Violence Against Nurses Surges in ‘Tinderbox’ A&Es

Violence against A&E staff in England has almost doubled over the past 5 years, with nursing leaders warning that chronic understaffing, long waits, and corridor care are fuelling the rise. 

The Royal College of Nursing (RCN) said that more than 4000 incidents of physical violence were recorded in 2024, compared with just over 2000 in 2019. It urged the government to take decisive action, warning that without change its 10-Year Health Plan would “fail completely.”

In one Kent hospital, cases of violence against staff increased by more than 500%, from 13 in 2019 to 89 last year. At a Bristol hospital, incidents almost doubled from 83 to 152 in the same period.

Punching, spitting, and acid attack threats were among the behaviours staff in emergency departments regularly face, according to the RCN. The figures came from a Freedom of Information request sent to NHS trusts, with 89 out of a possible 129 trusts responding.

Long Waits Fuel Tensions

Analysis of NHS data by the RCN also found that waits of more than 12 hours in A&E had risen more than 20-fold over the same period.

On a typical working day, a member of emergency department staff in England is attacked every hour, the RCN said.

Long delays were also causing anger among patients who were not typically violent. Senior charge nurse Rachelle said that “even patients you would expect to be placid are becoming irate because of just how long they have to wait.”

One senior A&E nurse described her hospital as a “tinder box” for violence. She had seen colleagues punched, kicked and threatened with a gun and had herself been spat at and threatened with an acid attack. The incidents caused depression and anxiety, prompting her to take a secondment in research to step away from the frontline.

Recruitment Concerns

Earlier this week, the government launched a Graduate Guarantee scheme, promising jobs for newly qualified nurses and midwives. 

However, one nurse warned that the level of violence was unlikely to help with retention or recruitment. “If you think you’re going to be clobbered every shift, why would you stay?” she said.

RCN General Secretary and Chief Executive Professor Nicola Ranger said: “Nursing staff not only go to work underpaid and undervalued but now face a rising tide of violence. It leads to both physical and mental scarring, lengthy time off, and sometimes staff never returning. You can’t fix the health service when vital staff are too scared to even go into work.”

‘Shocking’ Levels of Abuse

The 2024 NHS Staff Survey found that 14.38% of staff had experienced at least one incident of physical violence from patients, service users, relatives, or members of the public over the course of a year. 

A further 25.08% reported at least one incident of harassment, bullying, or abuse.

“Behind these shocking figures lies an ugly truth,” Ranger said. “Dedicated and hard-working nursing staff face rising violent attacks because of systemic failures that are no fault of their own.” 

She urged the government to move beyond recording incidents and focus on reducing them.

NHS Response

NHS England said it was committed to supporting colleagues in violence prevention, security management, and other high-risk roles.

It offers courses and programmes to help staff prevent and reduce the risk of violence and to support their wellbeing.

“Measures to keep staff safe day-to-day are crucial,” said Ranger. “But the stark reality is that unless the government does something about lengthy waits, corridor care, and understaffed nursing teams, more nursing staff will become victims of this utterly abhorrent behaviour.”

Rob Hicks is a retired National Health Service doctor. A well-known TV and radio broadcaster, he has written several books and has regularly contributed to national newspapers, magazines, and online publications. He is based in the United Kingdom.