Welsh NHS violence prosecutions hit new peak
Hospital staff and paramedics are the victims of thousands of violent attacks each year, latest figures show.
There are an average of 7,500 reported incidents a year, including 50 assaults involving weapons, a BBC Wales investigation shows.
At the same time, prosecutions and other sanctions have reached their highest rate.
There has been a Welsh Government drive to cut abuse, and it says the rise is due to more incidents being reported.
Last year 300 incidents resulted in prosecution or other action.
The Welsh Government said that improved safety measures are in place to protect staff and it is making progress.
Data shows that much of the abuse is carried out by patients with mental health problems like dementia and is unintentional.
The figures were obtained by BBC Wales using the Freedom of Information Act and show that the reported violence has remained fairly static over six years despite targeted measures to tackle the problem. However, it was down this year, from 8,343 last year to 7,558.
More than 9,000 incidents in the past four years resulted in injury to staff and led to thousands of days of work lost.
The most serious assaults included more than 80 sexual assaults of staff at hospitals across Wales. A further 50 involved weapons.
Betsi Cadwaladr University Health Board even had figures showing that since 2007, 258 members of staff had suffered abuse - either verbal or physical - at the hands of their co-workers.
They said that around 60 were reported each year with most relating to claims of verbal abuse or perceived disruptive behaviour.
A spokesman said: "While occasional disagreements will inevitably occur between colleagues, especially working in an environment that at times can be pressured and stressful, the fact that the number of incidents that are reported formally is so low shows that most of these are resolved at a local level."
The Royal College of Nursing (RCN) applauded the work being done but questioned why some health boards are still referring so few cases to the police.
Tina Donnelly, director of the RCN in Wales, said: "It is pleasing to see an increase in the number of prosecutions and the number of reported cases has increased due to a zero tolerance policy.
"Our anecdotal evidence is that nurses in Wales are delighted things are changing as four years ago eight out of 10 reported being a victim of violence," she added.
In 2009 a cross-party group of AMs said aggression against NHS workers in Wales had been tackled with a "lack of urgency".
CCTV was installed at four hospital A&E departments and in five ambulances, while thousands of lone workers were given panic buttons.
Last December then Health Minister Edwina Hart launched a new drive with the NHS, the police, and the Crown Prosecution Service.
But Dr Charles Allanby, a Cardiff GP who was been a victim of violence and once foiled a knife-wielding patient in his surgery, said more needs to be done to tackle the root cause - alcohol.
He told BBC Wales: "Attacks on doctors or nurses are indefensible.
"One does have to accept it's something you come across and is sometimes the result of people having mental health problems.
"In A&E departments there is a clear association with alcohol and it is directly to do with the longer licensing hours.
"People should be lobbying their councillors and local MPs to see this problem tackled."
His view was shared by the Welsh Ambulance Service, which saw attacks rise to 257 in 2010.
A spokesman said the causes of violence are "societal".
"Incidents experienced by ambulance crews are often associated with excessive alcohol consumption by the assailants.
"We uphold a zero tolerance policy against this form of abuse and do our utmost to report this behaviour to the police to pursue prosecution against offenders."
The Welsh Government said that when the programme started in 2008, prosecutions were in single figures.
In 2010-11 there were 126 successful prosecutions with some leading to custodial sentences.
In addition, there were 143 other sanctions, such as fixed penalties and anti-social behaviour orders.
A spokesperson said: "Case management is a key component of the Welsh Government's approach to protecting staff against violence and aggression, while supporting those who have been affected by it.
"There is still much to do, but the early indicators are that, working together, we are making progress.
"Pressure to reduce the risks of violence and aggression towards NHS staff will continue."
Encouraging staff to report incidents is a key priority, the spokesperson said.
In future hospitals in Wales are to try to reduce the levels of crime in their A&E departments through the use of better design.
Cwm Taf Health Board said: "Whilst no prosecutions have been made, there has been a noticeable rise in reassurance and a reduction in the fear of crime in all staff groups."
It said there have been 75 incidents in which the police were involved and in the period April 2010 to March 2011 there were 13 Asbo referrals while there are two incidents currently under investigation by the police.
Powys, which does not have any A&E units, said most incidents were connected with patients with mental health issues or elderly patients.
"It should be noted that the number of incidents has fallen considerably in the last year or so despite an increased awareness amongst staff in terms of reporting."
- Cwm Taf Local Health Board originally provided information stating there had been one case of rape in 2009 but later said this had been a mistake. A spokesman said: "The Health Board would like to make clear that there has been no case of rape against its staff and the initial inclusion of this incident was a coding error in the information system within the health board. This error has now been corrected and an internal investigation is taking place to ascertain how this mistake was made."