Violence in Healthcare Is Rising. Training Needs to Reflect Reality

Recent reporting has once again brought a difficult issue into focus. A survey highlighted by The Guardian found that hundreds of thousands of NHS staff in England have experienced abuse, harassment or violence in the course of their work. Alongside this, Community Pharmacy England has warned that racist, hostile, verbal and even physical abuse towards pharmacy teams is now becoming a regular occurrence, not an exception.

For many working across healthcare, care settings and public-facing roles, this will not come as a surprise. What is changing is the scale, and perhaps more concerningly, the normalisation of these behaviours. Situations that were once considered rare are now part of the expected landscape in some environments, whether that is a busy hospital department, a mental health setting, or a high street pharmacy dealing with long queues and heightened emotions.

Why One Approach to Training No Longer Works

Where this becomes particularly important is in how organisations prepare their staff. Training exists across the sector, often as a requirement, but too often it sits slightly detached from the reality people are dealing with day to day. A single approach delivered in the same way, regardless of setting, assumes that risk looks the same everywhere. It does not.

The pressures facing a lone worker in a pharmacy are very different from those on a mental health unit, and different again from a team in a hospital ward or community setting. When training does not reflect those differences, it becomes harder for staff to apply it when situations escalate, particularly when those situations are emotionally charged, unpredictable, and unfolding in real time.

Setting	Typical Pressures	Why Generic Training Falls Short
Hospital / NHS wards	High patient turnover, emotional stress, time pressure	Scenarios often too simplified or not time-critical
Mental health environments	Behavioural escalation, complex communication, distress responses	Requires deeper understanding of behaviour and triggers
Community / care settings	Relationship-based care, varied environments	Needs adaptable, person-centred approaches
Retail pharmacy	Lone working, public-facing conflict, long queues, frustration	Requires de-escalation in open, fast-moving environments

What staff are facing is not just physical risk, but complex interactions where behaviour can shift quickly. Recognising early signs of escalation, understanding why behaviour may be presenting in a certain way, and responding proportionately in the moment are all skills that require more than a generic framework. They require context, realism, and delivery that connects with the environment people actually work in.

Lived Experience Changes the Way Training Is Delivered

This is where lived experience begins to matter in a very real way. At BR Specialists, that perspective is not theoretical. It comes directly from experience on both sides of the situation.

As Nick Attard, General Manager explains, having spent time within the NHS as a patient, particularly within mental health services, changes how you understand behaviour, escalation, and the pressures staff are working under:

“Having experienced the NHS from a patient perspective, particularly within mental health services, it changes how you view behaviour and escalation. It’s not always as simple as it appears from the outside. That perspective feeds directly into how we design and deliver training. It has to be realistic, and it has to reflect what staff are actually dealing with.”

That insight shapes how training is approached. It is not just about what should happen according to policy, but what does happen in practice. It influences how scenarios are built, how discussions are handled, and how staff are supported to make decisions in moments that are often unpredictable and pressured. It also brings an added layer of empathy, recognising that behaviour is not always intentional, and that how it is managed can have a lasting impact on both staff and the individuals they are supporting.

When training is tailored to the environment, and grounded in real experience, it becomes far more than a requirement. It becomes something staff can rely on. Confidence improves, communication becomes more effective, and situations are more likely to be managed early, before they reach a point of crisis.

The increase in reported abuse across the NHS and within pharmacy settings is a clear signal that the environment is evolving. Training needs to evolve with it. Not by becoming more complex, but by becoming more relevant, more reflective, and more connected to the realities staff are facing on the ground.

Further reading:

• The Guardian – NHS staff survey on abuse and harassment

• Community Pharmacy England – Abuse towards pharmacy teams becoming a regular occurrence