UK Government

Department of Health (National): NHS joins forces with designers to tackle violence and aggression in A and E departments

Press Release   •   Feb 28, 2011 11:38 GMT

Designers are to rethink the design of hospital Accident and Emergency departments in a bid to develop innovative new ways to reduce violence and aggression towards NHS staff, which is estimated to cost at least £69 million a year in staff absence, loss of productivity and additional security.

The year-long project, ‘Reducing violence and aggression in A and E by design’ is being run by the Design Council, and has been commissioned by the Department of Health.

The project will involve designers, architects, healthcare experts, patients and frontline NHS staff working together to develop and trial potential solutions. The Design Council today launched a national search for a design team or teams to work with A and E staff and patients at three NHS Hospital Trusts – Guys and St Thomas’ NHS Foundation Trust, Chesterfield Royal Hospital NHS Foundation Trust and Southampton University Hospitals NHS Trust.

The winning design team or teams will develop a variety of innovative solutions to give patients, visitors and staff a better and safer experience in A and E.

The solutions will include:

  • Changes to interior design, such as redesigning layout and use of space, or introducing new products and furniture.
  • Improvements to information given to patients and their families.
  • Redesigned clinical and non-clinical services and systems.

An NHS staff survey from the Care Quality Commission in 2009 revealed that 11 per cent of staff experienced physical violence from patients or their families in the previous year. Figures from the NHS Security Management Service also show that in 2009/10 there were over 150 reported physical assaults per day on healthcare staff a total of 56,718 physical assaults in England. The problem is particularly difficult to handle in the complex, high pressure environment of A and E.

Commenting on the project, Sir David Nicholson, Chief Executive of the NHS said:

"NHS staff save lives every day and are committed to providing the best possible service to patients. It is completely unacceptable for them to be assaulted or work in fear of being physically or verbally abused.

“There is a substantial financial and human cost to violence against staff and I look forward to seeing the results of this project which will help A and E departments become calmer, safer and more productive environments.

“Anything which can help to diffuse difficult situations, demand mutual respect or reduce the pressure on busy staff is a welcome addition towards building a modern NHS, centred around high quality patient care.”

Lord Bichard, Chairman of the Design Council said:

“Design is now recognised by the Department of Health as having the potential to develop new solutions to difficult problems within the National Health Service. This is a great opportunity for designers to really make a difference to staff and patients and, hopefully, save money.”

‘Reducing violence and aggression in A and E by design’ follows the success of similar interventions by the Design Council and the NHS to improve patient privacy and dignity and reduce MRSA and C. difficile.

Professor Matthew Cooke, National Clinical Director for Urgent and Emergency Care at the Department of Health said:

"As an A and E consultant I have witnessed the effect of violence on colleagues. Verbal abuse is a daily occurrence and unfortunately physical violence against staff is not rare. This violence also increases the anxiety of other patients and their families in the emergency department at a time when they need a calm atmosphere to aid their recovery from their illness. 

“Better design can help reduce violence and reduce its adverse effects. I look forward to seeing the results of this project that will not only make work safer for my colleagues but also enable us to provide better care for our patients."

Teams will be invited to submit a proposal on how they would approach the challenge, with solutions which will offer good value for money, and could significantly reduce the financial and human cost of violence against staff.

Designers have already proved that re-designing aspects of A and E departments can reduce violence and aggression against staff. This brings a variety of benefits, including:

  • increase of staff morale/satisfaction and confidence;
  • reduction of litigation costs and a reduction of security and insurance costs;
  • reduction in staff absence;
  • increase in productivity and quality of care;
  • calmer environment;
  • improved ‘patient experience’;
  • cultural change among staff and patients which encourages mutual respect; and
  • improved efficiency.

Whilst these have been specific to the hospitals in which they have been trialled, the innovations emerging from this latest project are intended to be universally applicable, with the ambition of being rolled out across England’s hospitals.

The closing date for entries is the 4 April with shortlisted entries to be announced on the 18 April 2011. The winning designs will be showcased in October 2011.

Notes to editors

1. The estimated £69 million figure to reduce violence and aggression towards NHS staff is from: A Safer Place to Work: Protecting NHS Hospital and Ambulance Staff from Violence and Aggression, published by the National Audit Office, March 2003

2. The three hospital Trusts taking part in the programme are: Guys and St Thomas’ NHS Foundation Trust, Chesterfield Royal Hospital NHS Foundation Trust and Southampton University Hospitals NHS Trust.

3. To help in the development process, the Design Council has recruited an Advisory Board of highly respected designers, clinicians, NHS managers, healthcare experts, staff and patients’ organisations to advise the winning teams during the design and development phase.

4. The Design Council places design at the heart of growth and renewal in Britain. As one of the world’s leading design institutions, The Design Council is a unified voice for a broad spectrum of design, architecture and public space, placing good design at the heart of social and economic renewal. We demonstrate how design can help build a stronger economy and improve everyday life through practical projects with industry, public services and education.

5. To see the design briefs please go to

6. You can find out more information and statistics on violence against NHS staff at

7. For further information, please contact:

The Department of Health press office on 020 7210 5221

Saskia Sissons, Design Council: 0207 420 5248 /

Nigel Campbell, Design Council: 0207 420 5282 /


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