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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


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)

Related documents

COVID-19 prevention and management of work-related aggression and violence prompt sheet (PDF, 880KB, 13 pages)

Preventing and managing work-related aggression and violence policy 2018 (PDF, 517KB, 21 pages)

Policy on lone working (PDF, 1.2MB, 43 pages)

Strategy for managing work-related aggression and violence within the Irish Health Service, 2008 (PDF, 794KB, 95 pages)

Department/Service Security prompt sheet (Word, 33KB, 2 pages)

Health and Safety interview room checklist (Word, 35KB, 3 pages)

HSE best practice guidance for mental health services, 2017 (PDF, 3MB, 218 pages)

2023 HSE enterprise risk management policy and procedures (PDF, 1.4 MB, 76 pages)

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Use the Health and Safety self-service portal or

Phone: 1800 420 420

Monday to Friday 10.30am to 12 noon and 2.00pm to 3.30pm