NHS staff are being sworn at, punched and threatened with rape in some cases, as violence on the frontline spirals, experts have warned.
Senior health officials told a London Assembly meeting on Thursday that physical and verbal abuse against staff is increasing, with many incidents going unreported due to a lack of confidence that action will be taken.
According to the latest NHS Staff Survey, 14.5 per cent of NHS staff in England experienced at least one incident of physical violence from patients, service users, their relatives or members of the public in the last 12 months, the highest since 2022 (14.8 per cent).
NHS staff, union representatives, and clinical leaders are now urging stronger protections for healthcare workers, enhanced reporting systems, and an urgent Government review of the ‘Right Care, Right Person’ initiative to address its impact on services.
Lisa Elliott, London director at the Royal College of Nursing, told the committee how an A&E worker was knocked unconscious after being punched in the face by a patient, later developing post-traumatic stress disorder and being forced to take months off work.
Paramedic Emily Jackson of the London Ambulance Service also gave a stark account of being assaulted while treating a man who had taken drugs and alcohol in a pub.
“We were called to him because he was unconscious, having taken some drugs and alcohol. He was in a pub. We got to him very quickly. We were concerned about him. He was not breathing particularly well when we got there,” she told the committee.
But as he came round, the man turned violent, punching her below the eye. Minutes later, he started drinking again, then threatened to sexually assault her.
“He eventually left the pub, came back after a few minutes, sat down, started drinking again, and then basically threatened to rape me and dump my body in an alleyway,” she said.
Experts warned that these cases are just the tip of the iceberg.
Many incidents go unreported, they said, due to a culture inside the NHS and reporting systems that staff see as ineffective or difficult to use.
Some workers believe nothing will happen to perpetrators of violence — especially if they were drunk, on drugs, or mentally ill — leaving them feeling reporting abuse is pointless.
Ms Elliott said staff often see the system as a “black hole”, where reports disappear without action.
“There is no way of being able to see, at a national level, how trusts are dealing with those incidents that are reported,” Ms Elliott added.
“We do not have that reporting structure there to be able to see those incidents that are being reported.
“We need to build a level of trust in so that nurses know that when it happens, it is going to be taken seriously, and it is going to be acted upon.”
There is also limited data on who perpetrates abuse against NHS staff, the committee heard.
Evidence indicates that men under the influence are more likely to commit physical violence, while verbal abuse more often comes from women; however, data remains insufficient to draw more detailed conclusions about perpetrators, experts revealed.
Meanwhile, the Committee also received criticism of the “Right Care, Right Person” strategy, which was implemented to ensure vulnerable individuals receive the most appropriate care.
While some mental health incidents require police involvement, others may be better addressed by alternative services.
However, the scheme has created operational challenges for NHS staff, the committee heard, as the rise in mental health presentations has placed additional pressure on already stretched services.
Experts warned that “patients are falling through the cracks,” as the underlying problem has not been resolved but merely shifted elsewhere.
The system remains under strain, with staffing shortages and the root causes of the issue still unaddressed.
Chairman of the London Assembly Health Committee, Emma Best AM, said: “Frontline NHS staff are doing extraordinary work in challenging circumstances, yet too many are being subjected to unacceptable levels of violence and abuse.”
“We heard strong evidence that inconsistent police responses, gaps in training and resources for NHS security teams, and unresolved issues with the rollout of the ‘Right Care, Right Person’ strategy/initiative are placing additional pressure on healthcare workers and allowing dangerous situations to escalate.
“No one should face threats, intimidation or assault simply for doing their job. We need a coordinated approach across Government, the Met and the NHS to ensure staff are safe, reporting is easy and meaningful, and offenders face real consequences. Without this, we risk a growing culture of fear that harms staff wellbeing and undermines patient care.”
Karen Bonner, Chief Nurse for the NHS in London, added: “There is absolutely no place in the NHS for violence. Any reports of violence are taken very seriously by NHS organisations across the capital.
"Our staff come to work every day to care for patients and communities across London, and it is vital that they feel safe to do so. We are working closely with NHS Trusts and partners across the city to tackle this issue together, and we remain committed to ensuring that nobody should ever face violence or aggression simply for doing their job."
