The following guide forms part of the standard for workforce policies. These policies apply to all eligible staff within NHS Scotland, regardless of the board you are employed by.

What is the purpose of the Work-related Violence and Aggression Policy?

The policy is in place to keep you safe. This guide will help you identify risks in your workplace. It also explains the protective and preventative measures you must take to stay safe.

Who is covered by this policy? 

This policy applies to everyone working within NHS Scotland. That includes all employees, plus bank, agency, and sessional workers, volunteers, contractors, and anyone on placement, such as students or trainees.

Employee responsibilities

Working in healthcare can sometimes involve difficult situations where people are anxious or worried. Your safety is a priority. As an employee, you must:

• Act safely and not endanger yourself or others.
• Complete all required training and education, as identified by the training needs analysis for you or your work area.
• Follow all procedures and safe systems of work to reduce the likelihood of violence and aggression.
• Report any risks or concerns you have about potentially violent situations or your working environment. 
• Report all incidents, including verbal abuse, threats, and physical assault.

Procedure

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

Committing acts of violence or aggression is 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 

Your manager is responsible for carrying out risk assessments for your work area. You may be asked to help gather information for the risk assessment.

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. It should be regularly reviewed by all the relevant parties involved, and safe management strategies may need to be added or adapted.

Download Combined risk assessment form.

Your manager can get expert advice from specialist teams, such as health and safety. This helps them make informed decisions about patient-specific issues, the work environment, and creating safe systems of work.

It's your manager's responsibility to manage any identified risks. They must put safe systems of work in place to eliminate or reduce the risk of violence and aggression to keep you safe.

Your manager's response to an incident will depend on its severity. This can range from:

• A formal warning to the individual about their unacceptable behaviour.
• Up to, in the most serious cases, the decision to withhold treatment.

Managing incidents

You may think of some incidents as 'part of the job', but you must report everything and understand why it is important. What seems like a minor incident could be part of a pattern that escalates.

It is important to recognise that reporting an incident is not about punishment. It’s about protecting your right to receive the support and compensation you may be entitled to if you are injured.

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

Your manager will promote a culture where you feel safe to report incidents of violence and aggression.  

Local procedures must be in place for managing violent and aggressive incidents. This should include details of emergency protocols. It's your responsibility to be familiar with your local procedures for managing incidents. This includes knowing:

• The emergency protocols and how to get help.
• How to record incidents using your board's official system.

Employee support

You should complete the necessary training on violence and aggression appropriate to your role.  

If you experience violence or aggression, you will have access to support. This includes a debriefing session with you and any other colleagues involved as part of the incident management process. Your manager can also refer you to occupational health or local counselling services.

Any time off for support would be considered in line with the following policies:

• Attendance Policy
• Special Leave Policy

Reporting and recording

You must report all incidents of violence or aggression, including near misses, to your manager as soon as possible. Your manager is then responsible for recording and investigating the incident in line with protocols and procedures.

RIDDOR reporting

If you're off work for more than 7 consecutive days because of a work-related incident, a formal reporting process is triggered.

Your manager will contact the health and safety team for advice. They will advise on any onward reporting to external agencies, including the Health and Safety Executive (HSE). Where this is required, notification must be made within 15 days of the incident. Similar reporting may also apply to modified duties due to injuries sustained. This meets RIDDOR requirements.  

Involving the police and prosecution

You are encouraged to report incidents of violence or assault to the police. NHS Scotland is committed to protecting you and will support proceedings against those who carry out assaults.

The Procurator Fiscal may decide to take legal action. Your manager will make you have access to ongoing support throughout any legal process. You can also get support from your trade union or professional organisation.

Useful links

• RIDDOR definitions
• HSE Management Standards 
• Emergency Workers (Scotland) Act 2005
• HSE – Violence and Aggression in the Workplace
• HSE / RIDDOR (report of an enquiry)