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Ambulance staff are facing rising levels of violence while trying to do their jobs – and incident reporting could be key to tackling the problem.
In the latest episode of the For Every Response podcast, Adam Hopper, National Ambulance Violence Prevention and Reduction Operational Lead at the Association of Ambulance Chief Executives (AACE), outlines the national picture – and what’s being done to protect frontline teams.
The scale of the problem
Ambulance workers recorded over 22,000 violent incidents in the past year – that’s 62 a day – across the UK’s 14 ambulance services. These range from verbal abuse to physical assaults, including attacks with weapons. When unreported cases are factored in, AACE estimates the figure could be closer to 30,000.
The number of reported incidents rose by almost 15% compared to the previous year, underscoring the need for urgent action.
In April, AACE Chair Jason Killens wrote to health ministers in England, Wales, Scotland and Northern Ireland, calling for a unified policy response. Soon after, the Crown Prosecution Service updated its guidance – paving the way for more cases of assault against emergency workers to be tried in magistrates’ courts, rather than face lengthy delays in the Crown Court.
Sharing what works
AACE works with ambulance trusts to share data, guidance and best practice on how to reduce incidents of violence.
A key focus is training – ensuring frontline staff are equipped with conflict resolution techniques and strategies to de-escalate tense situations. But reducing violence isn’t just about internal tools. Public perception matters too.
Campaigns such as Work Without Fear aim to ‘show the humans behind the uniforms’, highlighting the personal toll abuse takes on ambulance staff. Adam discussed the campaign with Catherine Levin at last year’s Emergency Services Show – and in the latest episode, he shares how the campaign is evolving and its early impact.
Using data to drive change
What’s having the most impact, Adam says, is data.
AACE’s national Ambulance Violence Dataset gives trusts insight into where, when and why incidents occur – and how to respond. The dataset categorises abuse in line with legal definitions, helping organisations track patterns and identify root causes.
Modelling tools are also being used to predict future trends. In one case, AACE forecast that more than 5,000 violent incidents would take place by January 2025 – and sadly, that projection proved accurate. By the start of the year, ambulance trusts had recorded 5,350 incidents.
Forecasting tools and real-time insights are now being used to advocate for national resourcing – from trauma counselling to more structured routes for raising safety concerns.
A cultural shift
Policy interventions matter, but cultural change is just as important.
Adam notes that a ‘zero tolerance’ approach can be difficult in practice, given the complex nature of emergency response. Crews may be dealing with patients who are frightened, confused, in pain, under the influence of substances or suffering from mental health conditions.
Understanding the root causes of aggression, without excusing it, is key to shaping an effective response.
What comes next
Looking ahead, AACE is planning a UK-wide staff survey, including voices from devolved nations. It’s also exploring how AI could help categorise incidents in real time, particularly for call handlers who frequently face verbal abuse. Trials of body-worn cameras are also continuing.
Funding remains a challenge. With only six months of confirmed support left, AACE is focused on building a legacy – through data, public awareness, and practical tools.
“There’s no short-term solution for fixing violence against ambulance and NHS staff. It takes sustained resourcing, strategy, planning and partnership working.
“Seeing this deployed will continue to improve the culture within the NHS – and that would help us drive these improvements, and have our people believe in what we’re doing.”
Adam Hopper.
Practical advice for staff
Adam offers clear advice to ambulance staff. For support staff, the priority is using the data – and working with partners to plan ahead. For frontline crews, staying aware, applying the training, and reporting every incident are key.
“It’s a great thing to report. Even if nothing’s happened, you learn more from a near miss than you ever will from an actual incident of legitimate harm. We’re not quite there yet, but reporting might stop the next incident from happening. Someone else could be forewarned.
“One of my personal mottos is: you can’t prevent what you don’t know. We’re starting to see acceptance of that – incident reports are going up, and that’s the right thing. Our incident reporting culture is progressing. It’s doing what it needs to do.”
To learn more about what Adam and his team are doing, listen to the full interview using the link below or through your favourite podcast platform.
