Gary McPartland offers a study of the psychological and physical stresses facing front-line security officers working in Britain’s accident and emergency/mental health units.
Introduction
I remember it like it was yesterday, but it was actually some 14 years ago; having already been a security professional for over a decade at that point, you can find yourself analysing colleagues that you come across, often in the strangest of places. It was a Saturday afternoon, and having fractured my ankle in four places, I was sitting in my rugby kit watching the chairs starting to fill up at a busy A and E in Essex.
I was triaged, taken away for X rays and then had a temporary cast put on whilst awaiting a bed for the imminent operation the following day. It was still fairly early when I returned to the A and E, and I was placed on a bed in the corner. This allowed me a full panoramic view of the waiting room, and all that unfolded in there. It was just prior to 2200 when a couple entered the A and E and ignored the small queue of people at the reception desk. Although nobody complained, the male continued to ask those waiting if they had any problem with his actions. Whilst I couldn’t hear the full interaction, what I did see was two security officers arrive and ask the man to quieten down and to take a seat. As voices started to rise, the male spat directly into the face of the taller officer and a full-on fist fight erupted.
The police arrived quickly, but I was still shaken up at what I’d witnessed; feeling helpless due to my injury, I had to sit on the periphery and just hope the violence didn’t reach me. It didn’t, but I couldn’t help but think how much these officers had to tolerate, and surely this wasn’t the norm? That wasn’t just a part of the job-something to accept and endure, surely?
The reality is that at the time, nobody really knew. Whilst studies into the levels of both verbal and physical abuse against NHS’ medical personnel were beginning to be undertaken, very little was known about the working experiences of this specific group of frontline security personnel. Frankly, looking at the number of dedicated articles on this topic, little still is.
Therefore, the aim of this paper is to investigate the levels of both the emotional and physical stresses faced by security teams working within A and E depts, as well as mental health units (MHUs) and to collate and present both qualitative and quantitative data to provide a snapshot of the typical day in the life of an NHS Security officer. Are the measures currently in place to safeguard their welfare adequate, or are we heading towards a crisis in their vocational confidence?
One of the key drivers for my focusing on colleagues working in emergency departments is the highly publicised rise in assaults on frontline NHS staff, in particular nurses and ambulance staff. The spikes continue to rise with NHS England reporting in March this year that “attacks on staff has increased since 2023 (13.88%) – though numbers are below the record levels seen between 2020 to 2022 during and following the pandemic. Staff experiencing discrimination at work reached its highest level in 5 years (9.25%), with more than half (54.09%) saying the discrimination they received from patients and the public was based on their ethnic background”.
Security personnel do not have the benefit of knowing how potentially dangerous their roles can be, and this lack of transparency or awareness could well be a contributory factor towards their interview responses, where crises of confidence, feelings of inadequacy and an acceptance of a desensitising towards both physical and mental trauma is commonplace.
Methodology
This article has adopted a mixed methods approach; research was conducted at four separate hospitals across the West Midlands, Hertfordshire and Essex over both day and night shifts, but specifically focusing on officers within accident and emergency departments. Two questionnaires were distributed to officers working within these four locations, with a total of 129 officers being involved.
The first questionnaire focused on their vocational experience within the industry and specifically healthcare, along with demographical questions, before looking at their exposure to verbal and physical assaults as well as the threat of violence and their coping mechanisms.The second questionnaire was a focus on civilian PTSD and was discovered during my research and first utilised in Violence, Abuse and the Implications for Mental Health and Wellbeing of Security Operatives in the United Kingdom: The Invisible Problem (Talas, Button et al 2020). This looked at both short and long term effects and provided some interesting discussion points with team members.
Following on, 15 officers were interviewed across the subject hospitals and three separate observational periods were conducted, focusing on officer interaction, inter-departmental co-operation and their exposure to stressful situations. The questionnaires were distributed with the permission and approval of the NHS trust and the incumbent security providers. All participants were made aware that they were under no obligation to take part in the research and that those who did would have their names anonymised and that all data, once harvested and transcribed, would be destroyed.
