Many public sector workers will be relieved the festive season is over – far from being a time of goodwill to all, for those working in the NHS, the police and social services, it is a time of heightened danger of assault by inebriated clients or members of the public.

As drunkenness increases during the Christmas and New Year celebrations, so too does the risk of violence against public workers. According to the British Crime Survey, victims believe that in 40% of assaults and 31% of threats at work, the attack was alcohol-fuelled.

But December is not the only dangerous time. In fact, violence is an occupational hazard for large swaths of the public sector. According to figures from the Health and Safety Executive, public sector workers are the most likely to be victims of serious violence. As the graph shows, six out of the 10 sectors with the highest rates of violence were in the public sector.

Of the more than 6,000 incidents reported to the HSE, almost 1,468 were against care assistants and home carers, 731 were against police officers, 627 were against nurses and 467 were against prison officers (see chart). Proportionally, staff in the Prison Service, the police and the NHS are in most danger (bus and coach drivers are also at risk but are mainly private sector employees).

The HSE’s figures are based on incidents reported through the regulations on reporting injuries, diseases and dangerous occurrences, so they only include cases where the victim needed at least three days off work. The data does not capture minor assaults and many cases are not reported. The frequency of violence is actually much, much higher.

The Prison Service’s own figures show that for the year to April 2008, 12,773 staff were assaulted, while the latest data from the NHS Security Management Service (SMS) reveals that there were 55,993 reported assaults against NHS staff. Recent research by Incomes Data Services for public sector union Unison found 71.5% of custody staff had been threatened with physical violence, more than 60% had been victims of minor assault and one fifth had been so badly attacked as to need medical treatment. Police community support officers, forensic services, traffic wardens, police station receptionists and security staff are also at particular risk of assault.

In local government, social workers, residential care assistants, library staff and day care workers are most likely to have experienced threatening or violent behaviour. Data from 2005 surveys found 3% of respondents reported having been victims of violence requiring medical assistance or first aid, while 14% said they had been physically threatened.

Tough measures

While some public sector professions do involve an element of risk, unions and other commentators feel much more could be done to mitigate the danger to staff and pose the question of why public employers have made so little headway in tackling the problem.

Dave Prentis, the general secretary of Unison, says: “It’s disgraceful that violence against nurses, paramedics, social workers and other public sector workers is on the increase and we need tough measures to deal with it. No one should have to put up with violence and abuse just for doing their job.”

Part of the problem is the perception by some staff that their employers do not take violence seriously enough. Around a third of victims of workplace violence or abuse do not report it. While in some cases, the individual may feel the incident was too trivial, 14% said they did not believe management would have done anything even if they had reported it.

The public sector also has a patchy record in terms of monitoring the extent of the problem. While the NHS collates data centrally, there are no comparable figures for local government or the civil service. “If we are going to stop the violence we must have accurate, up-to-date information about the number, nature and where these attacks are happening,” says ­Prentis. “A national database is a vital first step towards ­­knowing the extent of the problem and how to better protect the workforce.”

Preventative action is also piecemeal. The exception is the NHS. Following concern that hospital staff were being subjected to excessive danger, the Department of Health established the NHS SMS five years ago. As well as ­monitoring and collating data, it also promotes conflict resolution training, which is mandatory for all frontline staff in the NHS. Around 90% of trusts now have a dedicated local security management specialist who is on the frontline to deal with issues as they arise. The SMS provides them with support and guidance.

Taking action

Next year, the health department is paying for 30,000 ­personal alarms to be issued to frontline staff in trusts. Although that is just a drop in the ocean, given that there are 750,000 frontline workers in the NHS, it is better than ­nothing.

The NHS is also getting tougher with those who attack staff. Criminal sanctions have risen from 51 in 2003-04 to almost 1,000 in the past year and a total of nearly 3,500 since the SMS started work. It has brought 29 private ­prosecutions against individuals who have assaulted NHS staff, where the police haven’t taken the matter further. “If the police won’t take action we will consider bringing a private prosecution with the health body. It is important to send out a message that we won’t tolerate violence,” says Richard Hampton, head of security at the SMS.

“Clearly it is unacceptable that any public sector worker should face abuse or violence while they are doing their job. It is important that where at all possible, incidents are prevented rather than relying on action after the event. The responsibility lies with both employers and staff to ensure that risks are identified, action agreed and importantly taken to ensure that staff can carry out their duties free from fear of abuse.”

Ultimately, while prevention is always the best option, there may be a case for giving all public employees the same legal protection as police officers by making it an offence to assault a public sector worker.

• This article appears in January’s edition of Public magazine

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