NHS – Leading the world in insulting consumers


My GP’s noticeboard prominently displays a notice stating “This Organisation will not tolerate assault, abuse or threatening behaviour towards our staff.” You have probably seen similar notices.  What utter bilge, what an unwarranted attack on British decency.  What a stupid basis for a relationship with a consumer. And what a waste of paper.

For a start, any assault, abuse and threatening behaviour are, to a greater or lesser extent, criminal acts and so no organisation could lawfully tolerate them.  Secondly, the overwhelming majority of British people would never dream of assaulting, abusing or threatening anyone (except perhaps politicians).  To suggest that they need reminding of this is mildly insulting.  Thirdly, those who are so aggravated, inebriated or uncivilised as to be contemplating assault etc. are unlikely to either read the notice, or pay it any heed.

So how big is the problem?  The last such notice I saw was in my GPs surgery, so let’s find some numbers.  According to the NHS in 2014/15 there were 67,864 assaults on staff.  Of these the overwhelming majority were on mental health staff, which is not really a surprise.  The NHS strips these out, and that leaves 16,492 assaults on staff.  They chose to then express this as assaults per 1,000 staff, which comes out at around 13 assaults per 1,000 NHS staff.  What constitutes an assault is not clear, but these 16,492 assaults led to 870 criminal sanctions and 694 civil or administrative sanctions.  That’s under 10% of assaults leading to any form of sanction.  Assuming that the NHS acts vigorously to protect its employees the implication is that 90% of assaults are so minor as to not warrant any sanction against the perpetrator.

Of course, assaults per member of staff is the wrong number – a thoracic surgeon is unlikely to be assaulted as his patients are anaesthetised and a mortician is even safer as his patients are dead.  Administrators (who presumably produced this idiotic measure) should be safe provided they avoid the wards.  A&E and ambulance staff are probably at most risk, but that’s not the right number to justify idiotic notices either.  The question is what proportion of patients assault staff.

It turns out that its quite hard to find useful numbers, but I do now that in 2014/15 there were 23,363,638 attendances at A&E.  In spite of Google I can’t find data on GP visits or non-A&E hospital visits, but I don’t need it to make my point. The chance of an individual assaulting NHS staff is 16,492/23,363,368 or just about 0.07%.  If we assumed that A&E was 1/3 of the NHS (I suspect its rather less) then that falls to under 0.02%, or 1 in 4,250.

That’s not much.  (It’s a lot less If you ignore those assaults that do not result in a sanction. The number then falls to under 1 in 42,500).

According to the literacy trust, 5% of adults have the reading skills of a 5-7 year old and 16% are “functionally illiterate.”  Total illiteracy is quoted at under 1%. Let’s assume just 0.5% of the adult population can’t read the notice, that is 1 in 200.  So the average adult is 20 times more likely to not understand the notice than he (or she) is to assault staff.  What is the point of the notice? Which prat insisted it was put there?

It’s bound to be caused by some interpretation of an employer’s duty of care, which of course actually means some umbrella to shelter the employer if there is an assault.  Box ticked, move on – no harm done.  But of course, there is harm being done.  We have already established that at 99.98% of the population would not assault NHS staff.  You know these people – you’re one of them and so are your workmates, fellow parents at school etc.  And yet the GP’s prominent message to you is that you are so ignorant that you need reminding of the boundaries of acceptable behaviour.  You may, like me, feel mildly insulted.

Now of course one expects a certain level of commercially idiotic practice from the NHS or any other government organisation.  But it gets worse; the lunacy is spreading to the commercial sector – presumably in part because the government employs about 45% of the work force, (the NHS alone has 1.3 million employees, or 4% of the national workforce), and is therefore viewed as an exemplar of best practice.

I recently had a delicious cream tea in the Windsor Castle Farm shop with my cousin.  Although we’re both over 50 we reduced the average age of the clientele by about 20 years; this is clearly not a place where waitresses face a high risk of assault.  I can find no record of an assault on Windsor Castle staff by a member of the public.  And yet there was one of these ludicrous bloody notices by the till.  The charming staff had no idea why it was there, only that they had to display it as part of Health and Safety.

The sorry truth is that box ticking does not generate profit; customer service does.  I now chose to interpret these notices as a stating “The management here has no interest in either customer service.  It is simply serving out its time in the hope of a decent pension.”  I’m also building a prospect list for my (new) consulting business…