Likewise, interviewees were chosen at random and interviewed in an appropriate and private location, with the consent of both themselves and their line managers. All involved were reminded that their participation was voluntary and agreed to have their session recorded. Again, once transcribed verbatim, these would be destroyed.
Of the 129 questionnaires distributed, the number of responses was 58, which equates to 45%, which is roughly what was expected. As with previous studies into violence in the security environment, the overwhelming majority of those responding are male (56 out of 58 in this instance (96.5%), which is relatively reflective of the gender disparity prevalent within the industry, which currently stands at 89% male officers and 11% female personnel.
The ethnicity demographics of the questionnaire respondents do align closely to the latest published figures from the SIA in May 2025, with the three largest representative groups being Asian, White and Black.
Breakdown by ethnicity (%)
Asian 36
Black 18
White 30
Multiple ethnicity 16
Officer age categories (%)
Under 21 6
22-29 18
30-42 39
43-55 27
56 & over 10
Industry experience (%)
Years In the security industry Specifically healthcare
0-3 60 72
4-7 3 18
8-11 6 0
12-15 3 6
16-plus 28 4
This appears to demonstrate a constructive blend of youth and experience, which lends itself well to both a dynamic team environment as well as the opportunity for positive mentoring. This support network is a common theme throughout the interviews and is often referred to as the most enjoyable part of the role; the knowledge that your colleagues have your back whilst still having those around you who have experienced the highs and lows and can be used as a sounding board when a shift takes a turn for the worse.
This unity and camaraderie was present across all of the teams that were interviewed, and despite the data clearly showing worryingly high numbers of both physical and verbal abuse being encountered, this team ethos resulted in no officers who were interviewed asking to be transferred away from the A and E, nor looking to leave the industry either.
The above graphic represents the number of occasions whereby officers are indirectly sworn or shouted at. The question specifically asked for incidents that they felt were not directly targeting themselves, but rather the team or abuse borne of frustration or anxiety. This shows that the majority of officers experience some form of low level verbal abuse every working day, which is disappointing if not surprising. Compare this to the chart below which focuses on serious verbal abuse which is solely targeted at the individual, and it portrays a similar story, although the majority below is a third, suffering serious, direct verbal abuse weekly.
Physical assaults are also now worryingly frequent; however, there is very little quantifiable data with which to compare this below set of results against. Whilst the numbers of NHS staff are now closely monitored, accurate data on frontline healthcare officers does not seem to be centrally recorded anywhere, nor is data available freely from security providers themselves.
Ironically, this wasn’t always the case, and prior to 2017, NHS Protect, which was disbanded and replaced by the NHS CFA (the National Health Service Counter Fraud Authority) in April 2017, did keep this information up to date. NHS Protect had the remit to protect both assets and people working within the wider NHS family, including frontline security personnel. Incidents were reported and recorded onto a central database called SIRS (Security incident reporting system), and the data was fed back to respective trusts via monthly briefings. However, when NHSCFA superseded NHS Protect, inexplicably, all previous data was destroyed in its entirety. With the new iteration having a broader focus on fraud and corruption within the NHS and its supply chain, SIRS was not re-initiated, and the opportunity was lost.
Whilst the single largest group had never received minor physical abuse, two thirds of those responding had experienced a minor physical assault, with a third suffering at least monthly. I asked respondents about how many times they had been seriously assaulted (which during the interview process ranged from being punched, bitten, butted and hit in the face with a work boot, along with an officer being sexually assaulted by a female patient within the confines of a mental health unit). The large majority of those asked had never been subjected to a serious assault; however, as it shown, this still leaves a third of all security team members being seriously assaulted at least annually.
Conversely to this, a common thread throughout the onsite discussions was the perceived lack of support from NHS staff, with one officer stating;
“I have probably had 10,000 interactions with nurses and receptionists, and I genuinely cannot remember the last time they said thanks for anything. They just seem to look through us”.
