Emergency department staff are routinely subjected to physical violence, racism, and aggression, with nearly all workers experiencing such incidents on a daily or weekly basis, according to a new report from the Royal College of Emergency Medicine (RCEM). The findings indicate that this crisis has become normalized, exacerbated by long patient wait times and staff shortages.
The RCEM surveyed 2,126 emergency department workers, revealing that 96% have encountered violence or aggression from patients or the public. Of these, 73% reported that these incidents occurred weekly or even daily. Furthermore, two-thirds of respondents indicated that the incidents involved discrimination.
"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."
Many staff feel that their National Health Service (NHS) trusts have not taken sufficient action against perpetrators, leading to a sense of pervasive unsafety. Only 4% of staff surveyed always felt safe in emergency departments, while 57% felt safe most of the time. Among those who reported incidents, just 41% said their NHS trust took meaningful action.
Factors contributing to the problem include long waiting times (cited by 90% of respondents), overcrowding (85%), and staff shortages and corridor care (both 65%). In July, more than a quarter of patients waited over four hours to be admitted, transferred, or discharged after attending A&E.
Dr. Catherine Hayhurst, co-chair of the RCEM quality in emergency care committee, described some member accounts as "heartbreaking – but not surprising." She added, "Anyone who works in emergency departments knows that violence and aggression towards healthcare staff has become normalized. 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 from the British Medical Association stated that while long waits and overcrowding can cause frustration, they do not justify abuse or intimidation of staff. He noted that new NHS staff standards introduced this summer hold employers accountable for tackling such violence.
Professor Nicola Ranger, general secretary of the Royal College of Nursing, called the figures "profoundly shocking" and highlighted that the NHS is becoming a more dangerous place to work, disproportionately affecting female-dominated professions like nursing. She added that too many healthcare workers are being forced to take time off or leave the profession due to the physical and mental scarring resulting from these attacks.
A spokesperson for the Department of Health and Social Care affirmed that acts of violence, abuse, or harassment towards NHS staff are "completely unacceptable and will not be tolerated." The department stated that new NHS staff standards have been introduced to guide employers in preventing and reducing violence and abuse against staff and ensuring their safety.