Violence and Aggression Prevention and Reduction towards staff
Our new campaign and warning system at UHDB will take the necessary action against intentional abuse towards staff.
Abuse towards NHS staff is rising nationally and at UHDB, our staff survey highlighted that one in four people have experienced physical violence from patients, relative or members of the public while at work. Last year (2024-2025), more than 2,600 incidents of violent and aggressive behaviour were reported by our staff.
Everyone has the right to care safely and be treated with respect, without the fear that they will be harmed or bullied at their place of work. Abuse towards staff creates a culture of fear and undermines the safety, wellbeing and dignity of our people and includes violence, racial, sexual, physical or verbal harassment.
UHDB has listened to colleague feedback about how we can make a difference that is meaningful and has an impact - so we have worked closely with our partners and colleagues to develop and implement a new warning system that holds individuals accountable for acts of repeated, intentional and abusive behaviour.
We know there are vulnerable patients in our care who do not mean us harm and have complex health challenges that can result in aggressive behaviour they are not at fault for. The new sanctions standard will not impact these patients and is aimed at stopping those who intentionally abuse our staff.
What are the new sanctions standards?
The standards are guidelines that sets out how UHDB will manage incidents of abuse towards staff, balancing this with our priority to deliver care to our communities. The sanctions include an escalation process that investigation teams can use to manage and respond to extreme behaviour incidents and includes and a yellow and red card warning system.
- Informal verbal warning - A verbal conversation will happen to inform individuals they have breached the unacceptable behaviour criteria.
- Formal verbal warning - A recorded verbal warning will be raised on our incident system and alert will be placed on the patient's care records.
- Yellow card: written warning - The warning system will be triggered where a formal written warning will be sent to the patient and their GP which will be recorded on our incident system and an alert placed on patient care records . The investigating team will have a discussion with various stakeholders to review the incidents, learnings and appropriate action.
- Red card: right to withhold care - If a patient continues to exhibit violent and abusive behaviour, a Trust panel will consider all incidents, manage and assess risk to staff and patients, and assess whether the behaviour should result in excluding the patient from the premises and withholding non-emergency treatment. A letter will also be sent to the patient and GP.
How were the sanctions developed?
A wide range of Trust internal and external groups have contributed to our new approach to ensure it is fair, proportionate and reasonable and does not impact patient safety and essential care.
The sanctions standards have been developed in support of our Violence Aggression Prevention and Reduction (VAPR) stakeholder group, which includes Trust health and safety, clinical representatives, security, safeguarding and legal teams. We have engaged our workforce on where we need to focus our staff wellbeing and support services and which areas to focus our violence prevention and reduction efforts on, including updating staff training and setting out clearer incident reporting routes for staff.
Why have we put this new process in place?
Abuse and violence towards NHS staff is continuing to rise on a national scale and this is completely unacceptable. NHS staff come to work to provide patient care, not to be harmed and deserve the right to work safely. After years of abusive behaviour going unchecked and consistent patterns in national staff survey feedback, we are taking strong action against intentional and repeated aggression towards our people.
The Trust VAPR stakeholder group meets regularly to understand which areas are most prone to incidents and identify what we need to put in place proactively to prevent and reduce abuse towards staff from happening, while empowering our staff to deal with challenging situations through comprehensive Trust wellbeing support, and conflict resolution and de-escalation training.
UHDB serves over one million people across five hospital sites, and other community locations in Staffordshire and Derbyshire, with a highly diverse and vibrant workforce and patient population. We want all of our communities to benefit from exceptional, compassionate and inclusive care and this starts by respecting our right to care safely.
Our new anti-violence and aggression campaign
If you visit our hospitals, you may see artwork on the walls with some powerful quotes taken from colleagues who have experienced violence or aggression. We have worked with our colleagues and stakeholders, to develop a public anti-violence campaign that sets out a clear position that our workforce has the right to care safely, and actions will be taken where appropriate if incidents occur. These can be found across our Trust in areas where violence and aggression are most likely to occur.
