Violence, harassment and aggression (VHA)

The HSE had adopted the EU definition of work-related aggression and violence. This is 'any incident where staff are abused, threatened or assaulted in circumstances related to their work, involving an explicit or implicit challenge to their safety, wellbeing or health'.

You may be at a greater risk if you:

work alone
work after normal working hours
work and travel in the community
provide or withhold a service
exercise authority
provide care and advice for service users with risk factors
are a new, inexperienced employee that has not received the necessary training or developed the required skills
handle valuables or medication

Manager responsibilities

Ensure employees are aware of the HSE's Policy on the Prevention and Management of Work Related Aggression and Violence.
Carry out a risk assessment (clinical and non-clinical) to identify work-related aggression and violence hazards.
Put in place control measures to eliminate or control risks.
Ensure employees at risk are given training based on the training needs assessment.
Provide support and access to support services if needed.

Employee responsibilities

Use safe systems of work and adhere to risk assessments and controls
Be aware of the HSE's Policy on the Prevention and Management of Work Related Aggression and Violence
Minimise risks where possible
Undertake relevant education and training, based on training needs assessment
Report risks, concerns and incidents of work-related aggression and violence to your manager

Clinical risk assessments

Clinical risk assessments, including an assessment of aggression and violence risk, must be done by clinical staff.

A care plan and risk assessment must be carried out on service users posing a risk of violence. This should get reviewed regularly as part of the care planning process.

Non-clinical risk assessments

Non-clinical risk assessments must be done by the manager in consultation with staff.

The assessment should include the

tasks
interaction between the healthcare worker and the service user
organisation of work and the work environment
training and experience of healthcare employees

On-site security

Managers must ensure that on-site security staff are aware of the risks and control measures to manage aggression and violence. This includes contracted workers. Security staff should be given a copy of the site or service safety statements.

Service level agreements with security firms should include local aggression and violence procedures including emergency protocols.

Aggressive phone calls

You are not expected to deal with aggressive or abusive callers but we must consider our service users' needs. They may be annoyed and stressed. We should aim for a balance between the rights of the employee and the rights of service users.

What to do if you receive an abusive call

If a caller is abusive during the call you can:

tell them you find their language offensive and you will end the call if it does not stop
hang up, if the abuse continues despite your warning - this decision must be made in the context of risk assessment
make a detailed note of the call
inform staff members who are involved with the caller
report abusive language or threatening behaviour to your manager

How to avoid ending a call

There are things you can do to try to keep control of a call and avoid, if possible, hanging up.

These include:

keep calm and try to remain as open minded as possible
do not respond with aggression
try not to take what the caller is saying personally
ask as much as is necessary for the facts
try to keep the tone of your voice calm and measured
let the caller 'vent and have their say'
listen and then question and confirm what they are saying
remain positive and confident and do not allow the caller to take over the call
follow through on agreed actions

Incident management

All incidents must be reported, and managed in accordance with the HSE Incident Management Framework

Support

If you are exposed to aggression and violence you will be given sensitive and practical support to help you cope with the incident. Please also see Employee Assistance Programme and Occupational Health.

For more guidance, see the policy preventing and managing work-related aggression and violence, 2018 (PDF, 517KB, 21 pages)

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