Wednesday, October 28, 1998 Published at 12:33 GMT
Patient's Charter blamed for attacks on NHS staff
Almost half of nurses say they have been physically assaulted in the last year
The Patient's Charter has led to an increase in violent attacks on NHS staff, according to Health Secretary Frank Dobson.
Mr Dobson said frustration caused by patients' and their relatives' expectations of the health service was partly to blame.
Launching new guidance for health service managers and staff on reducing the threat of violence, Mr Dobson said: "Nurses, doctors and all staff working in the NHS are not paid to be targets of violence. It will not be tolerated and we are taking action to tackle it."
He added that the guidance, Safer Working in the Community, was one of several government initiatives to reduce violence.
Abuse and violence
A survey by the Royal College of Nursing (RCN) and Nursing Times, called Stamp out violence, showed that 47% of nurses had been physically attacked in the last year - the vast majority of them by patients.
Sixty-seven per cent said this happened often.
Over 80% said attacks were more frequent now than they had been in the past.
Nurses blamed a more aggressive society, alcohol abuse and patient frustration for the increase in violence.
Mr Dobson said the Patient's Charter had contributed to frustration.
"That's one reason why we are going to replace it with an NHS Charter in which patients will have responsibilities as well as rights," he said.
"One of their responsibilities will be to behave decently towards staff."
He added that the Department of Health was working with the Lord Chancellor, Attorney General and Home Secretary to ensure people who assault NHS staff were dealt with promptly and severely.
Seventy-four per cent of nurses want a mandatory custodial sentence for those found guilty of attacks on NHS staff.
New national guidelines are being drafted on prosecution and sentencing as well as how to prevent violence against staff.
Mr Dobson said that, under the new Crime and Disorder law, NHS trusts would be involved in local crime reduction partnerships.
Other recent plans aimed at reducing attacks on NHS staff include a £30m programme for modernising casualty departments to make their layout safer for staff.
The Stamp out violence survey showed a large majority of nurses thought there might be circumstances where care should be withdrawn from patients who were persistently aggressive.
Policy and practice
The 950 nurses surveyed said that, although most hospitals had policies for handling violence and reporting procedures, very few had security staff on the premises.
Only a quarter had staff helplines, 42% gave staff panic buttons and alarms and only 6% provided safe transport home for nurses who worked on shift.
Less than a fifth of nurses had had training to defuse violent situations.
The RCN and Nursing Times want managers to commit themselves to positive action to reduce violence.
The survey also showed that most nurses did not take time off work after being attacked, unless they needed medical treatment.
RCN assistant general secretary Tom Bolger said: "The findings of the Stamp out violence survey are shocking but not entirely surprising.
"Nurses are dealing with violence as part of their everyday working experience and their ability to provide the best case for patients must be affected."
One hospital that is taking action is Birmingham's Heartlands Hospital.
Nurses in its accident and emergency department are testing lightweight body armour to protect staff from attacks.
The armour can be worn under uniforms and are knife and bullet proof.