Violence and Aggression (V&A) directed towards NHS Wales staff and those who utilise NHS services in Wales is unacceptable and it is recognised that NHS staff are among some of the professions most likely to face aggression while carrying out their duties.
Where violent and aggressive behaviour is displayed, it is imperative that NHS Wales organisations seek the appropriate response to ensure the wellbeing of all concerned. Staff attending the workplace and those who visit the NHS Wales footprint, whether as a patient or for another reason, should do so confident of their safety.
The Anti-Violence Collaborative Wales (AVC) is a collaboration of all NHS Wales organisations, the Police in Wales, the Crown Prosecution Service in Wales and trade union and staff support organisations. Its aim is to support NHS Wales and emergency services organisations to reduce and manage V&A incidents. Facilitating collaboration with Criminal Justice Service partners, NHS Wales bodies, emergency services organisations and Welsh Government, the AVC promotes violence reduction strategies and communication with service users.
In June 2023 Jonathan Webb was appointed as the Chair the AVC. An interim National Advisory Team was created with the aim of managing and driving forward the vision of the collaborative. The Team was created by seconding a NHS Violence and Aggression case manager from a health board, a staff support officer from the Royal College of Nursing and a tactical advisor to the Chair who is an experienced V&A leader from the Welsh Ambulance Services University NHS Trust.
Originally formed in 2017, the AVC has coordinated an Obligatory Responses to Violence in Healthcare framework (ORV), which sets out the aims and process by which all of the AVC partners will collaborate. The work of the AVC in the NHS is underpinned by a Welsh Health Circular, which aims to ensure that the organisations which form NHS Wales fully embed the guidance given within the ORV document. All parties are committed to encouraging the most appropriate response to V&A cases to ensure the safety of NHS staff and others.
The AVC Team has actively refreshed and developed relationships with colleagues within the NHS, police, CPS and staff support organisations and trade unions, a new Terms of Reference was written and meetings for the AVC scheduled through 2023, 2024 and 2025. The Joint Emergency Services Group (JESG) for Wales supported the extension of the work of the AVC to encompass emergency services partner organisations and are proactively working with the AVC to achieve this.
In March 2024 a Senior Safety and Learning Advisor was appointed on a full-time basis to continue the work of the Interim AVC Team following the completion of their secondments. Additionally, a Tactical Advisor to the AVC Chair has been appointed on a sessional basis to further promote and coordinate the work. A number of staff who are experienced in supporting violence and aggression activities, have been appointed to the WRP Safety and learning Pool.
NHS Wales Violence and Aggression case managers operate in all NHS Health Boards, Trusts and Special health Authorities - supporting victims of violence. To achieve this, they work closely with partner agencies, particularly the police services in Wales. The AVC support their work by being represented on the NHS Wales Case Managers Group to better understand the issues faced by the case managers and with a view to working together with other members of the AVC towards a solution in terms of data recording, reporting and support to victims.
The agreement and guidance document for the collaboration, the Obligatory Responses to Violence in Healthcare (ORV) has been refreshed to better meet the needs of the AVC. New operational guides have been written for NHS and police colleagues. These new and refreshed documents are intended to provide the latest practical guidance to operational staff when confronted with an instance of violence and aggression and to reinforce the commitment of AVC partners.
For staff to report violence and aggression incidents easily and confidently, a task and finish group of NHS Wales V&A case managers was established to review the Datix Cymru reporting system. The review looked at the structure and efficacy of the current incident reporting form and the data that is reported on, to identify key trends and areas of risk. Following this review, key changes were made to the V&A incident report on Datix Cymru. The improvements to the system will mean that the V&A case managers and equivalent staff can conduct their investigations into incidents more effectively, and therefore provide even more support to victims of V&A.
Legislation pertinent to the safety of NHS Wales staff and those who visit health establishments has been reviewed and legislation which specifically relates to NHS premises has been identified. Working with colleagues in Welsh Government, the AVC Senior Safety and Learning Advisor is actively exploring the possibility of this legislation being made available to colleagues in Wales.
In 2024 and beyond The Senior Safety and Learning Advisor with cooperation from AVC colleagues, will focus attention on work themes which will enhance safety. These will include understanding the benefits of introducing violence prevention standards to help NHS organisations reduce violence, exploring V&A training for NHS staff and gain further understanding of what legislation may be available for colleagues to utilise when violence occurs in NHS settings.
NHS Wales Chief Executive, Judith Paget, Chief Constable Pam Kelly QPM (Gwent Police), Chief Constable Amanda Blakeman KPM (North Wales Police), Chief Crown Prosecutor for Wales, Jenny Hopkins with Chair of Anti-Violence Collaborative Wales, Jonathan Webb