Violence against staff in A&E: we need dates and names

We are the nursing and clinical staff of the Emergency Department, writing together and with the support of our RCN representatives. Violence, aggression and abuse are now part of our ordinary working day. They should not be.

How we got here

On 15 June 2026, about 25 of us met to talk about what is happening in the department. Colleague after colleague described being sworn at, threatened, spat at or struck, in many cases almost every shift. Several said they were close to breaking point. What came through most strongly was not the violence itself but the years of raising it and seeing nothing change.

We agreed at that meeting to stop raising it one by one and to raise it together. We elected six colleagues to lead this work on our behalf, headed by John Moroney. Following the meeting, an RCN Rep also asked the Trust for its own figures on violence and aggression in the department, and we were collecting written accounts from members of what has happened to them at work.

Since then, there have been useful talks with senior colleagues, the last being:

• 16 September 2026. We discussed setting up a working group on the £2m A&E redesign and other matters.

The Trust has also written to staff setting out its position, and the BBC has since reported on the problem. The issue is now public.

Where we are now

We are grateful for these meetings, and we think the promises made in them are the right ones. But a promise does not make us safer. What we still do not have is a timetable: what you will do, by when, who is responsible, and how you will tell us how it is going. Without dates and names, colleagues read these promises as good intentions rather than as changes they will see on their next shift. Please close that gap.

We ask you to act now on the following.

1. Body-worn cameras. Give every nurse in A&E a camera that works. Say who maintains them, who replaces them, and how we are trained to use them. We note that 20 cameras have been obtained and distributed to senior staff; however, it is our colleagues who work frontline with patients who are most at risk from Violence and Aggression.
   
   
2. Security staff. Put more security staff in A&E. These must be extra posts, not staff moved from somewhere else in the Trust.
   
   
3. Name badges. Take surnames off our ID badges. Patients use them to find us, and to target us.
   
   
4. Zero tolerance. Enforce the policy you already have. That means:
   • Real consequences for people who assault or abuse staff.
   • Follow-up on every reported incident, every time.
   • Telling us what you did about it.
   • Training managers and security staff to apply the policy the same way.
     
     
5. Final warnings. Set up a clear final-warning process for verbally abusive patients. Verbal aggression often turns into violence.
   
   
6. What happens after an incident. We need a process we can trust:
   • A simpler, quicker way to report violence, with every report read and acted on promptly.
   • A personal acknowledgement from a senior manager after every incident, spoken directly to the member of staff involved.
   • An offer of support, a debrief and wellbeing help for anyone who suffers or witnesses violence — offered, not waited for.
     
     
7. Rewriting the policy. Include clinical staff and our representatives in the review of the Violence at Work policy, so that frontline nurses and RCN reps shape what it says.
   
   
8. Filming. Strengthen the policy on filming and recording. Put up clear signs, enforce them, and step in at once when someone films a member of staff who has not agreed to it.
   
   
9. A published plan. Give us an action plan with dates, named leads, and set points at which we can take part and give our views.

We write this because we want to stay, and to stay safely. Every one of these things can be done, and several are half done already. What we are asking for is the plan, the dates and the follow-through.

We hope this would be part of a wider collaborative action of eliminating Violence and Aggression faced by staff at GSTT, providing a case study for other areas where the issue is acute.

Yours sincerely,

For the nursing and clinical staff of the Emergency Department, Guy's and St Thomas' NHS Foundation Trust, supported by [name], RCN steward and health and safety representative.