Violence and Aggression:
Ambulance workers should ‘Work Without Fear’
NHS ambulance workers who have been attacked while on duty are at the forefront of an ongoing high-profile national campaign to promote respect across the country and enable themselves and colleagues to treat patients safely and without fear of being attacked.
The #WorkWithoutFear campaign is led by the Association of Ambulance Chief Executives (AACE) and supported by NHS England (NHSE).
What is happening?
Our data shows a record 17,114 incidents of violence and abuse being registered during the 2023/24 financial year.
This means that every single day last year, a staggering 47 ambulance staff were abused or attacked – two every hour of every day throughout the whole year. This represents an increase of 123% in reported incidents since records began eight years ago and includes kicking, punching, slapping, head-butting, spitting, verbal abuse and sexual assault, and ranging from common assault to more serious attacks involving guns, knives and other weapons.
Who is it aimed at?
The aggression is aimed daily at frontline clinical staff such as paramedics, emergency care assistants, students and volunteers, as well as 999 and 111 call handlers in call centres, regardless of the age or gender of the employee concerned. Alcohol is the most prominent factor in assaults against ambulance staff, followed by drugs and people in mental health crisis. Race and sexuality have also increased as exacerbating factors in these assaults.
#WorkWithoutFear highlights the profound impact of this abuse on the everyday lives of ambulance workers and aims to encourage the minority of people who might commit these offences to have greater respect for the people who are trying to help them, their friends and families when they need it most.
The campaign features a number of ambulance workers from all over the country who have been subjected to violent behaviour. We will continue to add more stories to this page, showing the impact of this violence, aggression and abuse on our ambulance family.
What can I do to help?
- Spread the message that violence against NHS staff – and anybody else – is never acceptable.
- Share our #WorkWithoutFear tag on social media and share our films about some of those affected.
- Print off our posters and place them around your workplace or other social environments.
- You can download our campaign materials at our Resource Centre
What are ambulance services doing about this worrying issue?
As a result of the escalation in violence and abusive incidents, NHS ambulance services have prioritised the safety of their people and are undertaking several initiatives alongside the #WorkWithoutFear campaign to try and effect behavioural change among those who might carry out these assaults or become abusive, while providing employees with as much support as possible to reduce the incidence of assaults. This includes:
- Dedicated violence prevention teams established within each NHS ambulance service.
- Body worn video cameras are being piloted and evaluated in all NHS ambulance services.
- The establishment of a centrally coordinated violence data set that enables each ambulance service to report the type and frequency of assaults in a more consistent way, giving a greater foundation and better understanding of the prevalence and reasons behind violence and aggression directed at ambulance people.
- A new ‘restrictive interventions’ training programme giving ambulance people safer ways to protect themselves and patients in potentially volatile situations.
- Counselling and other forms of talking therapy and support for employees who have been subjected to violence and aggression; the sector continues to work hard to find new and innovative ways to provide better post-incident support for its people.
In addition, the Association of Ambulance Chief Executives (AACE) and the wider ambulance sector continues to be particularly vocal in encouraging the judiciary to use the full powers of the Assaults on Emergency Workers Offences Act 2018 legislation to ensure appropriate sentences for those found guilty of committing crimes against our people.
Daren Mochrie, Chair of the Association of Ambulance Chief Executives (AACE) and Chief Executive of North West Ambulance Service says:
Unfortunately, ambulance staff face the possibility of violence, assault and aggression every time they start a shift. When they occur, these attacks have a significant and lasting impact on the team member, affecting every aspect of their life.
Despite that, ambulance staff continue to turn up for work in order to help and serve their local communities.
We hope this campaign raises awareness of the impact of this behaviour on individuals, emphasises that it is totally unacceptable in any form and ensures that our staff are treated with the respect they deserve. The Assaults on Emergency Workers Offences Act 2018 legislation is in place, but we must now see the judiciary consistently using that to issue the most appropriate sentences to those found guilty of committing these appalling crimes.
Anna Parry, AACE Managing Director said:
Unfortunately, it is a sad fact that ambulance workers face the very real possibility of violence, aggression and abuse each time they start a shift. These incidents can have a significant and lasting impact on our people, sometimes even leading them to leave the ambulance service. This is why it is vital that the UK ambulance sector does all it can to help protect its people and support them if they are subjected to assaults.
