NHS staff benefit from conflict de-escalation training

Powers brought into force more than two years ago to help NHS staff deal with anti-social behaviour on hospital premises are proving very effective where used, according to employee feedback and national figures.

Set to conclude this month, a three-year training programme managed by NHS Protect and funded by the Department of Health has trained 618 staff at more than 80 hospitals in how to apply certain provisions under the Criminal Justice and Immigration Act (CJIA). The Act created a new criminal offence of causing a nuisance or disturbance on NHS hospital premises and refusing to leave, as well as a new power to enable authorised NHS staff to remove a person suspected of committing this offence.

Those trained have been educated on how to respond to daily disruptions, such as foul language and verbal abuse, intimidating gestures, excessive noise in waiting areas or wards, and the obstruction of public walkways and corridors. Feedback from staff trained in the use of the CJIA provisions suggests the powers are working well in practice, helping to provide a safer environment for NHS patients, staff and visitors.

In 2010/11, there were 57,830 reported physical assaults against NHS staff in England. Some 1420 criminal sanctions were taken following cases of assault, compared with 1128 in 2009/2010. The CJIA provisions can assist in helping prevent verbal abuse and other anti-social behaviour from building up to an outright assault.

CJIA programme manager at NHS Protect, Ivana Bartoletti, explains: “These new provisions reinforced the range of measures already in place to protect NHS staff, allowing them to concentrate on delivering patient care. The legislation was intended to prevent low-level disruptive behaviour from escalating to violence against staff. It brought in a reliable legal framework, giving NHS staff the confidence to be firm but fair with the minority who cause a nuisance in hospital premises.”

Illustrating the deterrent effect of the legislation, free training videos from NHS Protect highlight the experience of the security team of a busy North London hospital. The team is able to de-escalate conflict simply by informing trouble-makers that they may be breaking the law, and by explaining that if they do not modify their behaviour then they could be escorted from the premises.

In hospitals using CJIA powers an offence has been pointed out to disruptive individuals 908 times, yet the number of resulting removals totals just 133 – a sign of the effectiveness of the training.

“We see that in 775 out of 908 incidents, the behaviours changed without the need to resort to removal of the individual,” says Ms Bartoletti. “This is a very encouraging result and we urge all trusts to watch our training videos and undertake training.”

Any NHS hospitals that require ongoing assistance with the CJIA can contact NHS Protect for details of the ‘CJIA legacy package’, which includes a full range of free materials, including introductory videos.

Further information on NHS Protect is at www.nhsbsa.nhs.uk/Protect.aspx