Ways to tackle violence: the story so far
Alan Lofthouse, National Officer for UNISON, and Rebecca Smith, Director of Systems and Social Partnerships at NHS Employers, share details on the violence prevention and reduction work underway across the system.
In April 2025, we published our Ways to tackle and reduce violence against NHS staff report which we produced in response to a commission arising from the 2023 NHS staff pay deal. It includes 17 recommendations covering the following key areas:
- making workplaces safer
- strengthening leadership on violence
- data-driven decision making and supporting a reporting culture
- risk assessment, training and support
- working in partnership with trade unions.
All our recommendations have been accepted by government and we are now taking them forward in partnership. So, what progress has been made so far?
Violence Reduction Oversight Group
In August 2025, we established a violence reduction oversight group to coordinate trade union, NHS Employers, DHSC and NHS England activity on taking forward the recommendations. The group meets monthly and enables progress on the recommendations by working through a joint action plan. The group also contributes to a quarterly progress report to the NHS Staff Council.
Mandating the Violence Prevention and Reduction Standard
In December 2024, NHS England published a refreshed Violence Prevention and Reduction (VPR) standard, updated from the 2021 version. This was developed in partnership with NHS trade unions and employers through the SPF. The standard encourages a public health, trauma informed approach to preventing and reducing violence and understanding the root causes to distress, and includes an assessment tool to assist with implementation.
At our recommendation, updated wording has been included in the NHS Standard Contract 2026/27, which went out to consultation at the end of 2025. The new wording mandates the implementation of the standard for secondary care providers (NHS trusts and NHS foundation trusts). In 5.9.2 of the General Conditions, it states:
"The provider must use all reasonable endeavours to implement the NHS Violence Prevention and Reduction Standard (unless it is an NHS Trust or an NHS Foundation Trust, in which case the Provider must implement the NHS Violence Prevention and Reduction Standard)."
The previous contract stated "providers must use all reasonable endeavours to implement" the standard; mandating the standard strengthens this and we expect to see a more consistent, evidence-based approach taken to tackling violence across England.
Statutory and mandatory training
Linked to the violence recommendations, the SPF has been working with NHS England on its review of statutory and mandatory training. This includes competencies for all staff, managers, lead executives and board directors regarding civility and respect in the workplace. There are also competencies for staff in high-risk groups on reducing violence and aggression. These should be finalised and included in a new competency framework, which will replace the Core Skills Training Framework.
Post-incident support
We have commissioned the NHS Staff Council Health and Safety Working Group (HSWG) to develop a standard approach to post-incident support, to ensure staff who are victims of violence and abuse are offered the right kind of support. HSWG has established a working group to develop the resource, which includes employer and trade union representatives and is meeting regularly with the aim to complete the guidance by spring 2026.
National VPR data collection pilot and data reporting framework
There is currently no national reporting system or reporting framework for violence, and as such monitoring and learning from reported incidents of violence towards staff is challenging. NHS England has commissioned suppliers to develop a national data reporting framework to standardise data collection on violence towards staff and to roll out a pilot national data collection. This would allow for analysis of trends in violent incidents and facilitate continuous improvement of support and resources. The aim is for this guidance to be available later this year.
Safe working practices guidance
NHS England has also commissioned safe working practices guidance to help staff to safely and compassionately manage clinically related challenging behaviours from patients. The guidance will encourage a proactive, trauma-informed approach to manage challenging incidents of violence and support the move away from violence being an expected part of the job for NHS staff. This guidance also aims to be available later this year.
VPR messaging and communications
In part as a response to our recommendation for a need to develop consistent messaging for staff and patients about the impact of violence and aggression, NHS England has commissioned a set of comms materials and case studies to be used by organisations to prevent and reduce violence against their staff. These should be finalised in the coming months and will be hosted on the SPF website.
Sign up to receive the SPF Bulletin to be notified of when the guidance documents and resources are available.
What you can do to support this work
Employers have a general duty of care to protect staff from threats and violence at work, and trade unions can add real value to any steps taken to achieve this. We encourage employers and NHS trade unions to work in partnership to implement the VPR Standard, take steps to foster a positive culture that moves away from an acceptance of violence towards staff, encourage reporting of violent incidents and ensure lessons learned from incidents are taken forward to inform future activity.
You can access resources to support your efforts to improve the safety of NHS staff on our violence reduction web page.
If have an example of a project or organisational policy or approach that has supported a reduction in violence towards NHS staff, particularly if it was developed and implemented in partnership with trade unions, we want to hear from you.
Email us to share your good practice.
