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Issue date:

17 May 2024.






Implementation on the agreed approach to preventing Violence and Aggression towards NHS staff in Wales.

Date of expiry / review:


For action by:

  • chief executives, NHS Wales health boards / trusts / special health authorities
  • directors of workforce, health boards / trusts / special health authorities

Action required by:



Judith Paget CBE, Director General for Health, Social Care and Early Years and NHS Wales Chief Executive.


Health, Social Care and Early Years contacts: Welsh Government Contacts: HSS Workforce & Corporate Business mailbox:



Implementation on the agreed approach to preventing violence and aggression towards NHS staff in Wales


Through 'A healthier Wales' we made a commitment for the NHS in Wales to become an exemplar employer in respect of the health and well-being of its workforce. It is the responsibility of all of us to make the NHS in Wales a place where staff are treated with dignity and respect not only by patients but their peers, those who they work alongside. The prevention of violence and aggression towards our NHS staff is vital to creating a culture where our staff feel safe and supported. Regrettably, prevention does not eliminate all acts of violence and towards our staff. In these instances, we need to appropriately respond and manage all incidents.

Following a short hiatus, the Anti-Violence Collaborative (AVC) has been re-established with a new Chair, Jonathan Webb, Head of Safety and Learning within NHS Wales Shared Services Partnership Legal and Risk Division. Following the group's reinstatement, there was a commitment to refresh the 'Obligatory responses to violence in healthcare document'. The document sets out the responsibilities of healthcare organisations when dealing with incidents relating to violence or aggression in the NHS.

The work of the AVC through the 'Obligatory responses to violence in healthcare document' is important to drive both practical and cultural change to ensure that:

  • the public, staff and patients are aware how seriously the NHS in Wales takes incidents of violence and aggression against its staff and that the NHS have first responsibility to energise the initiative
  • all NHS staff in Wales can be confident that we are taking a concerted effort to actively protect them from violence and aggression whilst they are at work; including but not limited to overt discriminatory conduct, racist behaviours, sexual misconduct and assault
  • if staff are involved in any such incident, they can be reassured there are clear policies and procedures in place, these will be followed robustly and effectively to support them through the process and appropriate actions will be taken against the perpetrators

Purpose of the circular

To inform organisations of the refreshed 'Obligatory responses to violence in healthcare document' including the requirements to implement and report upon violent incidents as set out in document.


  1. Provide the Anti-Violence Collaborative with contact details of the board member with responsibility for anti-violence and aggression within your organisation.
  2. Ensure that your organisations have systems in place to carry out effective incident reporting as set out in section 2.1 of the 'Obligatory Responses to Violence in healthcare (ORV) part 2: guidance document'.
  3. Ensure your organisation has assigned appropriate resource to the NHS Violence and Aggression Case Managers' role to enable them to play a proactive role, including:
  • promoting incident reporting via Datix Cymru
  • support and guide victims through the criminal justice system and signpost them to well-being support available in the NHS
  • promote the ORV agreement within the organisation
  • provide reports and data to support awareness and prioritisation on violence and aggression matters
  • liaise with partners to the agreement in order to create effective local pathways of communication and understanding
  • provide a quarterly report to the AVC for review and reflection in collaboration with the Crown Prosecution Service (CPS) and police

The 'Obligatory responses to violence in healthcare document' can be found on the Shared Partnerships Service's webpage for Key Documents 2024 - NHS Wales Shared Services Partnership.