Aim

This policy outlines NHS Scotland's zero-tolerance approach to work-related violence and aggression. It explains how risks are identified, the procedures in place to protect employees, and the support they will receive if an incident occurs. It aims to:

• Raise awareness of the issues relating to violence and aggression at work.
• Help managers identify risks and put protective measures in place.
• Reduce injuries and incidents resulting from violence and aggression.

Scope

This policy applies to all employees. It also applies to bank, secondees, agency, sessional workers, volunteers, contractors, and those on placement, such as trainees, students, or individuals undertaking work experience.

Reference to employees applies to all these groups unless otherwise stated.

This policy complies with current legislation and meets the aims of the Public Sector Equality Duty of the Equality Act 2010.

Definitions

The Health and Safety Executive (HSE) defines work-related violence and aggression as: “Any incident in which a person is abused, threatened or assaulted in circumstances related to their work....” 

RIDDOR – Reporting of Injuries, Diseases and Dangerous Occurrences Regulations. The purpose of RIDDOR is to inform the relevant enforcing authority that a work-related accident or incident has happened.

Roles and responsibilities

There is a range of standard expectations which underpin all policies. Read more about standard roles and responsibilities. In addition, the following specific responsibilities apply to this policy.

Employer

The employer is responsible for putting safe systems of work in place to protect staff. This includes making sure that all incidents are properly recorded and acted upon. They must also make employees aware of their rights in relation to serious incidents.

Promote a safe culture

• Uphold the duty of care to protect everyone covered by this policy from harm.
• Actively support the health, safety, and wellbeing of the entire workforce.
• Make sure all managers are familiar with this policy and their responsibilities.

Implement robust systems

• Implement safe systems of work designed to eliminate or reduce the risk of violence and aggression.
• Make sure all risks related to violence and aggression are recorded and that appropriate action is taken.
• Use incident data from reporting and investigations to inform preventative measures and improve safety.

Support employees

• Inform employees of their right to report serious incidents, such as assault or threats, to the police.
• Explain the importance of timely reporting, as this can be crucial for any potential compensation claims.

Manager

The manager must:

• Raise awareness of the Work-related Violence and Aggression Policy with their employees.
• Promote a safe culture where employees feel comfortable reporting incidents of violence and aggression.
• Carry out risk assessments and review them regularly.
• Implement safe systems of work to eliminate or reduce risks.
• Provide training and clear instructions to all at-risk employees.
• Support the team emotionally and practically after any incident.
• Encourage and support employees to report relevant incidents, such as physical assault, threats of violence, or damage to property to the police.
• Inform employees that reporting incidents promptly is crucial. Explain that delays can impact any potential compensation claims.
• Investigate and record all reported incidents to improve safety and make sure preventative measures are effective.

Employee

The employee must:

• Act safely and do not endanger themselves or others.
• Follow all procedures and safe systems of work.
• Complete all required training and education, as identified by their training needs analysis.
• Report any risks they identify or any concerns they have about potentially violent situations or their working environment.
• Report all incidents involving verbal abuse, threats, or physical assault.

Procedure

NHS Scotland Boards have a zero-tolerance approach to violence and aggression towards employees. They are expected to take a positive stance against violence and aggression, aiming to prevent incidents and support employees affected by them.

Committing acts of violence or aggression are unacceptable and will not be tolerated. Many forms of violence or aggression are criminal offences. They may also breach corporate and professional codes of conduct.  

Specialist risk assessment and advice

If an individual is known to pose a risk of violence or aggression, a full risk assessment must be completed. This assessment must consider all specific prevention and management strategies associated with that person's aggression. The multidisciplinary team and any other agencies involved should regularly review it. Safe management strategies may need to be added or adapted.

Where risks of aggression or violence have been identified, the risk must be controlled. The hierarchy of control, as set out by the Health and Safety Executive, must be followed. This requires the most effective control measures to be considered first. The first priority is always to eliminate the risk entirely before considering other options, which reduce the likelihood of aggression.

Responses to incidents will depend on their severity. For less serious issues, this could be a formal warning about unacceptable behaviour. In the most serious cases, it could involve the decision to withhold treatment from violent patients.

Advice on patient-specific issues, the environment, equipment, and safe systems of work should be obtained from the relevant department where required.

Download Combined risk assessment form.

Managing incidents

Employees must be familiar with their local procedures for managing violent and aggressive incidents. This includes emergency protocols and procedures for getting help quickly.

Employee support

If an employee is a victim of violence or aggression, they must have access to appropriate support. This includes a debriefing as soon as possible after the incident as part of the incident management process.

Counselling services can be accessed through self-referral or a referral from a manager.

Reporting and recording

Employees should report all incidents of violence or aggression, including near misses, to their manager as soon as possible. Managers should record and investigate the matter in line with local protocols and procedures.  

All work-related violence, aggression, accidents, and incidents must be recorded on the board’s incident reporting system. 

RIDDOR reporting

If a work-related accident causes a serious injury or death, you may need to make an official report. This is done under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR).

RIDDOR is the legal system for reporting serious workplace incidents to the Health and Safety Executive (HSE). Not every accident needs a report, only those that meet specific criteria:

• the accident is work related
• it results in a reportable injury

Regulation 4 of RIDDOR lists ‘specified injuries’ which must be reported.

You must submit a RIDDOR report if a work accident stops an employee from doing their normal duties for more than 7 consecutive days.

This rule applies even if the injury isn't obvious immediately. The 7-day count begins as soon as the injury stops the employee from being able to do their job.

This 7-day period does not include the day of the accident but does include weekends and rest days. The report must be made within 15 days of the accident. 

Some situations may include days when the injured person would not normally be expected to work. These non-working days must be taken into account when deciding whether the employee was unable to do their normal duties for more than 7 consecutive days. 

Involving the police and prosecution 

Where an incident occurs, the employee affected is encouraged to report it as soon as possible to the police. Early reporting supports the ability to access compensation through either the criminal injuries compensation schemes or personal injury claims.

It's important to recognise why reporting an incident matters. It protects an employee's right to receive support and compensation if they're injured.

The Criminal Injuries Compensation Authority (CICA) requires that the incident be reported to the police for a claim to be considered. Without this step, employees who have been harmed may be unable to access financial compensation, even when the injury is serious.

The procurator fiscal may decide to take legal action. Managers must make sure that employees have access to ongoing support throughout this process. Other support may also be available to employees through trade unions or professional organisations. 

Monitoring and review 

Local statistics and incident reports are regularly reviewed to assess the effectiveness of this policy. This helps to identify trends, reduce risks, and improve safety for everyone. 

The review processes will include: 

• Collecting and monitoring all reported incidents.
• Regular reporting of incident statistics and safety improvement measures to appropriate health and safety committees and partnership forums.
• Reporting to the board to highlight progress in reducing risk and incidents and making recommendations for the forthcoming year. 

Related policies 

The following workforce policies are related to the Work-based Violence and Aggression Policy:

• Lone Working Policy
• Attendance Policy
• Special Leave Policy
• Conduct Policy