Paramedics in Harms Way daily at work
28 March 2019

Please see below a response to our letter to the Department of Health regarding what we believe should be included in the NHS Violence Strategy.

The sub-group leading our 'In Harm's Way' campaign will be able to consider this response when determining the next steps for the campaign.

Thank you for your correspondence of 19 February to Matt Hancock with GMB's recommendations for the National Violence Strategy. As you know, Mr Hancock announced the Strategy on 31 October at the Royal College of Nursing Conference about the new Assaults on Emergency Workers (Offences) Act. I have been asked to reply.


The scope of the proposed Strategy appears to align with your recommendations, as it aims to:

  • clarify roles and responsibilities of national organisations in supporting NHS employers who are responsible for protecting their staff against violence and abuse;

  • ensure optimum use is made of the new Act and other relevant legislation to ensure that, wherever appropriate, perpetrators of violence are brought to justice;

  • improve the environments where patients are treated and staff work to reduce the likelihood of violence;

  • and raise the profile of this as an issue through national campaigns and improve the training and development of staff in mitigating the risk of suffering violence or abuse and to ensure accredited security management experts continue to maintain and develop their skills and knowledge through appropriate continuous professional development.


  • It is expected that there will also be a national data collection of physical assaults that aims to understand the context of the incident and offer appropriate advice and guidance.


Ministers asked NHS Improvement and NHS England to work together to develop recommendations for central support arrangements to help NHS organisations in their responsibility for protecting their staff from assaults and abuse. This was in response to the Government's manifesto commitment to tackle violence and abuse of staff, and to go alongside strengthened legislation to deter violence and abuse of emergency workers across all public services. These steps have been taken in recognition that violence against and abuse of staff should not be tolerated.


The Department will ensure that GMB’s recommendations are considered as part of the ongoing process for rolling out the Strategy. The Strategy and how it will be prioritised is being taken forward as part of the Workforce Implementation Plan (now called the People Plan) announced in the NHS Long Term Plan and led by Baroness Dido Harding, Chair of NHS Improvement, and Julian Hartley, CE of Leeds Teaching Hospitals NHS Trust. An interim version will be published in May and a final version after the spending review later this year. The People Plan will support delivery of the Plan, which committed up to £2million per year to tackle violence against and bullying of staff.


Details of how that money is to be committed will be outlined in the Plan.

Subject to ongoing deliberations, the Strategy will be rolled out from April as follows:

  • agree how standards are placed in provider contracts;

  • agree future training and development for staff;

  • develop national staff support packages;

  • develop toolkits for Providers to: undertake Assessments, develop Interventions and Measure progress;

  • begin to develop plans for Mental Health Providers;

  • commence body cameras pilots;

  • undertake a public awareness campaign;

  • rollout of agreed data collection method/tool;

  • begin analysis of incidents and effectiveness of targeted interventions; and

  • ensure correlation between sickness, retention and violence is captured.


The key to successfully developing and implementing the Violence Reduction Strategy will be through working in partnership and this is already being achieved through regular dialogue with the national Social Partnership Forum and through work to deliver the People Plan, as described above.


You refer to reducing the retirement age for ambulance staff due to increased violence.


The retirement age for NHS staff was agreed by all parties involved in negotiations that led to the introduction of the 2015 NHS Pension Scheme, but the Department recognises the challenges faced by staff across the NHS and wants to support all staff in having a long, rewarding career in the NHS.


To help organisations manage this, the Staff Council established the Working Longer Group, which developed a range of recommendations about how employers could plan in partnership with staff who wish to extend their careers by making good use of their talents and skills as their capabilities change overtime. The Staff Council has brought the Group's work to a close, but its recommendations can be found on the NHS Employers website (


NHS Improvement has also established a retention collaborative, which is currently looking at how best to support staff at different stages of their careers, for example, through mentoring when they first start, access to flexible working options mid-career and a range of retirement options as they approach the end of their working lives.

The ongoing work to develop the People Plan includes a group led by the East London NHS Trust looking at how the NHS can become the best place to work and an employer of choice. Outcomes from this Group's work will be included in the interim People Plan in April.


Finally, you rightly refer to the need for better trauma and mental health support for staff. NHS Improvement, which is leading work with a collaborative of 73 trusts, including all the ambulance services to reduce NHS

staff sickness absence by 1per cent by 2020 has embedded “Thriving at Work – a review of mental health and employers”. Thriving at Work was commissioned by the Government and produced by Paul Farmer, of MIND, and Lord Dennis Stephenson. It includes core health standards that all employers are expected to implement and enhanced standards that larger employers and public services should put in place.


In addition, recommendations including a 24/7 Mental Health Support service and quick access for staff to post trauma support were included in the recently published Mental Health of NHS Staff and Learners Commission report that was produced by Health Education England and launched by Matt Hancock last month, are being considered by the Best Placed to work Group for inclusion in the interim People Plan.


Once again, thank you very much for your very comprehensive letter and valuable input to the Department’s agenda for tackling violence against and abuse of staff working in ambulance services and across the NHS.

Yours sincerely, Jane Spencer Ministerial Correspondence and Public Enquiries Department of Health and Social Care

GMB North West & Irish Region

NHS Paramedics In Harms Way