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regular comment for managers on workplace health issues

Complete Tolerance – Why Zero Tolerance is failing

 This is the last summary from the papers delivered at the Northern Ireland OH Update in 2005.

Walter Brennan, Independent Training Consultant & Expert Witness on Conflict Issues, Oliver Brennan Training Ltd, www.oliverbrennan.co.uk

Facts and Figures

The much vaunted Zero Tolerance campaign aimed at addressing violence in the NHS has made little difference to “shop floor” staff who feel no better protected now than they did before the Zero Tolerance Campaign was launched in 1999.

This is what they said:

  • They put posters up saying that we will do this and that and then when we are hit or attacked they do nothing! – Paul – a Porter
  • I was threatened with having my house torched and was told by my manager, I needed to be more caring! – Catherine – receptionist
  • The Police came and had a friendly chat with a woman who spat in my face and threw chairs around the waiting area – Carol – Junior Doctor

 A total of 221 NHS employees interviewed

  • 80 Nursing staff, 14 Junior Doctors, 12 Medical Students, 47 Porters, 68 Admin. Staff (Secretaries, Ward Clerks)
  • Staff worked in: GP Surgeries (28%), NHS Trusts (49%), Private Sector (23%)
  • Geographical areas: North Wales (4%), South Wales (11%), Scotland (13%), North of England (19%), South of England (53%)

 How much of a problem would you say violence is within your area of work?   Score 1=low, 5=Medium, 10= High

  • Nursing staff average score 8
  • Porters average score = 9
  • Admin. Staff average score = 5
  • Overall =scored an average of 7
  • North Wales scored average 6
  • South Wales scored average 7
  • North of England scored average7
  • Scotland scored average 9
  • South of England scored average of 8

If you have been attacked or hit how much positive support did you get from:

Colleagues (84%), Managers (1%), The Trust (3)%, The Police (8%), The Judiciary (none)

 If you were attacked tomorrow what positive support would you expect

Colleagues – 93%, Managers (2%), The Trust (None), The Police (2%), The Judiciary (none)

* Three respondents said they got no support from anybody!

 The problem with some managers

  • Send staff on training courses, but don’t go on the course themselves and then contradict what the staff have been told on training course
  • Haven’t got a clue about violence. They seem to be oblivious to the problem
  • Haven’t done a risk assessment into the hazard of violence
  • Take the aggressor’s side against their own staff!

 Problem with Some Trusts/Employers

  • Blame staff for being a victim
  • Don’t examine training courses for content and duration
  • Rarely prosecute on behalf of their staff
  • Much more concerned about patients or relatives complaining than about looking after their own staff
  • Fail to have in place formal support mechanisms for victims of violence

 Problem with the Police

  • Don’t appear to want to attend to incidents
  • Appear to feel Security staff should be dealing with violence
  • Often advise staff that prosecution will not work because they were not in control of their bodily functions!
  • Appear to advise staff that Crown Prosecution Service will throw the case out so arrest and prosecution is pointless

 Problem with the Judiciary

  • Appear to be badly informed
  • Appear to continue to view violence against NHS staff as an occupational hazard
  • Appear to be reluctant to punish offenders
  • Appear not to understand that verbal abuse is also an act of violence as defined by the Zero Tolerance Campaign in 1999

 The problem with training

  • Training rarely linked to risk assessment and training needs
  • No standard training course
  • No standard requirement for trainers
  • No clear guidance on the use of physical interventions
  • Not enough done to make policy awareness a training issue
  • None or little inclusion in helping staff to cope with being a victim

 The way forward

  • Re-launch the Zero Tolerance Campaing and give it a new name e.g. – SAFE ENOUGH TO CARE
  • Provide training courses for Magistrates, Judges, Crown Prosecution Service
  • Provide training courses for Police
  • Provide a 1 day training course especially for managers  and include:
  • How to do a risk assessment for violence
  • How to put in place formal support mechanisms for staff affected by violence
  • Emphasise a duty of care to staff by providing case law of Civil cases or Employment Tribunals where managers have failed to execute their duty of care to staff

 Training Courses

Minimum of one day

Ensure trainers are trained to train. They should have a professional qualification

They should have a good working knowledge of:

  • – Violence
  • – Trigger factors
  • – Legal/ethical issues
  • – Self awareness
  • – Defusion skills
  • – Verbal abuse
  • – Break a way skills
  • – Restraint skills (where identified)
  • – Critical Incident Debriefing

Courses need to have a competence assessment for participants 

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