Staff in accident and emergency departments are being exposed to punching, spitting and acid attack threats, among a range of violent and “utterly abhorrent” behaviours, the Royal College of Nursing has warned.
It has called on the government to take “decisive action” to reduce lengthy waits in A&E, end corridor care and tackle chronic understaffing in emergency departments.
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Freedom of Information requests to 89 trusts in England found that there were 4,054 incidences of physical violence against staff recorded in 2024, compared to 2,093 in 2019 – almost double.
The college’s analysis of NHS data also showed that waits of more than 12 hours in A&E increased by more than 20 times in the same period.
The rise has been so pronounced it means that, during a typical working day in England, a member of staff working in the emergency department is being attacked every hour.
At a Bristol hospital, incidents of violence against staff almost doubled between 2019 and 2024. The number of reported attacks increased from 83 to 152.
While at a hospital in Kent, incidents rose by more than 500% from 13 in 2019 to 89 in 2024.
A senior A&E nurse said her hospital was a “tinder box” for violence. She has seen colleagues punched, kicked and had a gun pointed at them, and has herself been spat at by a patient and threatened with an acid attack.
She developed depression and anxiety and has taken a secondment in research as a break from the profession.
Professor Nicola Ranger, RCN general secretary and chief executive, said: “Behind these shocking figures lies an ugly truth. Dedicated and hard-working nursing staff face rising violent attacks because of systemic failures that are no fault of their own.
“Every incident is unacceptable, but we need ministers and trust leaders to acknowledge some of the key underlying causes.”
Responding to the RCN investigation, Rebecca Smith, director of system and social partnership at NHS Employers, described the findings as “deeply worrying”.
“No one should have to face violence at work – it is totally unacceptable. These kinds of incidents not only have a huge impact on staff health and wellbeing but also retention of staff as well as NHS services and patient experience. Preventing and reducing violence benefits everyone,” she said.
“Preventing and reducing violence is one of the areas to be included in the new set of standards for staff to be introduced by April 2026 as set out in the Ten-Year Health Plan. We will need to build upon the work led by the Social Partnership Forum and the recommendations they have made to help tackle these challenging issues which we know can be exacerbated by long waits and poorly designed A&E departments,” Smith added.
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