This comment was given during my very first officer interview and initially observed as a potentially one-off opinion. However, as the interviews will show, there is a clear perception that the security teams are far removed from the NHS family, and that their roles and responsibilities are neither understood nor considered by NHS personnel. Furthermore, the growing expectation of nursing staff in regard to using front-line officers for roles such as bed watch seems to increase these tensions and further diminish working relationships. When questioned about this aspect in particular, Officer A at Herts said;
“I think that there is a lack of knowledge about what we can and cannot do in terms of putting hands on. When it kicks off in the A and E, they (nursing staff) think we can just grab people and throw them out. I often get told to do this, and when I try to explain the legal reasons why I can’t, I get screamed at. “Why not – it is literally your only job – do I have to do it myself? It’s embarrassing and undermines what we are trying to achieve”.
Furthermore, Officer W at West Midlands also developed a fractious working relationship with the front desk staff over a more delicate matter. The Officer noted that a middle-aged man was regularly attending the reception area without engaging with the staff nor seeming to venture any further into the building. The reception staff told the security officer to approach the man and to ascertain what his intentions were; which he duly did,
“The man, who was shy and nervous, seemed confused when I struck up the conversation. I said that I had noticed that he had been coming back regularly but was just tending to hang around the area without appearing to be visiting or attending an appointment. He started to well up, and explained that his father had recently passed away, and he was really struggling to come to terms with the loss. Being around the hospital made him feel closer to his deceased dad and he was trying not to get in the way”.
When I relayed this to the receptionist, they stated that I wasn’t a social worker, and it was my job to keep these sorts of people away? There was no empathy, and I had to tell the man that he had to leave the area and wasn’t allowed to return. He looked heart-broken.”
To the officer’s credit, he did caveat this response by stating that he has to regularly check on the reception area, and it can also be a very stressful workplace; tempers are fraying and sometimes staff need to vent, but it does seem as though a reciprocation of goodwill is often absent.
Desensitisation and detachment
Some of the most common and worrying phrases that occurred during the interview stages were “It’s just part of the job” or “You just get used to it after a while”. Officers often have very different views on what they feel is a reportable incident – this is often affected by their workload or the time required to complete a report, but can also be something more insidious, such as peer pressure or not wanting to appear vulnerable to colleagues. It is important to note that robust reporting processes were in place at all of the locations visited; however incidents classed as minor by some interviewees included being grabbed and shaken, spat at and having an article of clothing torn.
Conversely, the majority of personnel spoken to reinforced that their psychological safety was deemed as important by their employer and that reporting mechanisms were functional, so this disparity between the reported and non-reported incidents remains apparent. Almost 40% of questionnaire respondents stated that they have not reported a minor incident; a number of officers stated that the intention to report an incident was there but subsequent events or issues during their shift took precedence and other issues became the focus. Clearly, these numerous service providers will have their own established reporting platforms and procedures, but it does appear that the inability to register a report in real time for following up later in the shift isn’t readily available.
Whilst leadership was praised throughout the process, to have viable data, providers need to reinforce the importance of reporting any and all incidents of abuse, regardless of the perceived threat or severity.
Likewise, it is important to understand the types of incident that officers regularly attend, and which ones have the most profound effect on them. To that end, the following concise case studies focused on the frequency of any abuse encountered and whether this had resulted in a critical incident (whereby they had seriously considered either leaving the sector or the industry as a whole).
Officer AH, a supervisor from Herts said;
“When I look back over my eight years in the role, I find it hard to put any sort of accurate figure on the number of times that I have been kicked, punched or verbally abused – it’s not dozens – it has to be in the hundreds now. We are lucky that we have now built a team around us that looks out for each other, and I know they have my back”.
When asked about the churn of personnel through his team over the years, he stated;
“Something that you quickly learn in my role is that two types of people do this-the ones who are passionate about helping others, who enjoy being in a team and thrive on it. The others do it as a job and soon find out that it is not for them. I totally respect that too and would never hold that against them”.
Ironically, it wasn’t a physical or verbal incident that almost made AH leave his role, it was the pandemic in 2020. As the pandemic peaked and lockdown was announced, AH was expecting his first child imminently;
“The uncertainty in my mind was horrible. I knew I had to go to work as I needed to pay for so many things; but the sense of guilt was also pretty bad. We had limited PPE, as the NHS staff were prioritised. Even getting the bus into work was worrying, as at the time, we were not seen as key workers. I’m not saying we weren’t appreciated; it was just a case of the medical staff having to focus on their roles and us on ours”.
