Urgent action needed to protect NHS staff amid rising harassment, discrimination and abuse

Health service leaders have warned that the NHS workforce is facing a crisis of morale as staff experience escalating levels of abuse, discrimination, racism and pressure linked to the wider political and economic climate.

On the eve of the UK’s leading annual health and care conference, The NHS Alliance is calling for a new national campaign on respect for NHS staff, developed in partnership with staff and patients.

As NHS organisations continue to make inroads in improving productivity while meeting rising demand, health service leaders say they are increasingly worried about the well-being and safety of the NHS’ greatest asset – its staff.

Sir Ciarán Devane, the new chief executive of The NHS Alliance, has warned that staff from diverse backgrounds feel particularly under threat at present.

A recent report by The NHS Alliance, based on an extensive survey and interview feedback from local NHS leaders, highlights this trend at a time when demands on health service staff are greater than ever. It found that staff morale is a particular concern for NHS leaders – the majority of NHS trust and Integrated Care Board leaders (93 per cent) and GP leaders (91 per cent) say declining staff morale is a key area of concern this year.

Sir Ciarán Devane, chief executive of The NHS Alliance, said:

“There is a very bleak picture emerging that is one of a profound crisis in the morale of NHS staff. Protecting staff from all forms of abuse, discrimination and as far as possible the pressures created by the wider political climate is not optional — it is essential. If we fail to safeguard the workforce, we fail patients.”

Recent data reveals a worrying rise in verbal aggression, discriminatory behaviour, physical violence and sexual misconduct directed at NHS staff by a minority of patients and members of the public.

These trends are set against a backdrop of the ongoing cost-of-living crisis, an increasingly polarised political debate, and a hostile public discourse.

Health leaders warn that these pressures are directly undermining morale, accelerating burnout, and threatening the stability of an already overstretched workforce at a time when a major NHS service transformation is underway – this is crucial to the future success of the service if it is to continue serving generations to come.

Asked about staff morale, NHS leaders responded to The NHS Alliance survey detailing their concerns.

One NHS leader warned that the drive to ever increasing levels of productivity and tighter finances had led to “significant damage to staff morale”.

Another acute trust leader said: “Our people experience everything that's going on in wider society, so there is no doubt, certainly for colleagues I work with, that people are experiencing racism, they're experiencing the things that we're seeing in terms of social fragmentation.”

And a health service manager added: “The staff survey has taken a hit due to low morale and staff saying they don't have a doable job.”

Sir Ciarán added: “Put bluntly, this cannot be allowed to continue, the NHS cannot function without its most valuable asset, its people.

“Policymakers, NHS leaders and the public alike must work together to ensure that every member of NHS staff – from porters and healthcare assistants, nurses and physios, to doctors and managers – can work free from fear, discrimination and hostility.

“We need a united response to drive this out of our health services and in wider society.”

Findings from the recent annual NHS staff survey paint a bleak picture and support what NHS leaders are reporting:

• Discrimination: Nearly 10% of NHS staff report experiencing discrimination from patients or the public, the highest level on record. This equates to almost 140,000 people, with disabled and ethnic minority staff disproportionately affected.

• Harassment and abuse: The recent publication of the Mann Review into racism and antisemitism and its recommendations make clear the urgency needed to tackle all forms of racism in the NHS. Figures from the NHS staff survey show that more than one in four NHS workers experienced harassment, bullying or abuse from patients or the public in the past year. That is an estimated near 400,000 staff, with rates rising to nearly 30% for Black and minority ethnic staff.

• Sexual misconduct: Nearly 1 in 12 report unwanted sexual behaviour from patients or the public. For ambulance staff, this surges to nearly a third of the frontline ambulance workforce.

• Physical violence: Almost 220,000 NHS staff were physically attacked in the last year, the highest level in three years.

• Work related stress: Staff reporting being unwell due to work-related stress has risen again, from 41.65% to 42.36%.

With over 1.5 million people working in the NHS — the largest employer in England — the health service employs 1 in every 19 working adults in England. Yet these findings show that staff are being placed under unprecedented strain.