Managing violence and aggression towards NHS staff working in the community

Abstract

This paper presents a brief overview of the research project conducted during the preparation of the national guidance document Safer Working in the Community: A guide for NHS managers and staff on reducing the risks from violence and aggression. (RCN and NHS Executive, 1998). An integrated organizational approach was adopted, seeking risk reduction measures at the levels of the organisation, the work team and the individual, and encompassing prevention and preparation before incidents occur, timely reaction when incidents happen, and rehabilitation and learning after incidents have occurred. Five main domains were considered: trust policies and organizational arrangements; normal working practices; emergency action procedures; post-incident procedures, and staff training. Information was gathered from academic, professional and guidance literature, documentation from healthcare trusts, trades unions and professional associations, and interviews with practitioner, managerial and support staff in a wide range of disciplines. Findings indicated that matters requiring particular attention were: commitment of senior management; generation and communication of policies; discrepancies in perception between managers and practitioners; provision for risk assessment; training provision; staffing, resources and equipment; ability to meet patient expectations; sharing of safety information; traceability and communication away from base; accessing help; emergency procedures; incident reporting; post-incident support; and trauma debriefing and counselling.