A Year On, NHS Staff Safety Is Still …Getting Worse

In April 2025, the government announced new support measures intended to benefit around one million NHS staff, including action to tackle violence, improve working lives and strengthen support for frontline teams.

A year on, the latest figures suggest the problem has not gone away. If anything, the pressures facing NHS staff appear to be intensifying.

Recent reporting from Healthcare Today revealed that NHS England has spent £190.9 million over the past five years resolving personal injury and accident claims brought by its own staff. The figure is striking, but it only tells part of the story. Behind every claim is a person who came to work to care for others and ended up injured, unsupported or exposed to risk.

For healthcare leaders, this is not just a legal or financial issue. It is a cultural issue, a staffing issue and a safety issue.

When frontline staff are not safe, care is affected

Violence, aggression and abuse in healthcare settings are often discussed as if they are unavoidable features of the job. They are not.

There will always be complex situations in hospitals, mental health settings, community care, emergency departments and other frontline environments. Patients may be distressed, frightened, confused, intoxicated, unwell or in crisis. Families may be anxious or angry. Staff may be working under pressure, with stretched teams and limited time.

But recognising complexity is not the same as accepting harm.

Staff should not have to absorb verbal abuse, threats, intimidation, physical assault or repeated low-level aggression as part of their working day. When these behaviours become normalised, they change the atmosphere of a workplace. People become more guarded. Confidence drops. Morale suffers. Experienced staff leave. New starters learn to expect hostility before they have had time to build skill and resilience.

That has consequences for patients too. Safe staff are better able to deliver calm, compassionate, consistent care. When staff feel unsafe, unsupported or exposed, the whole system becomes more fragile.

The cost is financial, but the damage is human

The reported £190.9 million figure is a reminder that workplace safety failures have a measurable cost. Claims, legal processes, absence, recruitment, retention and operational disruption all place further strain on services that are already under pressure.

However, the true cost sits much deeper than the balance sheet.

An injury at work can affect confidence, sleep, relationships, career choices and long-term wellbeing. A member of staff who has been assaulted or repeatedly threatened may return to the same environment carrying fear that others cannot see. Colleagues may also be affected, especially when they witness incidents and feel powerless to intervene.

This is why staff safety cannot be treated as a poster campaign or an annual compliance exercise. It has to be built into everyday practice.

Nick Attard, General Manager at BR Specialists, said:

“Healthcare staff are often dealing with people at their most distressed, frightened or unpredictable, so the answer cannot simply be to tell staff to be more careful. They need practical skills, clear procedures and a culture around them that takes every warning sign seriously. Good training helps people recognise risk earlier, communicate more calmly and respond in a way that protects everyone involved.”

Support measures need to reach the floor

Government announcements and national frameworks matter, but the real test is what changes for staff on the ground.

Do staff know how to recognise escalation before it becomes a crisis?

Do managers respond consistently when incidents are reported?

Are teams trained together, so they understand the same language, boundaries and response options?

Are new starters given realistic preparation for the environments they are entering?

Are incidents reviewed properly, not just recorded?

These are the practical questions that determine whether policy becomes protection.

In many healthcare and care settings, the challenge is not a lack of concern. Leaders care deeply about their teams. The issue is often that safety training, incident reporting and behavioural awareness sit in separate boxes. One team manages compliance. Another deals with HR. Another handles training. Another responds after something has already happened.

The result can be a fragmented approach, where warning signs are missed and staff feel that the system only becomes interested after harm has occurred.

Prevention starts before physical intervention

Physical intervention training has an important place in some healthcare and care environments, but it should never be seen as the starting point.

The best safety cultures focus first on prevention. That includes understanding behaviour, recognising distress, noticing environmental triggers, using calm communication, setting boundaries early and knowing when to step back, seek support or change approach.

In practical terms, this might mean staff learning how to spot the difference between frustration, confusion, intimidation and imminent risk. It might mean improving how teams communicate during a difficult interaction. It might mean helping staff understand how their body language, positioning and tone can either calm or escalate a situation.

None of this removes responsibility from people who behave abusively or violently. Staff should be protected, and unacceptable behaviour should be dealt with properly. But frontline teams also need tools that help them reduce risk before a situation reaches the point of injury.

A safer NHS needs more than promises

The NHS is built on care, but care cannot depend on staff simply enduring unsafe conditions.

A year after new support measures were announced, the continued rise in violence, abuse and injury-related costs should concern every healthcare leader. The issue is no longer whether staff safety deserves attention. It is whether organisations are prepared to treat it as a core part of workforce wellbeing, patient care and operational resilience.

Training alone will not solve everything. But the right training, delivered in the right way, can help create safer habits, more confident teams and a stronger shared understanding of what good practice looks like.

For NHS, healthcare and care organisations, the next step is not just to respond when incidents happen. It is to build cultures where staff are better prepared, better supported and less likely to be harmed in the first place.

References

GOV.UK, One million NHS staff to benefit from new support measures, 7 April 2025
https://www.gov.uk/government/news/one-million-nhs-staff-to-benefit-from-new-support-measures

Healthcare Today, NHS bill for staff injuries hits £190 million, 2026
https://healthcaretoday.com/article/nhs-bill-for-staff-injuries-hits-190-million

NHS England, 3-year high in attacks on NHS staff, 17 March 2026
https://www.england.nhs.uk/2026/03/3-year-high-in-attacks-on-nhs-staff/