Furthermore, Officer Q in the West Midlands, a supervisor with extensive security experience, was asked about the worst aspects of his working life in the A and E dept;
“Fights are pretty commonplace, as you’d expect. I have had a self-harmer who was threatening to cut her own throat. I managed to pull her arm away, but she stabbed me through the hand which needed stitching. There is also a lot of spitting and I had someone spit vomit into my face once – I had to have my eyes tested. Over the last couple of years, there seems to have been a huge increase in mental health cases-the majority which seem to be younger females now.
The challenges are different to those we are used to facing- if a tricky patient comes in and starts kicking off in A and E, we need to supervise them in their cubicle, often for hours at a time. This means we are short-staffed elsewhere. This is a pretty deprived area, and we have a real problem with stabbings. The A and E was locked down seven times last month alone. Trying to keep a Mum from getting in to see her stabbed son isn’t the nicest thing to do. The repercussions and revenge attacks from these can linger and we try to de-escalate as best we can.
We can also see some striking similarities in this officers response when we look at Officer W in Herts talking about NHS staff (non-medical) and their expectations regarding the security remit.
“Essentially, they think we are punchbags. We are getting more calls than ever for assistance with violent behaviour; we can get to A and E and be told that a patient has no capacity and is a suicide risk, meaning that we have to sit with them for the entire shift. They don’t seem to understand that all we have is a stab-vest. We don’t have cuffs, nor can we search them for hidden weapons. This is why I focus on de-escalation but some staff think I am too soft. You put hands on them and then you’re being too rough…..”
Again, there is this clear disconnect in terms of the relationships with the security officer and the wider NHS team. Officer W at West Midlands said;
“Just last week, we were called to A and E and told that a young woman was screaming and kicking nurses. We got there quickly and held her arms – the nurse started shouting at us saying that we were over-reacting and that what we were doing was unnecessary. I said what did you call us for then? We often get to incidents with very little information, such as the level of aggression or whether the person is contagious.
“Last month, another officer and I (both black officers) were called to a couple who were arguing loudly inside the A and E lobby before they continued outside the man doors. When we arrived, the woman shouted that she didn’t want these fucking monkeys to come near her – she said it a few times. Lots of people heard her but she didn’t care. The police were called and spoke to her but she was not removed. The police said that she was known to them, and did we want to pursue the matter, or just leave it be on this occasion. We left the area to calm down and decided after that to just let it be. The woman has been back to the hospital a couple of times since then”.
It is quite sobering to see that a third of respondents to the below chart believed that assaults on their person were directly linked to their ethnicity. The two officers stated that whilst their management teams took the situation very seriously, they felt as though they were dissuaded from progressing the issue as a police matter. It is down to the individual to decide whether to press charges, but would it be best practice going forward to insist that incidents of hate crime be followed up as a matter of course? As previously mentioned, only 100% reporting of these issues will ensure information capture is accurate and workable in terms of actionable data.
In the same vein, one aspect of assaults that we thankfully see rarely is that of sexual assault against an officer; however, that does not mean they don’t happen. Officer W at Herts was on a day shift when he was requested to escort a patient to their mental health assessment unit. This unit is generally by referral only, as opposed to self-admission and the patient was not showing any signs of agitation or anxiety, according to the officer.
However, whilst accompanying her in a room adjacent to the lobby, the woman suddenly appeared next to the officer, completely naked, and pushed him against the wall. The officer was obviously very shocked but had the awareness to have his body-cam on and recording. The officer shouted for assistance and very quickly nurses were available to support.
The officer appeared to take the issue in his stride, but this could have had profound effects had the recordings not been readily available. Indeed, this happened the day before I conducted the interviews, so the emotional trauma may not have been evident at this point. One thing that is for certain, however, is that the proliferation of all recordings in modern life is a double-edged sword for security staff.
Where assaults have taken place, security staff usually face a number of potential risks to overcome. As in cases stated by Officer A and others at Herts, whilst they are assessing the risk of a potentially violent offender or a patient under the influence of drink or drugs, others within the A and E are readying their mobile phones ready to record everything that is about to unfold. This substantially raises the levels of intimidation and rapidly escalates the situation.
