“Zero Tolerance” Is Not a Violence Prevention Strategy

For years, organisations have declared that they will not tolerate violence or abuse towards staff.

The message itself is familiar.

It appears on posters, in policies and throughout public-facing workplaces.

However, a statement of intent is not the same as an effective workplace violence prevention strategy.

A zero-tolerance policy may communicate an organisation’s position, but it does not, by itself, identify risks, prevent incidents, support affected staff or provide evidence that people are safer.

New NHS Staff Standards Increase Accountability

In July 2026, NHS England published new NHS Staff standards setting clear minimum expectations for secondary-care organisations in England, including acute, mental-health and ambulance trusts.

The standards cover six areas:

• Violence prevention and reduction
• Line management
• Health and wellbeing
• Tackling racism
• Championing sexual safety
• Promoting flexible working

Performance will be measured through the NHS Oversight Framework and wider assurance processes.

This development matters because it shifts the focus from organisational promises to evidence and accountability.

The question is simply no longer:

“Does the organisation have a zero-tolerance policy?”

Leaders must now be prepared to answer a more important question:

“What evidence demonstrates that our violence prevention arrangements work?”

Violence Against NHS Staff Remains a Serious Risk

The 2025 NHS Staff Survey found that 14.47% of respondents had experienced at least one incident of physical violence from patients, service users, relatives or other members of the public during the previous 12 months.

This was an increase from 14.38% in 2024 and 13.88% in 2023.

The risks are particularly high in some parts of the NHS.

According to the government’s detailed NHS staff standards, physical violence was reported by 38.04% of staff in ambulance trusts and 34.33% of staff working in nursing and healthcare assistant roles.

Behind those percentages are thousands of people dealing with the physical and psychological consequences of workplace violence.

These consequences may affect:

• Physical and psychological health
• Confidence and morale
• Sickness absence
• Staff retention
• Team performance
• The quality and continuity of patient care

Violence must not be accepted as an unavoidable part of working in healthcare or any other public-facing service.

Five Questions an Effective Violence Prevention Strategy Must Answer

An evidence-based violence prevention strategy should enable leaders to answer five fundamental questions.

1. Where and when are staff most exposed?

Organisations need to understand where incidents occur, when they happen and which activities, roles or circumstances create the greatest exposure.

2. Are warning signs and recurring patterns being analysed?

Near misses, warning signs, repeat incidents and high-risk locations should be identified and analysed.

Looking at individual incidents in isolation can prevent organisations from recognising wider patterns.

3. Does the design of work reduce foreseeable risks?

Staffing levels, workloads, communication systems, equipment, environmental design and local procedures can all influence the likelihood and severity of violence.

Risk assessments should lead to practical controls, not simply record that a hazard exists.

4. Are staff trained for the situations they actually encounter?

Training should reflect the roles people perform, the environments in which they work and the risks they are reasonably likely to face.

Generic training that is disconnected from operational reality may achieve a completion target without improving workplace safety.

5. Are staff supported and lessons learnt converted into action?

Following an incident, those affected should receive appropriate support.

The organisation must also identify what needs to change, allocate responsibility and verify that the required action has been completed.

Training Alone Cannot Prevent Workplace Violence

Training has an important role in any violence prevention and reduction strategy, but it is only one part of the answer.

Training cannot compensate for:

• Poor incident-reporting systems
• Inadequate staffing
• Unsafe environments
• Weak management or supervision
• Ineffective communication
• Failure to investigate recurring incidents
• A culture that treats violence as “part of the job”

Responsibility must not be transferred to individual employees by expecting them simply to become better at de-escalating difficult situations.

Employers still need to identify hazards, assess foreseeable risks and introduce suitable measures to reduce the likelihood and severity of harm.

The NHS Violence Prevention and Reduction Standard supports this broader approach.

It uses evidence-based indicators across seven domains:

1. Leadership and accountability
2. Governance and assurance
3. Collaboration
4. Data
5. Workforce
6. Interventions
7. Evaluation

This reinforces an important point: violence prevention is an organisational responsibility, not purely a training requirement.

Post-Incident Support Must Go Beyond an Incident Form

Post-incident action should extend far beyond asking a member of staff to complete an incident report.

Depending on the circumstances, staff may require:

• Immediate welfare support
• A prompt and visible management response
• Medical attention
• Psychological support
• Time away from normal duties
• Preservation of evidence
• Assistance with reporting the incident to the police
• A clear explanation of what will happen next

Managers must then examine the incident in context.

They should ask:

• Was the incident foreseeable?
• Were earlier warning signs missed?
• Have similar incidents occurred previously?
• Did staffing, communication, equipment, layout or local procedures contribute?
• Were existing control measures followed and effective?
• What must now change?
• Who is responsible for implementing those changes?
• How and when will completion be verified?

Reporting without analysis produces data but does not prevent violence.

Investigation without action produces recommendations, not safer workplaces.

From Zero-Tolerance Policies to Visible Accountability

The important development is not another promise of zero tolerance.

It is the move towards visible accountability: evidence that risks are understood, suitable controls are in place, staff are supported and organisations learn when harm occurs.

For NHS trusts, this means being able to demonstrate that violence prevention and reduction arrangements are implemented, monitored and evaluated.

It means looking beyond policies and training-completion figures to examine whether:

• Incident patterns are understood
• Reporting is encouraged
• Investigations produce organisational learning
• Control measures are implemented
• Staff receive appropriate support
• Risks are reducing over time
• Boards remain informed and accountable

Every employer whose people work with patients, customers, passengers, service users or members of the public should take notice.

If your board were asked today to demonstrate that its workplace violence prevention arrangements work in practice, not merely that a policy exists, what evidence could it produce?

Strengthen Your Organisation’s Violence Prevention Arrangements

NFPS Ltd helps organisations develop legally informed, evidence-based approaches to conflict management, workplace violence prevention, risk assessment and staff training.

If your organisation is reviewing its violence prevention strategy, governance arrangements or training provision, contact NFPS Ltd to discuss how we can help.