A&E nurse Amai Gold: 'It took 11 people to get the man off me'
The NHS is being accused of not doing enough to protect staff from a daily barrage of punches, slaps and kicks.
Despite a promise of a "zero tolerance" approach, there has only been a 0.5% increase in criminal sanctions against offenders in the last three years.
Between 2004/5 and 2007/8, the number of attackers who faced punishment has risen from 1.3% of those carrying out physical assaults to 1.8%.
The health union Unison says promises to get tough on offenders have failed.
It says the figures show agreements between the NHS, the police and the Crown Prosecution Service to take a tougher approach to the problem are not working.
Amai Gold is one of the faces behind the NHS assault statistics.
A staff nurse in A&E for 10 years, she has been assaulted three times.
In the most serious incident in 2004, she was trying to treat a diabetic man who had collapsed when he grabbed her, dragging her on to a hospital trolley and stabbing her in the finger.
The attack caused permanent nerve damage - she has no feeling in her ring finger - and she is registered disabled.
Mrs Gold was off work for six months and had two years of counselling to get over what happened.
She was determined to press charges, but the case was dropped by the CPS due to a lack of evidence and it not being in the public interest.
It was then taken up by the NHS security management service, but ultimately they dropped the case too.
"They had a meeting just before we went into crown court to be told that the case was dropped because the other team were saying he wasn't in a fit state of mind when the injury took place, and the fact that they didn't want to get egg on their face, and that was like a kick in the teeth for me", says Mrs Gold.
"I just felt I had been kicked in the stomach.
"To raise my hopes like the counter fraud and security management service did, and then to drop it at the 11th hour, well, I would rather have gone in there and had a judge and jury decide.
"And then if the judge and jury said, 'Yep, I'm sorry Mrs Gold, he's not guilty', then at least we'd tried, at least we did it."
The local security management service did not proceed after an expert report said the man who attacked her had diabetes - which meant he could not be held responsible for the attack.
In 2006 the police and NHS security services signed a joint agreement which promised to vigorously investigate and prosecute offenders.
At the launch, the then chief executive of the NHS security management service, Jim Gee, said: "With the promise of more prosecutions and tougher sentences, NHS staff should be able to look forward to the day when assaults are an increasingly rare occurrence... Violence against our staff will not be tolerated.
"We will do everything within our power to ensure offenders are punished."
A similar agreement was also signed with the CPS.
Since then, the percentage of people facing criminal sanctions - anything from a police caution to a jail sentence has gone up by 0.5%.
Unison say the agreement is not working.
"Nobody goes to work to be assaulted"
Richard Hampton, head of the NHS security management service
Karen Jennings, head of health at the union, says: "The issue here is that we have a national policy and the policy is absolutely correct.
"What's wrong is that it's not filtering down to the employment situation or the health care-giving situation.
"So we have got to start looking at how we can ensure that the policies that are there are being implemented on a local level.... Unison would be absolutely clear that we have to see board governors, board managers, taking this much, much more seriously."
'Part of the job'
The security management service says the situation is more complex than it appears.
It says 70% of the attacks on staff involve people with mental health issues, which means it is not always appropriate to take action.
In other cases, the staff themselves may decide they do not want to go forward because it means dragging up the experience all over again.
Nevertheless, the head of the NHS security management service, Richard Hampton, says he is not complacent: "There is an underlying problem that people in the NHS accept violence as a part of the job.
"Nobody goes to work to be assaulted.
"Our role is to encourage staff to report the incident and two, to support sanctions against those who offend... Each case has to be seen on its own merits."
The overall trend for the number of reported assaults has been going down, with almost 4,500 fewer assaults last year, compared with before the agreement was signed - that at a time when the number of people being employed in the service has been rising.
At the same time, though, there was still a physical assault every nine-and-a-half minutes against a member of staff.
There is still a long way to go before the promise of attacks being "increasingly rare" becomes a reality.
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