A Royal College of Nursing investigation has painted a stark picture of rising violence against accident and emergency staff across London and beyond, with physical assaults in A&E reported to have nearly doubled between 2019 and 2024. According to the Evening Standard’s reporting of the RCN’s Freedom of Information analysis, nurses describe being punched, spat at, threatened with acid and even having a gun pointed at them — a catalogue of incidents that union leaders say is having a severe effect on staff safety and morale.

The human cost is clear. The Evening Standard quotes political figures condemning the attacks: the Health Secretary, Wes Streeting, and the Liberal Democrats’ health spokesperson, Helen Morgan, have urged that perpetrators face the “full force of the law”. Ms Morgan told the paper: “Violence against hospital staff is utterly abhorrent and those committing it should feel the full force of the law. Those working in hospitals often do so under incredibly difficult conditions to look after us when we are most in need.”

The RCN’s findings sit alongside other regional investigations showing similar trends. A BBC analysis of recorded incidents in Kent and Sussex found a 47% rise in physical assaults on hospital staff over four years, while union surveys report that many nurses face violence or abuse on a daily or regular basis. Unions and researchers warn that the rise in assaults is contributing to worsening retention and recruitment problems in an already stretched workforce.

Nurses’ accounts collected by unions and the RCN are harrowing and varied: staff report being spat at or punched, subjected to verbal abuse and threats, and in a minority of cases confronted with weapons. Unison’s recent survey for Nursing Times highlighted that a substantial proportion of nurses and midwives required time off work after physical attacks, with a notable number considering leaving the profession as a result.

Unions and think-tanks point to common drivers behind the increase. Understaffing, prolonged waiting times and overcrowding are repeatedly cited as factors that can escalate patient and visitor frustration into aggression. The RCN’s position statement and Nuffield Trust analysis both argue that poor working conditions and pressure on services make violence more likely and aggravate its impact on staff wellbeing and sickness absence.

Policy responses are emerging but critics say implementation is uneven. The NHS England Violence Prevention and Reduction Standard, updated in December 2024, offers a comprehensive framework urging board-level accountability, better data collection, workforce training and a red–amber–green benchmarking system for progress. Trials of measures such as body-worn cameras and government proposals to increase sentences for attacks on emergency workers have been reported, but unions say technological fixes and tougher sentences alone will not address root causes.

There are practical obstacles to translating guidance into safer workplaces. Unison’s press release notes that only a minority of staff feel supported after reporting incidents and that police response can be inconsistent; the RCN stresses that legal measures must sit alongside prevention, better reporting systems, thorough incident investigation and victim support. Research bodies recommend improved, consistent data collection so trusts can target interventions based on evidence rather than anecdote.

Taken together, the evidence points to the need for an integrated approach: enforce the law where appropriate, but also invest in staffing and the service improvements that reduce waits, provide comprehensive training and support for staff, roll out proven protective technologies where helpful, and ensure board-level oversight of violence reduction plans. NHS England’s standard sets out those components; unions and independent analysts argue that sufficient funding and political will will determine whether guidance translates into safer shifts for frontline workers.

For clinicians and patients alike, the stakes are high. Unless trusts, government and criminal justice partners convert guidance and rhetoric into consistent, well-resourced action, front-line services risk further erosion through staff sickness, resignations and the long-term damage to morale that repeated assaults cause. Unions say urgent, measurable steps are required if hospitals are to remain places where patients can be treated and staff can work without fear.

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Source: Noah Wire Services