Whilst the advent of Body-worn Video (BWV) has been heralded as a key driver in officer safety, the feedback from the questionnaires does not bear this out. Indeed, sometimes in situations of high stress and impending violence, the verbal statement given by officers (You are now being recorded etc) often incites the start of a physical confrontation as opposed to lessening the likelihood of it. The operational feedback is also far from positive.
Whilst an incident like the sexual assault on Officer W at Herts was a positive one for the use of BWV, officers did repeatedly state that their video footage was an ever-present thought when dealing with difficult situations. The acknowledgement of accountability was clear, but the increasing levels of violence within A and Es are stretching officers in ways not seen before.
The recent case of PC Lorne Castle, a Dorset Police officer, who was dismissed without notice for treating a knife-carrying youth without courtesy or respect, was recorded on the officer’s BWV and used in his disciplinary hearing. Without prejudice, security staff are having to tolerate new levels of violence and aggression and still have their focus on courtesy and respect. Without the support of colleagues with tasers or cuffs, nor the powers to search for weapons?
Even when officers follow the letter of the law, they can still fall foul of the legal system, again undermining the professionalism and legitimacy of the role. There is a dearth of data relating to the wearing of BWV within the sector, and whilst various requests for further information have been submitted to numerous sources, nothing can be confirmed at the time of writing.
So, whilst we have focused on the frequency and severity of abuse levelled at A and E/MHU security, what does the prognosis look like? Whilst occupational mental health and wellbeing are now undoubtedly at the forefront of employee welfare, the long term effects of working within stressful and often violent environments is unknown. A clear step forward is the levels of self-awareness observed during the interview stage and the willingness of officers to talk about their feelings, along with the readiness to open up to colleagues or management about this.
We still have a quarter of those asked being unwilling to discuss their anxieties with anyone else. This is symptomatic of an industry that is hugely prevalent by males, particularly a sector where violence and the exposure to it appears to be so rife. This is from a subject group where 70% said that they could confidently identify signs of deteriorating mental health with 18% being unsure and the remaining 12% saying they could not. Again, whilst there is no other data to compare this with, it is similar to recent studies such as those in male-dominated industries such as construction.
Whilst mental health retains its focus, the subject of post-traumatic stress disorder is one that is rarely broached. Officers seem to have a reluctance to acknowledge it; however, it is something that is evident when interviews concentrate on incidents of hyper-stress or tragedy whilst working.
Three separate incidents from many discussed during this research stay with me and go some way to highlighting the ever-increasing risks they face. Officer F from Herts has been working within the hospital for two and a half years and in March 2025 had this encounter;
“… I was called on the radio to support a colleague next to the smoking shelter nearest to the car park. When I arrived, the man was very angry and looked like he was on drugs. The guy was self-harming and slicing his arms and screaming at others around him. The small knife was being swung around, and he was approaching people and trying to grab them. As I tried to usher the public away, he ran and kicked me- another officer and me wrestled the guy to the floor but he was very strong. We held him as tightly as we could until the police arrived. I had cuts to my hand and arm and was admitted to the ED myself, resulting in four days bed-rest”.
When asked whether he had fully recovered, he said he had. When prompted to think about the effects in retrospect and what he felt about the situation now, he said that he was physically fine but when patrolling past the location of the incident, he became anxious and could feel his heart starting to race. Asked whether he intended to monitor these symptoms and bring them to the attention of a colleague or manager, he simply said he’d see what would happen.
Furthermore, Officer S at West Midlands recalled an incident late last year;
“A man who had been admitted to hospital with mental health issues had apparently discharged himself. Not sure how, but he had managed to get to the roof where he threw himself off. We were called to manage the scene and keep people away, as well as putting up screens to stop people looking. It was horrible and we stayed in place until the police and paramedics arrived and took over”.
In a worryingly similar vein, the officer stated that he didn’t have any psychological side effects but did recall the incident every time he passed the incident location. It is important to state that post-trauma was offered by the incumbent provider on all occasions, but the uptake seems to be relatively low. Whether a positive step forward would be mandatory de-briefs or counselling in the wake of such events would be a viable options should perhaps be explored as an option.
