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NICE updates guidance to halt violence against NHS staff

19 June 2015 - 8:46am

The National Institute for Health and Care Excellence (NICE) says clinicians should involve mental health patients in decisions about their care and treatment.


Between 2013 and 2014 nearly 68,700 assaults against NHS staff in England were reported

In updated guidance on the management of violent and aggressive behaviour in people with mental health problems, NICE recommends developing care and risk management plans jointly with them.

The guidance covers NHS treatment across all health and social care provider organisations. It says that if a service user is unable or unwilling to participate, they should be offered the opportunity to review the plans as soon as they are able or willing.

Mark Baker, director of the NICE centre for clinical practice, said: ‘The guideline focuses on how to assess risk and prevent violence, including how to recognise warning signs, to calm potentially violent patients and manage difficult situations, as well as to intervene safely when violence happens.’

Key recommendations cover

  • an understanding of the relationship between mental health problems and the risk of violence and aggression
  • skills to assess why behaviour is likely to become violent or aggressive, including personal, mental, physical, environmental, social, communicational, functional and behavioural factors
  • skills, methods and techniques to reduce or avert imminent violence and defuse aggression when it arises, for example verbal de-escalation
  • skills, methods and techniques to undertake restrictive interventions safely if these are required

NICE statistics show that between 2013 and 2014 there were nearly 68,700 assaults reported against NHS staff in England. Almost 70 per cent of these occurred in mental health or learning disability settings and included incidents involving the families or carers of patients as well as patients themselves.

Donna Steele, the CSP’s national health and safety officer, recommended resources provided by NHS Protect, which leads on work to protect NHS staff in England from violence.

‘NHS Protect has a remit to ensure employers have proper procedures in place for adequate training and policies that protect staff from violence and aggression in the workplace. It’s worth visiting their website to see how they may be able to help,’ she said.

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