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Hospitals step up security as attacks on staff rise 

They are supposed to be places of safety, but Britain's hospitals are having to be turned into fortresses. 

Security measures to protect patients and staff are being stepped up to cope with increasing cases of violence and bad behaviour. Latest research shows that, in the last 12 months, there was an average of more than 500 incidents for every NHS trust in the country. 

It is not just hospitals in big cities that are being turned into fortresses in the NHS. The problems of dealing with drunk and violent patients has become an ever-present symptom of the weekend in hospitals across the country. Almost every hospital is now vulnerable, and so too are the increasing number of health professionals working in the community. 

In almost all major teaching hospitals, police presence has now become routine, especially around hotspots like A&E departments. NHS trusts are also employing their own security guards, hiring private companies to carry out round the clock patrols, using closed circuit TV cameras and alarms, and in some cases giving staff mobile phones and pagers purely for extra security. Staff accommodation has to be protected from intruders, and trusts have had to introduce tight security in maternity units because of the fear of baby snatching. Many hospitals are also plagued by thieves and vandals. 

One hospital trust in the South Wales valleys has become so concerned about the amount of violence taking place in and around its maternity unit that it is employing a 24-hour security guard to protect staff and expectant mothers from violent partners. The trust, which runs the Prince Charles hospital in Merthyr, currently spends around £250,000 on security.

The government wants a 20% reduction in violence against nurses and other health care staff by the end of this year as part of a zero tolerance campaign. But a spokesperson for the Department of Health said that, at present, there was no data available to confirm whether or not it was on target to meet this figure. The campaign was launched in 1999 to try to stamp out aggressive behaviour against health service staff but in fact there has been an increase in reported incidents since the campaign's start - from 419 per trust per year in 1999 to 511 in 2000.

Trusts are aware that many incidents still go unreported and are urging staff to record all incidents in the workplace but despite the efforts, it seems unlikely that the 20% reduction target will be met. 

"We do not expect that the government will reach their target of a 20% reduction, we think that was too optimistic, and the latest research shows that about 80% of the trusts are unlikely to meet it," says Jon Richards, of Unison. 

Mr Richards says it is important to target areas where problems are greatest: "What is important is to analyse where staff are going to encounter problems. People who work in mental health, ambulance workers, A&E, maternity units and in the community, are all in the frontline. 

However, he says: "We welcome what has been done so far because it increases the profile of violence in the NHS, which is something that we have been concerned about over a long period. We need to give people as much information and training as possible so that when they encounter aggression they have the skills to help them deal with it and get out of the situation safely." 

The total financial cost to the NHS of dealing with violence and bad behaviour is hidden because, although individual trusts keep figures on the cost of security, hospitals do not pay for police presence, and the wider costs to the service of staff and patients who are injured are simply not recorded. 

"There is no reliable data available that can give an overview of the levels of violence within the NHS or how much it costs as a whole, and there do need to be systems in place that supply accurate information about of all the incidents that take place. Such information does not exist, because there are no accurate recording systems," says Professor Betsy Stanko, director of the violence research programme at the Economic and Social Research Council in London (ESRC). 

"What is needed is a system that makes the connection between why and how violence occurs within the health service and the way in which both staff and patients can be caught up in violent incidents. For instance, it is not surprising to find domestic violence overflowing into maternity units and then patients, staff and family members becoming involved." 

Research does show that nurses are most likely to be the victims of aggression with 64% of recorded incidents against them. But even when offenders are caught, they aren't necessarily dealt with severely enough, which sends out the wrong messages, say unions. 

A sentence in a case in Scotland involving a nurse, Marie Lloyd, who was punched in the face in an unprovoked attack in a Glasgow A&E department, has been criticised by Unison in Scotland. The attacker, a drunken teacher, James Archer, was ordered to pay only £350 in compensation to his victim.