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

This policy provides a framework to help you identify risks and put the right protective measures in place. Its main aims are to increase awareness and reduce the number of incidents and injuries from violence and aggression. 

Who is covered by the policy?

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. 

Manager responsibilities

Violence to NHS Scotland employees is believed to be related to the nature of the work. This is because it involves contact with a wide range of people in often difficult circumstances. Patients and their relatives may be anxious and worried. Some patients may be predisposed towards violence.

As a manager, you have an essential role in creating a safe working environment. Your responsibilities are to:

• Know the policy and make sure your team is aware of it.
• Promote a safe culture where employees feel comfortable reporting incidents of violence and aggression.
• Make sure all incidents are recorded and investigated.
• Carry out risk assessments and review them regularly.
• Implement safe systems of work to eliminate or reduce the likelihood of violence and aggression.
• Make sure that staff groups and individuals identified as being at risk are given appropriate information, instruction and training.
• Support your team emotionally and practically after any incident.
• Monitor the reporting, investigating and recording of incidents to make sure preventative measures are effective.
• Provide advice to employees on when it would be appropriate to report incidents of violence and aggression to the police.
• Advise and support employees to report serious incidents to the police. This could include physical assault, threats of violence, or damage to property.
• Consider where it is appropriate for incidents to be timeously reported to the police and offer support to employees where required.
• Explain the importance of timely reporting for any potential compensation claims.

Procedure

NHS Scotland Boards have a zero-tolerance approach to violence and aggression towards employees. They are expected to take a proactive stance against violence and aggression, aiming to prevent 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.

Where a patient or service user displays violent or aggressive behaviour, a clinical assessment must be undertaken to inform and support decision-making. This assessment should make sure that appropriate action is taken while also safeguarding the patients right to access care and treatment, and making sure that this right is not unlawfully restricted.

Specialist risk assessment and advice 

As a manager, you must make sure that a risk assessment for your department is completed and reviewed. This must be done according to your area's local requirements.

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.

Download Combined risk assessment form.

Where required, advice should be taken from the relevant health and safety team. This may include advice on patient-specific issues, environmental factors, or equipment, as well as safe systems of work. 

As the manager, you are responsible for managing any identified risks. Overall, safe systems of work should be put in place to eliminate or minimise the risk of violence and 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.

Managing incidents

Employees may consider some incidents as 'part of the job', but they must be encouraged to report all incidents. Minor incidents can escalate, and reporting is essential for protecting an employee's right to support and compensation. It’s not about punishment, it’s about protection.

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 in cases of serious injury. 

As a manager, you should promote a culture where employees feel safe reporting incidents of violence and aggression.  

Local procedures must be in place for managing violent and aggressive incidents. This should include details of emergency protocols and procedures. As the manager, you should make sure all employees are familiar with these procedures, including how to record incidents using the appropriate systems within your board.

Employee support

You are responsible for making sure that all employees have completed the necessary violence and aggression training relevant to their role.  

All employees who have experienced violence or aggression in the workplace must have access to appropriate support. Where appropriate, you should make sure that a debriefing is carried out with the employees involved. This is part of the incident management process and should be done as soon as possible after the incident. 

You play a crucial role in connecting your employees with the right support. You can:

• Refer an employee for an occupational health assessment if it's appropriate.
• Let them know about local counselling and other support services available to them.

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

• Attendance Policy
• Special Leave Policy

Reporting and recording

You should make sure your employees report all incidents of violence or aggression, including near misses, to you as soon as possible. Your manager is then responsible for recording and investigating the incident in line with protocols and procedures. This includes timely reporting to the police for any potential compensation reasons. 

RIDDOR reporting

If someone has died or been injured in a work-related accident, this must be reported under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR). 

Not all accidents need to be reported – a RIDDOR report is only required when: 

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

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

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

The 7-day period

The 7-day period begins on the day after the accident. You must include non-working days, like weekends and rest days. This rule applies even if the injury or condition is not immediately obvious. The accident must be reported as soon as the injury prevents the employee from working for more than 7 consecutive days.

Some situations may include days when the injured person would not normally be expected to work. You must count weekends and any other scheduled non-working days as part of the total.

The report must be made within 15 days of the accident. 

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

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)