A&E staff are routinely subjected to physical violence, racism, and aggression, with nearly all healthcare workers in emergency departments experiencing such incidents on a weekly or daily basis, according to a new report from the Royal College of Emergency Medicine (RCEM).
The RCEM's survey of 2,126 emergency department workers found that 96% have faced violence or aggression from patients or the public. Of those, 73% reported these incidents occurring weekly or even daily. Two-thirds of affected staff indicated that these encounters involved discrimination.
Health leaders describe the situation as 'normalised,' attributing the escalating crisis to prolonged waits for care and persistent staff shortages. Many staff feel their concerns are not adequately addressed by their employers, leading to a pervasive sense of unsafety and an expectation of being attacked or intimidated.
"No-one should go to work fearing – or, worse, expecting – to be attacked, intimidated or abused," said RCEM President Dr. Ian Higginson. "Nor should they lack confidence that their employers have their backs, or that the judicial system will kick in. Yet, that's the reality faced by the majority of my colleagues in emergency departments across the country. They often do not feel safe to care for patients."
The survey highlighted that less than 5% of staff always felt safe in emergency departments, with 57% feeling safe only most of the time. Furthermore, only 41% of those who reported incidents said their NHS trust took meaningful action.
Long waiting times were cited by 90% of respondents as a factor exacerbating the problem, followed by overcrowding (85%) and staff shortages and corridor care (both 65%). Latest figures show that over a quarter of patients waited more than four hours to be admitted, transferred, or discharged after attending A&E in July.
Dr. Catherine Hayhurst, co-chair of the RCEM quality in emergency care committee, noted the heartbreaking nature of staff accounts, stating, "Anyone who works in emergency departments knows that violence and aggression towards healthcare staff has become normalised. That must end and we call on policymakers and NHS leaders to help us make emergency departments a safer place for staff."
Dr. Den Langhor of the British Medical Association emphasized that while long waits can cause frustration, they do not justify abuse or intimidation of staff. He pointed to new NHS staff standards introduced this summer that make employers accountable for tackling such violence.
Professor Nicola Ranger, general secretary of the Royal College of Nursing, expressed profound shock at the figures, stating, "We know the NHS is becoming a more dangerous place to work, and this falls especially hard on female dominated professions like nursing. Far too many are being forced to take time off or even leave the profession because of the physical and mental scarring that can result from these attacks."
A Department of Health and Social Care spokesperson affirmed that any acts of violence, abuse, or harassment towards NHS staff are unacceptable and will not be tolerated. The government recently introduced new NHS staff standards to help prevent and reduce violence and abuse against staff, ensuring they can perform their jobs safely.