate support to staff wishing to pursue civil actions. Trusts are also criticized for failure to work in partnership with the police and other agencies. Criticism of Trusts is supported by a survey from the Royal College of Nursing which suggests that in four out of five cases no action arises from an incident being reported.

The GMB union has called for support and training to be extended to include ancillary staff . Sharon Holder, GMB National Officer for Health said: “The porter, the clerical assistant and the person that serves tea are just as much at risk as others.”

Measures announced by John Hutton in response to the NAO report include a poster campaign to raise awareness amongst general practice staff and to spell out to patients in family doctor surgeries that violent behaviour will not be tolerated. The posters, which include images of staff being physically and verbally abused, will be in every practice surgery and carry a clear warning that violent and abusive patients will be reported to the police, may be subsequently prosecuted and may be struck off a GP’s list.

From next week the new Counter Fraud and Security Management Service and Special Health Authority will take over lead responsibility for tackling violence against NHS staff. From 2004, as part of their accreditation process, security specialists in health bodies will receive training in law enforcement techniques, such as interviewing and taking statements from witnesses.