Developing a Collaborative Approach: Reducing Incidents of Violence in A&E

Violence within the emergency department (ED) and against ED staff causes both significant physical and mental distress to ED staff. Vincent Smith is a former member of the armed forces and police service. They specialise in Local Security Management at Leicester General Hospital. Speaking at our NHS Workforce Event in February 2021, Vincent shared his insights on collaborating with the police to improve safety in the ED. 

Identifying the trend of Police callouts being associated with the night-time culture of Friday and Saturday nights, Vincent proposed that on such nights, it would be beneficial to have officers based within the hospital ED. 

Leicester City Council were already working with Nighttime Economy Solutions, a group of night-time economy experts, who work with businesses, local authorities, business improvement districts and police forces to create safer nights out. They equally wanted to understand how the nighttime economy impacted Leicester General Hospital’s ED

The University Hospitals of Leicester NHS Trust offered £9000 in funding, for the 3-month pilot. Leicester City Council agreed to match it.  

The pilot ran for 3 months and gained positive feedback from ED nursing staff, consultants, and the mental health triage team. Staff reported that incidents were being processed faster and that there was far less disruption to other patients. 

As well as receiving positive feedback from health workers, the initiative was successful in improving the relationship between the police force and the in-house hospital security team. As a consequence of the initiative, data was shared, including bodycam footage from two teams. Now, the security teams can download their bodycam footage straight to the police systems which is significant in speeding up prosecutions.  

The success of the pilot was recognised by Leicester City Council who agreed to fully fund the initiative. Leicester police stayed in the ED until the beginning of lockdown in March 2020.  

The lockdown period has given the University Hospitals of Leicester NHS Trust and Leicester Police Department time to look at the data surrounding the initiative’s impact on violence reduction. It was found that in the 6-month period from the beginning of the pilot that violence and aggression to staff and other patients within the ED reduced by 70% [1]. Equally, Leicester police callouts to the ED were down by 60% [1]. 

Following these successes, Leicester City Council plans to restart the initiative when the nighttime economy opens up again.  

Additionally, Vincent told us that they are now looking to expand the initiative. There is a discussion of placing ED nurses within custody suites with access to consultants, x rays, and the hospital computer network. Consequently, those taken into custody who may need ED assistance can be processed quickly through the department with less disruption. 

With Leicester City Council being awarded the Purple Flag, an accreditation acknowledging the excellence in the management of town and city centres at night, they are feeling confident for the re-opening of the nighttime economy.  

Learn more about Night Time Economy Solutions and Purple Flag accreditation. 

Sources:

[1] Smith, V. 2021. The NHS Workforce Event: Recruitment, Retention and Wellbeing