Violence Against NHS Staff Has Reached a Three-Year High. A Slogan Is Not a Safety Strategy.

Violence against NHS staff has reached its highest level in three years - and the response from across the sector has been almost entirely verbal.

In March 2026, the Royal College of Emergency Medicine described the latest figures on violence against NHS staff as "disgraceful, appalling and so much more." The Health and Social Care Secretary had already promised zero tolerance. NHS England had published a refreshed Violence Prevention and Reduction Standard. Trade unions had called for urgent action.

The words were strong. The intent was clear.

But words alone do not reduce assaults. And the figures make uncomfortable reading.

What the latest data shows

The 2025 NHS Staff Survey completed by approximately 760,000 NHS workers, roughly half the entire NHS workforce and thought to be the largest workplace survey in the world - found that around one in seven staff experienced at least one incident of physical violence from a patient, family member, or member of the public in the previous year. That figure of 14.47% represents a three-year high. 

The headline figure alone is sobering. But the breakdown tells an even more specific story.

Staff in ambulance trusts remain by far the most likely to face violence from patients and the public, with 31% of respondents in 2024 saying they had experienced at least one incident in the past 12 months. Staff in mental health and learning disability trusts are more likely to experience multiple incidents of violence.

These are not abstract statistics. They represent nurses, paramedics, healthcare assistants, and clinical support workers being physically assaulted while trying to provide care. They represent staff taking time off, leaving the profession, or continuing to work while carrying the psychological weight of repeated trauma.

And they represent a problem that has not improved despite years of stated commitment to address it.

Why "zero tolerance" is not enough

Saying that violence will not be tolerated is a useful statement of principle. It tells staff that abuse is not part of the job. It tells the public that assaulting healthcare workers is unacceptable.

But a statement is not a strategy.

The Health and Safety at Work Act 1974 places a clear legal duty on NHS employers to protect staff from foreseeable risks, including violence. NHS England's refreshed Violence Prevention and Reduction Standard, published in December 2024, goes further, encouraging a public health, trauma-informed approach to preventing and reducing violence and understanding the root causes of distress. It delivers a risk-based framework that supports employers to create safe and secure working environments for NHS staff.

That framework matters because it moves the conversation beyond statements of intent and towards a structured, accountable approach to reducing harm.

But frameworks only work if organisations act on them. And acting on them requires honest answers to uncomfortable questions.

Are staff working alone in the community at night, with unreliable communications and no immediate backup?

Are waiting times and environmental pressures increasing frustration before staff even make contact with a patient?

Are incident reporting systems trusted? Are staff confident that reporting an assault will result in action rather than silence?

Are risk assessments current, specific, and actually used to plan safe working, or are they documents that sit in a folder?

And critically: is the training staff receive genuinely preparing them for the situations they face or is it a compliance exercise that ticks a box and then fades?

The training gap

For many healthcare workers, violence and aggression are not abstract risks. They are Tuesday afternoon.

A community nurse visiting a patient with dementia who becomes suddenly agitated. A paramedic crew arriving to find a patient in acute mental health crisis who turns violent without warning. An emergency department receptionist facing a family member whose distress has tipped into aggression while they wait for news.

These situations do not resolve themselves through goodwill and common sense. They require staff who have been genuinely prepared - who can recognise early warning signs, communicate under pressure, create distance where possible, and know what to do when communication alone is not enough.

That preparation has to be honest about what staff actually face. Training that stops at de-escalation theory but ignores the physical dimension of real incidents leaves staff exposed in precisely the moment the training was supposed to help. Training that focuses entirely on technique without building judgement and decision-making produces staff who can perform in a drill but freeze when the situation doesn't match the script.

Effective conflict management and physical intervention training for healthcare environments has to do both. It has to be built around the specific risks of clinical and community settings. It has to be delivered by people who understand those environments. And it has to be refreshed regularly - because skills that are not practised fade, and in healthcare, the consequences of that fade are serious.

What good training looks like in healthcare

Stand2 has been delivering conflict management, personal safety, and physical intervention training to NHS trusts, ambulance services, hospitals, and community healthcare providers for over 25 years. In that time, the fundamentals of what works have not changed - even as the environments have become more complex and the regulatory expectations have become more demanding.

Good training is principle-led, not technique-led. It helps staff understand what they are trying to achieve in a difficult situation, not just what move to perform. That understanding is what allows staff to adapt when the situation changes - which in healthcare, it always does.

Good training is realistic. It is built around the environments healthcare staff actually work in -  the cramped corridor, the home visit, the emergency department at 2am - not a generic classroom scenario that bears no resemblance to the working day.

Good training is medically reviewed. At Stand2, every physical programme is independently reviewed by an emergency medicine consultant and fully risk assessed by a NEBOSH-qualified practitioner. In a sector where a technique that causes harm can result in a serious incident investigation, that level of oversight is not optional.

And good training is refreshed. A member of staff who was trained two years ago and has not practised since is not the same as a member of staff who trained last month. The General Medical Council's review of the evidence on skills fade confirms that skills decline significantly over periods of non-use, with the sharpest decline in the first six to eighteen months. Annual refresher training for physical intervention skills is not a commercial preference. It is what the evidence requires.

The duty of care is not symbolic

Violence against NHS staff should never be accepted as part of the job. That principle is right. But principle without action is not protection.

Organisations that take their duty of care seriously do not stop at policy. They ask what their staff face, they assess the risk honestly, they invest in training that reflects that reality, and they build systems that support staff when things go wrong.

The figures in the 2025 NHS Staff Survey are a measure of how far there still is to go. For healthcare organisations genuinely committed to staff safety, the question is not whether training is needed. It is whether the training they have is good enough.

Stand2 has delivered specialist conflict management, personal safety, and physical intervention training to NHS trusts, ambulance services, and healthcare providers across the UK for over 25 years. Our programmes are AIM accredited, independently medically reviewed, and built around the specific risks of clinical and community healthcare environments. To find out more, visit our healthcare sector page or get in touch.