According to the National Audit Office, violence and aggression towards frontline hospital staff is estimated to cost the NHS at least £69 million a year in staff absence, loss of productivity and additional security. Some hospitals spend tens of thousands of pounds on police cover to prevent violence towards doctors, nurses and other staff in A&E departments, particularly at weekends. As many as 56,000 physical assaults occur in English NHS hospitals each year, and in A&E departments the problem of violence and aggression is particularly difficult to solve.
Watch this film to find more about how frontline staff perceive the issue of violence and aggression in A&E.
Victims suffer both physically and psychologically, and the time that’s needed for them to recover means resources in affected A&E departments are strained. Staff morale, retention and productivity are also all adversely affected.
The government and the Department of Health are committed to reducing violence and aggression in A&E. David Cameron has said: “We’re going to accept nothing less than a zero tolerance approach to those who attack NHS staff. That means prosecution as standard practice — with the attack regarded as an aggravated offence. I want to see this stamped out”.
What can design do?
Design can help reduce both the financial and human cost of the thousands of violent and aggressive acts that occur in A&E departments each year.
A&E patients are often in pain and the visitors that accompany them are worried about their condition. The pain and worry can alter the behaviour of patients and visitors, perhaps reducing their tolerance levels and making them more likely to behave aggressively. The experience of A&E could be improved to prevent visitors from becoming aggressive.
Some individuals are more likely to behave aggressively or violently than others. People with mental health problems and people who are drunk or under the influence of drugs are the most likely perpetrators of violent or aggressive behaviour. When visitors behave violently or aggressively, staff need systems, spaces and access to security staff that can protect them.
Ethnographic and desk research commissioned by the Design Council and conducted with the support of three NHS Trusts has shown there is significant potential for designers to make A&E departments safer.
“Often, it is just as simple as good lighting, comfy seats and a good standard of cleanliness that can help people feel more relaxed and positive about the care they receive,” says Sir Jonathan Asbridge, National Patient Champion for A&E Experience, NHS Modernisation Agency.