The Guardian view on protecting NHS staff: ministers must take a lead in reducing attacks on the health workforce | Editorial
P.Nicola Ranger, general secretary of the Royal College of Nursing (RCN), is right to describe the growing level of violence directed at NHS staff in England as urgent. Freedom of Information requests from the Guardian have revealed a sharp rise in the number of attacks reported in hospitals, with an average of 285 per day in 2024-25. Some of the details shared with our reporters were horrific. An emergency room nurse said she sees guns brandished every month and described two incidents in which male patients deliberately ejaculated on nurses while waiting for treatment. A consultant – now retired – said he had been violently attacked twice in a few weeks.
The increase in racist incidents is also very worrying. Because the UK’s healthcare workforce is so diverse and constantly interacts with the public, its members are highly exposed to growing anti-migrant sentiment. In November, Health Secretary Wes Streeting said he was shocked by the impact on the NHS of the resurgence of “1970s and 1980s-style racism”.
But actions as well as words will be necessary if we are to end a worrying trend of aggression against frontline workers – which also affects teachers and others. Employers’ current obligations to prevent sexual harassment, including from their own staff, are strengthened in the Employment Rights Act. But tackling abuse and violence in the health care sector is a difficult task, with officials facing difficult decisions about whether to deal with people who threaten or insult. Such incidents harm institutions and individuals. Entire departments suffer consequences when victims need time off to recover or when a service is closed to provide a safe environment for a violent patient.
Last year, patient satisfaction fell to a record low: 59% of those surveyed said they were dissatisfied. But while frustration with an overburdened healthcare system may be understandable and some concessions can be made for mentally ill patients, the current levels of hostility and violence are a shame. A workforce accustomed to such behavior risks losing morale and providing poorer overall service. There is already alarming evidence that recruitment is being affected. Between April and September last year, the number of foreign nurses and midwives registering on UK registers fell sharply compared to the previous year. There are also growing concerns that the NHS Sexual Safety Charter, intended to improve the recording of sexual misconduct, is not being respected.
Even if it were possible, a return to old-fashioned deference to doctors and other high-level professionals would not be desirable. Rigid hierarchies and dynamics by which members of the public and young workers are infantilized and dominated cause terrible problems, with considerable costs for patients. But a situation in which people feel entitled to abuse service providers or muscle their way to the front of emergency queues is also very harmful.
Although the NHS is a particularly challenging environment in which to deal with such behaviour, these problems are not unique to the health service. Reduced trust in institutions and increased distrust of experts are widely observed societal trends that many public-facing organizations are grappling with. Mr Streeting must empower his staff to respect standards and limits. The police also have a role to play in ensuring that violent offenders are dealt with. The social contract of which the NHS is such a powerful symbol is strained and frayed, but it can be repaired.