The last example of many, and perhaps the least expected source of trauma, was conveyed by Officer P at Herts; once we had established that he had received countless assaults in the previous two years, he was asked whether he had experienced a critical incident-something that he had found so unpleasant, that he had considered resigning and leaving the industry;
“The swearing and spitting is water off a duck’s back now – the worst thing I have had to do was in paediatrics. A young girl was refusing to eat, so we were called down to restrain her whilst a nurse force-fed her through a tube. She was gargling and trying to scream, and I couldn’t look at her. It was the worst – afterwards I had to go and find a place on my own. Then to go back and have to repeat this twice a day for a month almost took me to the point of saying, enough is enough”.
Incidents such as this must be having an impact, and ironically, the officers themselves are possibly masking the extent of the issue with their robust dispositions and willingness to continue putting themselves in these situations. The only universally positive response to any of the questions was “Have you ever asked to be moved from the A and E to a role away from healthcare”, with the answer being unequivocally 100% No. We still have 45% who do experience stress recall to some extent. Couple this with what appears to be blurred lines between normal mental health issues such as anxiety with the more insidious symptoms of PTSD, and it becomes clear that further, in-depth study is required.
As previously mentioned, a study referenced by Randle (2021) focused on the security industry in general, including retail staff and door supervisors.
With almost 40 per cent of those in security surveyed exhibiting symptoms of PTSD, it leaves a very clear message that the issue of mental health is not currently being taken seriously by security managers. There is an emerging picture of a failure by the security industry to address these issues.
However, it’s not all negative; the officers now have greater levels of support and access to pastoral/welfare initiatives than ever. As well as their employers providing mental health training, most now provide EAPs (Employee assistance programs, usually via an app). These have several modules covering a raft of wellbeing initiatives from 1-2-1 counselling sessions to health assessments and debt advice and have proven to be a valuable addition for responsible employers in reducing absenteeism, boosting productivity and increasing engagement.
As well as access to union membership (usually Unison; although, again no data is available on membership numbers), they have the support of the NAHS (National association of healthcare security), a non-profit organisation with around a thousand members currently. The NAHS is a professional body dedicated to developing the skills and reputation of healthcare security professionals, and provides bespoke training on several levels, along with online forums to discuss relevant sector issues and a monthly magazine.
Training availability for officers and supervisory staff is certainly better than ever before, with NAHS providing courses up to a Level 5; this goes alongside the vocational training that runs alongside their statutory training, such as crisis management, prevention and management of violence and aggression (PMVA), and use of restraint equipment along with key skills for job specific roles such as bed watch, where officers are trained to react quickly to sigs of self-harm, disorientation and medical emergencies.
Service providers are often looking to third party specialist companies in supporting in-house training. Organisations such as Ikon and Maybo give the officers the added skills and confidence to carry out their roles effectively, but anecdotal evidence given during interviews suggests that incidents on officers continues to increase despite the enhanced training. The chart below shows that over two thirds of participants feel that conditions have stayed the same or worsened in the last two years.
Summary and conclusion
Firstly, it is important to acknowledge that had multiple service providers allowed full access to their teams, this would have enhanced and further ratified this research; However, numerous organisations were approached, and despite initial agreement, they refused or ignored further requests.
Furthermore, the lack of comparable data specifically on healthcare officers has meant a dependency on the data collected solely from the research process and discussions with all managerial and operational levels of the service provider. The main aim from this paper is to encourage the inception, development and maintenance of a publicly available platform that accurately collates incidents of verbal, physical and psychological abuse suffered by frontline security officers working in A and E/MHUs-in the same way figures on the NHS are kept and analysed.
As previously mentioned, the demise of NHS Protect in 2017 meant the loss of data that would have at least provided a benchmark for the sector; Also, what is also suggested by this new data is that those reporting platforms available to the operational teams, whilst a huge step forward, may not be wholly reflective of the issue either.
We have seen that officers may intend to report what they construe as minor incidents of abuse, but their workload simply gets in the way and events go unreported. Along with that, we have the more worrying aspect of racial abuse being suffered and reported to the Police, who appear to throw the onus of prosecution back at the officer. The officers in this instance felt that there was little point in progressing the complaint when the tone used by the Police was one of futility and resignation.
