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17 hours ago
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Nurses, doctors and paramedics are reporting tens of thousands of violent and sexual assaults by patients every year, amid warnings that the abuse of NHS staff has become a national crisis.
More than 295,000 incidents of physical violence and aggression by patients against staff were recorded by 212 NHS trusts in England between 2022 and 2025, freedom of information requests by the Guardian found.
Healthcare unions warned of a spike in assaults on staff over Christmas and the New Year. A man attacked and injured six staff and patients with a crowbar in Newton community hospital in Merseyside last week. He has been arrested and detained under the Mental Health Act, according to Merseyside police.
Hospitals records show that the number of violent incidents, which range from violent threats to attempted and actual assaults, rose from 91,175 in 2022-23 to 104,079 in 2024-25. This is equivalent to about 285 cases being reported every day in the most recent year.
Prof Nicola Ranger, the general secretary of the Royal College of Nursing (RCN), said: “The scale, frequency and severity of the abuse faced by the NHS workforce make this a national emergency for staff safety.”
Trusts also recorded a steep rise in sexual assaults and sexual harassment against staff, which range from abusive remarks to rape. There were nearly 24,000 alleged such incidents recorded in the past three years, compared with about 20,000 over the previous five years.
Some female staff said they were sexually assaulted while providing treatment, while others said they had witnessed patients deliberately ejaculating on nurses in A&E.
“Working in the NHS is becoming increasingly dangerous,” said Ranger. “It should cause total outrage that healthcare professionals, especially in a female-dominated profession like nursing, face the prospect of being sexually assaulted, violently assaulted or sometimes both.”
Doctors and nurses said they faced a torrent of assaults, including attacks with knives and other weapons, while rooms and equipment were destroyed, causing hundreds of thousands of pounds of damage. Yet they added that perpetrators rarely faced bans on treatment or prosecution.
The British Medical Association (BMA) said the spike in violence and aggression by patients was caused by a combination of anger about long waits for treatment, growing distrust of medicine fuelled by conspiracy theories about Covid, and a sharp rise in racism against staff of colour.
Emma Runswick, the deputy chair of the BMA council, said all NHS staff were “living in increasing fear of harassment, abuse, violence”.
Frontline staff and managers said it was increasingly common for entire hospital wards to be shut down to hold violent mentally unwell or emotionally dysregulated teenagers in isolation for weeks or months. This was now routinely happening due to a lack of appropriate specialist care for young people with severe mental health needs or autism, they added.
One risk manager at a large NHS hospital trust in the north of England said: “Out of a year, we probably have six or seven months where we have at least one ward shut down completely for one patient who is so violent there can’t be other patients on the ward with them. They’re locked wards, staffed predominantly with security, not healthcare staff.
“We had one teenager last year that caused tens of thousands of pounds of damage to a ward, ripping fittings off the walls, smashing windows, ripping doors off hinges. These patients require 24/7, two, three, four [staff] to one care for their safety, whether because they’re self-harming or they’re assaulting family members or staff. The issue at the moment is there’s no bed space in secure mental health units, so they’re with us until it’s available.”
Runswick, a resident doctor working in a community mental health team, said she was aware of similar incidents at other trusts. In one example, a teenage patient required “six members [of staff] in touching distance of this person at any given time and a whole ward shut down in order to stop them attacking others and, indeed, harming themselves”.
But she said while patients with severe mental health problems, dementia and delirium were responsible for many assaults on staff, there was also growing deliberate aggression from other patients due to long waits for care.
“The cause of their violence is the poor service that we are giving them and all their family members,” said Runswick. “That can only be prevented if the service improves.”
The doctor said that rising levels of abuse were correlated with the wider staffing and funding crisis in the NHS. Some of the highest levels of abuse appeared to be in trusts dependent on high numbers of overseas staff, where racism was often the main factor in assaults by patients and relatives, she added.
“Race-based abuse is massively on the rise,” said Runswick. “The racist abuse in Greater Manchester where I work has been really horrible and severe.”
There were also increasing numbers of hostile patients who did not trust healthcare staff or the NHS due to conspiracy theories about Covid and vaccines, she added. “Now if I go to A&E to assess people, you hear people shouting in the waiting room: ‘Well, you just want us to die.’ Nobody used to say that.”
Healthcare unions also raised concerns about how accurate the official records of abuse were because some NHS trusts’ figures seemed implausibly low.
Of the 212 NHS trusts surveyed by the Guardian, 40 recorded more than 2,000 alleged violent incidents each over 2022-2025, including seven with more than 5,000 cases. And 26 NHS trusts each recorded more than 500 alleged incidents of sexual harm over 2022-2025, including six with more than 1,000 cases.
But, according to the data released, over the three years, eight trusts reported fewer than 10 cases of violence, while 45 trusts recorded 20 or fewer sexual harm incidents, of which 19 reported fewer than 10. Experts said such low numbers appeared to be highly improbable, given the huge numbers of patients treated and staff employed.
NHS trust managers and healthcare unions said the recorded figures represented a fraction of the true scale of physical and sexual abuse because incidents were so frequent that staff did not have time to formally report them all.
“These figures show that some trusts are dealing with explosions in incidents, while others refuse to share data or claim they’ve barely had a single case,” added the RCN general secretary. “You can’t keep your workers safe if you ignore what is happening or don’t know where the danger is.”
A survey of 20,000 nurses published by the RCN last month found that more than 27% said they were physically assaulted by patients, their relatives or other members of the public in the past 12 months. More than 10% reported being sexual harassed.
Ranger called on the health secretary, Wes Streeting, and NHS England to urgently get to grips with the crisis, adding that there was little doubt that some NHS trusts were in breach of their legal duties under the Health and Safety Act and the worker protection act, which requires employers to prevent sexual harassment of their staff.
Runswick agreed, adding: “The evidence that we’ve seen is definitely pointing to that. If the Health and Safety Executive came in [to inspect them], there would be lots of places which would fail on these grounds.”
NHS trusts which robustly addressed assaults on staff were the exception not the rule, Runswick added. “Most trusts say they have zero tolerance and then do nothing about it.”
Between 2018 and 2022, the Health and Safety Executive found 60% of 60 NHS trusts it inspected to assess their compliance with legislation aimed at preventing and reducing workplace violence to be in breach of the law.
Responding to the findings, the health and social care secretary, Wes Streeting, said: “Violence, aggression, racism, and sexual misconduct against NHS staff is completely unacceptable. Our doctors, nurses and healthcare workers deserve to feel safe at work without fear of abuse, assault or harassment.
“The NHS has zero tolerance for this behaviour. Last year we announced an urgent review into discrimination in the NHS and measures to tackle threats and violence against staff. Now trusts will go further to identify and take swift action against perpetrators of sexual misconduct while strengthening staff training to spot incidents.
“Any cases should be reported to the police. We’re cracking down on the worst offenders with new guidance making sure the most serious attacks will face the harshest penalties, including life sentences.”
An NHS England spokesperson said physical violence against staff was “totally unacceptable”, and urged those affected to report incidents to their employer or the police.
A spokesperson from the National Police Chiefs’ Council said: “Policing stands firmly behind a zero‑tolerance approach to violence, aggression or assault, in any form, against frontline and NHS staff as they carry out their vital work.”
