Ambulance Assaults: 62 Staff Attacked Every Day. Is Your Training Keeping Pace?

Ambulance assaults have reached a record high. In April 2025, the Association of Ambulance Chief Executives published figures that should have been front page news in every NHS boardroom in the country.

Across the fourteen UK ambulance services, there were 22,536 recorded incidents of violence, aggression, and abuse against ambulance staff in the 2024-25 financial year- the highest figure ever recorded. That is an increase of almost 15% on the previous year. 

Every single day, at least 62 ambulance people are abused or attacked. Almost three every hour. 

At London Ambulance Service, incidents of violence, aggression and abuse increased by 11.3% in 2024 compared to 2023, with physical assaults up 8% and verbal abuse up 13% - a pattern repeated across ambulance services nationwide.

The incidents range from verbal abuse to serious physical assault. Kicking, punching, slapping, head-butting, spitting, sexual assault, and attacks involving weapons. Female ambulance workers are three times more likely than the NHS average to be assaulted at work. Male ambulance workers are twice the NHS average.

And those are only the reported incidents. The true figure, as the AACE acknowledges, is higher.

Why ambulance staff face a uniquely high risk

The NHS Staff Survey consistently shows that staff in ambulance trusts are by far the most likely of any NHS workforce group to experience violence from patients and the public. In 2024, 31% of ambulance trust respondents said they had experienced at least one incident of physical violence in the previous twelve months.

That figure is not difficult to explain when you consider what ambulance work actually involves.

Paramedics and emergency care assistants routinely enter environments they have not been able to assess in advance. They arrive at private homes, roadside incidents, public spaces, and crowded venues - sometimes with limited information, sometimes alone, often at night. They work with people who are in acute distress, who may be intoxicated, who may be in mental health crisis, and who may be frightened or confused about what is happening to them.

In some cases, the person they are trying to help is also the person presenting the risk. The patient who was calm when the call was made may have deteriorated significantly by the time the crew arrives. The carer who called for assistance may themselves be volatile. The crowd that gathered may have become hostile.

These are not edge cases. They are the working reality of ambulance services across the UK every shift.

What the figures mean for training

The AACE has called for further government intervention. Calls for zero tolerance have been made, repeated, and made again. Sentencing for assaults on emergency workers has been strengthened. All of these responses matter.

But none of them change what happens in the moment when a crew arrives at a difficult scene.

What changes that is preparation.

Ambulance staff need training that reflects the actual risk profile of their role - not generic conflict management content designed for a reception desk or a call centre, but training that is built around the specific environments, pressures, and risks of pre-hospital care. That means training that addresses lone working, dynamic risk assessment, managing patients in acute mental health crisis, responding to intoxicated individuals, and the physical intervention skills that may be necessary when communication alone is not enough.

It also means training that is honest about the physical dimension of the risk. Stand2's guidance on managing the risk of violence and aggression is explicit: staff caring for persons that present a serious risk of physical aggression may need training in physical intervention techniques as well as basic training. For ambulance crews, that risk is not theoretical. The data confirms it happens every day.

The impact on staff wellbeing and retention

Behind every statistic is a person who went to work to help someone and came back having been assaulted.

The AACE has been clear that the impact of these incidents extends far beyond the immediate physical harm. Repeated exposure to violence and aggression takes a cumulative toll - on confidence, on mental health, on the ability to continue in a role that already carries significant emotional weight. For some staff, it is the reason they leave the ambulance service.

That matters for recruitment and retention in a sector that is already under significant pressure. But it also matters for patient care. A crew that has been assaulted is a crew that may be taken out of service. An ambulance that has been damaged is an ambulance that cannot respond to the next call.

Protecting ambulance staff from violence is not simply a welfare issue. It is a patient safety issue.

What good training for ambulance services looks like

Stand2 has been delivering conflict management, personal safety, and physical intervention training to ambulance services across the UK for over 25 years. West Midlands Ambulance Service has been a client since 2003. We have worked with London Ambulance Service and other NHS ambulance trusts, training crews from newly qualified paramedics to experienced senior clinicians.

That longevity reflects something important. Ambulance services do not renew training contracts for a quarter of a century because a provider is cheap or convenient. They renew them because the training works - because it is built around the real situations their staff face, because it is delivered by people with genuine operational credibility, and because it is refreshed and updated as the operating environment changes.

Stand2's training team includes former military personnel, specialist police officers, and professionals with direct experience of high-risk pre-hospital and emergency environments. Every physical programme is independently medically reviewed and fully risk assessed. Every programme is built around the specific risks of the environment it is designed for.

For ambulance services facing record levels of violence against their staff, that standard of preparation is not a luxury. It is what the situation demands.

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