Where reporting protocols don’t have a zero tolerance approach, it will be left to the officer to decide whether to press charges. With the desensitising of the vast majority of those interviewed stating that the sheer frequency of incidents makes reporting everything unworkable, this acceptance as the norm or it “just being part of the job” is going to become more pervasive within the sector.
Another key takeaway from the interviews was the working relationships between the security teams and the wider NHS family. Given the huge stresses faced by both parties, you would expect a certain amount of friction during incidents, but the division seems to go much deeper than that, which is having an effect on the morale of the team.
Looking at the latest NHS absentee figures for this year, it shows a worryingly high figure of 5.7% overall, with regional fluctuations, particularly in the North West (6.7%) and London (5%). With medical staffing levels within A and E struggling to cope, there appears to be an expectation that security can help with picking up the slack.
Whilst tasks such as bed watch may be necessary, officers have complained about being told to accompany non-violent patients throughout a shift, making themselves short staffed themselves. A lack of communication prior to arriving at an incident is more prevalent, with officers being unaware of capacity status (Having capacity means that the patient has control of their faculties and mental awareness-those without capacity are not and consequently may need restraining) until they are already involved in the process.
A common theme also picked up earlier is the lack of understanding of the legal parameters that officers must adhere to. Comments such as “They expect us to be punchbags” or “They just want me to grab the loudest person and throw them out” were common. Speaking to supervisory personnel, this is an issue that has been identified, and remedial action was undertaken, it would seem that there is still some work to be done.
Despite this, one of the main disparities in the data collected seems to be the number of officers who have experienced serious assaults, yet relish their role within the A and E. With a quarter of those interviewed having undergone a critical incident (one serious enough to make them consider leaving the industry), the most staggering statistic for me throughout this process was that not a single officer had, or would, ever request a transfer away from the accident department.
When questioned about this, the overwhelming response was the team ethos; as Officer A in Herts alluded to
“The guys who come in and don’t fancy this are aware almost instantly. They go and I fully understand that; the team that is left look out for each other and we all have each other’s back”.
A supervisor in the West Midlands was asked the same question;
“I love it. The interaction with the public is mainly great but the other moments can give you a bit of a buzz too – I wouldn’t want to work anywhere else now”.
Whilst I often struggled to see how these officers could face risk so regularly and deal with it so admirably, it is evident that they find their own level and work internally to strengthen their team ethos. They have the support of engaged and experienced line managers, so the prospect of a crisis in recruitment for A and Es doesn’t look to be likely any time soon.
That said, the industry, and specifically the sector, does need to start asking those difficult questions and looking at data collectively. The officers may be coping, but the figures are still clear; over a third of those asked are not reporting minor assaults, over a third believe assaults they have suffered were due to their ethnicity or sexuality, and well over a third of all respondents are being seriously assaulted at least every year. The numbers of officers suffering from signs of PTSD can hopefully be identified and given the support that they need and deserve, too.
With teams stating that working conditions with their departments have either remained the same or gotten worse over the last two years, the onus must be on the responsible security providers to step up and evolve the reporting process to allow the harvesting of accurate data to inform decision and policy making going forward.
Lastly, the NHS has this month published a ten year road map to recovery, where the focus is clearly on cost control and improving efficiencies, which will undoubtedly put more pressure on procurement teams who will be looking at outsourced services such as security. Now seems like a good time to show the NHS what they are getting for their money and the lengths that their security teams are willing to go to, to uphold their values and those of its patients.
Acknowledgements
A huge debt of gratitude goes to John Lambert and his team across the home counties and the West Midlands; despite working in some of the most challenging environments, they have allowed me to interact, interview and observe as they carried out their roles. The candour of their interviews was often surprising and sometimes emotional, but always professional. A special mention to Riaz Malin, Mobeen Hussain, Jack Durham, Ethan Walker and Martin Lomas – your assistance is truly appreciated. Also, a big thank you to Jonathan Crouch for allowing me the time and flexibility to study alongside my work – I’m grateful.
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