How Safe Are NHS Workers?

Violence against NHS staff is not new, but its scale has reached a level that is now affecting recruitment, retention and the quality of care itself. In 2024, trusts across England reported 87,200 physical assaults on staff — an average of 239 per day.^[1] These range from punches thrown in A&E waiting rooms to sustained attacks on mental health nurses by patients in crisis. Behind the headline figure sits a much larger volume of verbal abuse, threats and intimidation: over 210,000 reported incidents in 2024, and the true number is almost certainly higher.^[2] Staff Survey data consistently shows that 40-60% of incidents go unreported, often because staff see it as "part of the job" or doubt that reporting will lead to any consequence.^[2]

The drivers are structural. Emergency departments are overcrowded, with patients waiting 12 hours or more in corridors. Mental health wards are running at over 100% occupancy. Community services have been cut, meaning people in crisis arrive at hospitals as a last resort, more agitated and more unwell than they would have been with earlier intervention. Alcohol and substance use are factors in roughly a third of A&E-related assaults. Staff shortages mean fewer people managing more patients, reducing the capacity for de-escalation. The result is a vicious cycle: violence drives staff out, shortages increase pressure, and pressure breeds more violence.

Mental health trusts bear the heaviest burden by far, with 127 reported assaults per thousand staff — more than three times the rate in acute hospitals and nearly seven times the rate in primary care.^[3] Ambulance staff face the second-highest rate. These are not statistics that can be explained away by the nature of the patient population alone; they reflect a system under sustained pressure, where the conditions that generate violence are themselves a product of underfunding and understaffing.