Pregnant doctor kicked in the face as RCEM finds 3 in 4 A&E staff experience or witness violence and aggression every week

What the survey found

1. 163% have faced discriminatory abuse. Racism, sexism and homophobia, directed at staff by patients and by members of the public while they are working.
2. 24% always feel safe at work. Everybody else answered below that: safe most of the time, safe only sometimes, or not safe at all. Feeling safe at work is the exception in emergency medicine rather than the baseline.
3. 352% of resident doctors do not report it. Across all staff, 30% had not reported an incident they experienced. Among resident doctors it is the majority.

Why is this happening?

Every one of those is decided above the department, which is what moves this from a staff welfare problem to a government one, and it is the ground RCEM has built its Safe to Care campaign on. And none of it is a matter of opinion either. RCEM's own figures for England put 489,138 patients waiting 24 hours or more in an emergency department in 2025, about 150,000 more than 3 years earlier, with 60.5% of patients seen within 4 hours against a constitutional standard of 95%. That is the department the survey is describing, and the same one that the assaults happen in.

What it is doing to the people doing the work

That last row is where this stops being a wellbeing statistic and becomes a workforce one. Emergency medicine is already short of people, and every departure lands back on the waits and the crowding that the survey says caused the incident in the first place.

Reporting it mostly changes nothing

3 in 5 of those who did report an incident got nothing meaningful out of their trust. Unfortunately, that is the answer to the first row of the chart, and to why half of the resident doctors who answered no longer bother.

There is no published trust-level count of any of it either: how many staff were assaulted, how many reported it, or how many prosecutions followed. Nothing is comparable between one trust and the next, so nothing is accountable. A problem counted nowhere is one nobody has to answer for. It is also what makes every other number in this survey an undercount.

The thing is, none of this is waiting on a new rule. Trusts already have to protect their staff so far as is reasonably practicable under the Health and Safety at Work Act 1974. The obligation is on them today, and based on these numbers it is clear that it is not being met.

Moreover, in RCEM's separate survey of clinical leads in England, 99% said the government was not taking the right steps to fix the pressures on emergency departments, whether or not it understood them.

What needs to happen

The findings went to the 4 UK governments on 7 September in a briefing that asks them to end it by the end of the decade.

• Government. The crowding is what staff named, and no emergency department can fix it from the inside. It needs the 4-hour standard treated as a number that matters again, enough staff to meet the demand actually arriving, and bed occupancy watched across the whole hospital rather than at the ED door.
• Trusts and health boards. The duty is already theirs and has been since 1974. What is missing under it is security that turns up, a way of reporting worth the time it takes, someone telling the person what came of their report, and support afterwards for anyone who was in the room.
• The police and the prosecutors. More than half of the staff who answered expect nothing from them, which is its own kind of evidence. Nothing else on this list changes that: an assault in an emergency department has to be treated like an assault anywhere else.

The briefing carries the full list of RCEM recommendations, down to the security standards it wants made mandatory and the trust-level data it wants published. And the case put to the governments is a financial one as much as anything else: the sickness, the turnover, the recruitment, the litigation and the lost productivity that come out of this already cost more than the standards being asked for.