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Freedom-of-information returns compiled by the Royal College of Nursing show 4,054 recorded incidents of physical violence against A&E staff in 2024, broadly double the figures reported in 2019. Unions and clinicians link the surge to overcrowding, long waits, understaffing and rising mental\u2011health presentations, and say immediate protection measures must be paired with investment to end corridor care.<\/p>\n<\/div>\n
Nurses working in hospital accident and emergency departments are facing what their union describes as an \u201cabhorrent\u201d and rapidly rising level of physical violence, with freedom-of-information returns collected by the Royal College of Nursing showing thousands of recorded assaults in recent years. According to the RCN\u2019s survey of trusts, 4,054 incidents of physical violence against A&E staff were recorded in 2024 \u2013 broadly double figures reported in 2019 \u2013 a trend the union and health commentators warn is being driven by overcrowding, long waits and chronic staffing shortfalls. (According to the original reporting, the RCN compiled its figures from FOI responses across trusts.) <\/p>\n
The human toll is stark. Nurses who spoke to the union described being punched, spat at, threatened with acid and, in one case, having a gun pointed at them. A senior sister in an east London A&E who was knocked unconscious after being punched said the violence was \u201cjust constant\u201d, and a senior charge nurse in the East Midlands described being struck \u201csquare in the face\u201d by an intoxicated patient. These first\u2011hand accounts have been used by the RCN to illustrate how routine clinical environments can quickly become unsafe for staff. <\/p>\n
Union leaders and frontline clinicians link the violence to system pressures. The RCN warns that prolonged waits, corridor care and understaffed teams are creating frustration among patients \u2014 including some who would previously have been placid \u2014 and that that frustration is increasingly expressed as aggression towards staff. The college has also highlighted a sharp rise in mental\u2011health presentations to A&E and lengthy waits for specialist beds, arguing that inadequate community mental\u2011health capacity is a key contributor to pressure on emergency departments. <\/p>\n
The consequences for the workforce are immediate and long term. RCN officials say physical and psychological injury from assaults leads to lengthy absences and, in some cases, people leaving the profession entirely. A separate survey cited by UNISON and Nursing Times found extremely high levels of physical assault experienced by nurses and midwives, with many reporting repeated or daily incidents; unions warn this undermines recruitment and retention and damages morale and patient care. <\/p>\n
The government has described the reports as \u201cappalling\u201d and set out steps it says will help protect staff. The Health and Social Care Secretary said he had reaffirmed his commitment to standing with frontline workers and outlined measures including a graduate recruitment guarantee and enhanced victim support, training and security measures. More detailed proposals published by the Department for Health and social care and reported in professional press include mandatory national recording of incidents, trust\u2011level reporting on progress, analysis to identify groups at greater risk and powers for staff to refuse treatment when abused. Ministers say perpetrators should face the full force of the law. <\/p>\n
Political and local responses vary. The Liberal Democrats have called for a panic\u2011button system linking A&E staff directly to their nearest police station, while some hospital trusts have trialled or expanded physical security measures such as increased patrols, CCTV and body\u2011worn cameras after local investigations showed rising assault figures. Campaigners and unions, however, argue that such measures are necessary but insufficient without simultaneous investment to cut waiting times and expand community and mental\u2011health services. <\/p>\n
Experts and union leaders urge a two\u2011pronged approach: immediate protective measures and a longer\u2011term strategy to remove the pressures that precipitate aggression. The RCN has called for urgent investment in community mental\u2011health nursing and a comprehensive plan to end corridor care, arguing that without tackling the underlying workforce shortages and service gaps the rise in assaults will continue and could jeopardise wider NHS reform plans. Nursing bodies and unions are pressing for clearer, consistent national data so policy responses can be targeted where staff are most at risk. <\/p>\n
Protecting clinical staff, the unions say, will require a sustained political and operational commitment: better surveillance and reporting of attacks, robust support and training for staff, rapid policing responses where appropriate, and the workforce and service changes needed to reduce delays and overcrowding. Absent that combination, the increasingly frequent and severe assaults on A&E teams risk becoming another entrenched consequence of a health service under strain. <\/p>\n