Our ongoing #WorkWithoutFear campaign is shining a light on this alarming issue and raising awareness of the hugely negative impact of this behaviour on our people.
There is also a considerable amount of work ongoing within ambulance services to help protect our people and minimise the opportunities available for perpetrators to attack and abuse them
Tracy Nicholls, chief executive of the College of Paramedics said:
The College of Paramedics wholeheartedly supports the #WorkWithoutFear campaign and firmly believes that every paramedic should be able to go to work and do their job without fear of abuse or violence.
The fact that every day last year, 47 ambulance staff were abused or attacked is totally appalling and unacceptable. We know from our own engagement with members that nearly three-quarters of paramedics have feared for their own safety or felt threatened at work. Enough is enough, it has to stop.
We can see the work that the trusts are doing to mitigate the risks to their staff, whether in the operations centres or on the front line but we commit to finding new ways of working together to prevent abuse from happening, as well as demanding zero-tolerance when it does occur.
Amanda Pritchard, NHS England Chief Executive, said:
It is horrific that in just one year, thousands of our hardworking ambulance staff have experienced unacceptable violence and abuse at work. Ambulance staff are already under huge pressure delivering urgent care to patients and they have a right to feel safe when they come to work.
We know there is more to be done right across the NHS to ensure staff are protected and Work Without Fear is an important campaign which will highlight the horrendous impact this is having on the ambulance workforce and hopefully help towards preventing such violence from happening.
The Deputy Chief Executive of NHS Providers, Saffron Cordery said:
We are proud to support this national campaign to ensure that ambulance staff can go to work without fear. The safety of staff is the top priority for trust leaders.
It is unacceptable that NHS staff experience violence or aggression, whether that be physical or verbal. We are particularly concerned that Black, Asian and minority ethnic staff, LGBTQ+ staff and other staff with protected characteristics face additional challenges in the workplace.
NHS ambulance staff provide an incredibly important service to our communities, ensuring that people receive the care they need as quickly as possible, often in life-threatening situations. This involves working incredibly hard to treat people at the scene or getting them to A&E departments, if necessary, while control room staff ensure that those with the most urgent needs are prioritised.
Staff being intimidated or attacked not only impacts the staff members involved, but also leads to an impact on the care provided to patients and undermines vital staff recruitment drives.
Karl Demian, TASC’s Chief Executive Officer, said:
Ambulance staff face the possibility of violence and aggression every time they start a shift and at TASC we regularly hear about the devastating and long-term impacts an assault can have on someone’s physical and mental health. The abuse we hear about ranges from spitting, intimidation and having faeces thrown at them, to physical attacks such as punches, kicks, and in a small number of cases, even involving weapons, such as knives, glass or baseball bats. Despite that, they continue to turn up for work in order to help and serve their local communities.
Already having one of the most stressful jobs in the UK, our lifesaving ambulance staff deserve to be able to work without fear of assault or aggression. Violence in any form is completely unacceptable and TASC continues to support this campaign to raise awareness of this growing issue.
Helen Ray, Chief Executive at North East Ambulance Service, said:
For our colleagues, working for the ambulance service is so much more than a job; they come to work to help people and under no circumstances should they expect to find themselves a victim of any form of abuse whilst trying to do so.
The majority of our patients are extremely thankful for their service, but the minority who choose to abuse our staff need to be under no illusion that we will not tolerate this, and we will always support our colleagues to prosecute.
Meet some of our people who have experienced assaults:
- Bradley is an ambulance service call assessor who has experienced violence, aggression and abuse from the people he tries to help.
- Michael is a paramedic who was stabbed by a person he tried to help.
- Steph is a paramedic and operational who has suffered transphobic abuse from the people she tries to help.
- Charlotte is a paramedic who was sexually assaulted by a man she was trying to help.
- Steve is a paramedic who was assaulted and had his jaw broken by a man he was trying to help.
- Lauren is a paramedic who was sexually assaulted by a man she was trying to help.
Where can I find out more?
Contact the AACE National Ambulance Violence Prevention and Reduction Operational Lead via adam.hopper@aace.org.uk.
