Improving the safety of ambulance staff through better data

Ambulance staff are reporting higher numbers of violent incidents against them than ever before but talking to Adam Hopper from the Association of Ambulance Chief Executives (AACE) at The Emergency Services Show to understand what is happening, he reveals a more complex data picture and shares why the Working Without Fear campaign is so important.

Adam Hopper is the National Ambulance Violence Prevention and Reduction Operational Lead for AACE. He previously worked for North East Ambulance Service. He sat down with me at The Emergency Services Show to talk about the Work Without Fear campaign, which moved to its second phase of activity earlier in the summer.

Launched in February 2022, the campaign is funded by NHS England and is designed to highlight the ever-growing incidents of violence against ambulance staff.

“In the year 2023/24, ambulance service staff across England reported just over 17,000 incidents of violence and abuse from members of the public.”

This has more than doubled in the last eight years, with a spike in the last 12 months.

The aggression is aimed daily at frontline clinical staff such as paramedics, emergency care assistants, students and volunteers, as well as 999 and 111 call handlers in call centres, regardless of the age or gender of the employee concerned.

As the campaign has evolved, the messaging has changed to, in Adam’s words, “bring out the human behind the uniform.” Members of ambulance services share their experience of violence, showing the impact it is has had on their lives. Steve Raven from West Midlands Ambulance Service did this and his story is highlighted below.

Adam says that the abuse has a profound effect on ambulance staff and through the campaign, staff have been encouraged to report all incidents early on.

Making reporting part of ambulance culture is a big part of the campaign. By itself the increase in reporting about violent incidents may not mean more incidents rather an increase in willingness to report them. Adam says that layering other data on top of this dataset will reveal more insights into levels of harm.

The reporting is captured in an ambulance service’s Integrated Risk Management system where it records the details of an incident. It is this data that is crucial to build up a profile of where incidents are happening and why.

As part of his work, Adam has developed the Ambulance Violence Dataset in a bid to bring consistency to reporting across ambulance services. He thinks there is a fine line between asking for enough data to develop insights but not putting up barriers and making the job too hard to complete them.

And while reporting is critical and having a data standard to ensure it is captured in a consistent way across the ten ambulance services in England, on its own it doesn’t help Adam understand why violence takes place and what methods will be successful in reducing it.

AACE is looking at how incident reporting data can be reviewed and layered with other metrics such as the NHS England staff survey, reported levels of harm to determine the extent of injuries sustained, and the number of incidents cross referenced against the number of ambulance calls and attendances.

The analysis of these additional metrics helps to understand the increases in violence data and the effectiveness of violence initiatives. When last collated, Adam says that over sixty per cent of reported incidents were reported cited drugs, alcohol or mental health as contributing factors.

Body worn cameras as a deterrent

Looking at methods of deterring violence, all ambulance services have invested in body worn cameras after an initial pilot in three services that started in 2021. Adam says that NHS England commissioned a report to look at the impact of BWC on ambulance service staff.

Due to be published soon, it should provide valuable data about how wearing BWC can help reduce the potential levels of violence against staff and confirm whether staff feel safer wearing the technology day to day. Adam is supportive of BWC and can see staff using them more and more and it normalising. The culture is changing, he says.

Adam says that there has been a lot of interest in the campaign from ambulance services across England; each one has access to the campaign assets and uses them at a local level. He encourages services to continue to do so and in spring next year the campaign will be evaluated.

---

AACE has provided the Working Without Fear campaign assets on its website.