Emergency medicine consultant Professor Rob Galloway has warned of a national crisis across NHS hospital accident and emergency departments after witnessing staff being punched, kicked, and spat at during a night shift.
The ferocious assault took place in a crowded hospital corridor filled with patients lying on trolleys who were unable to move away from the violence and feared for their own safety.
Professor Galloway said the patient who attacked the medical staff should never have been in the department and was only present while waiting for a mental health bed. Accident and Emergency (A&E) departments in National Health Service (NHS) hospitals are intended to be places of safety, but Galloway warned that escalating violence is putting both healthcare workers and patients at risk.
Having worked in emergency medicine for 25 years, Galloway stated that while he is accustomed to cardiac arrests, dying patients, and grieving families, the violent episode left him shocked and sickened. He cautioned that without urgent reform, worsening conditions in emergency departments could result in the death of a medical professional or a patient before authorities act.
According to Galloway, the crisis is driven by two main factors: a severe shortage of NHS mental health beds and recent changes to police custody procedures. Intoxicated and drugged individuals showing aggressive behavior, who were historically managed inside police station custody suites, are now routinely brought to A&E departments by police for observation.
In the past, detainees in police custody were regularly assessed by doctors, typically general practitioners with specialist training. These custody doctors could treat minor injuries, evaluate whether a detainee was safe to remain in custody, or arrange a police-escorted hospital transfer when medically necessary, balancing the needs of the individual with public safety.
That system changed as fewer general practitioners were employed due to higher costs compared to alternative clinicians. Custody assessments are now frequently conducted by less experienced staff, including nurses, who may lack the training or authority to make complex legal and medical judgments.
As a result, custody staff err on the side of caution and send intoxicated, aggressive detainees with minor wounds to hospital rather than keeping them in police cells. Galloway noted that while preventing illness in custody is vital, focusing solely on individual risk transfers dangerous behavior directly into busy A&E departments.
Staff Survey and Underreporting
The true extent of violence in emergency departments remains hidden because many healthcare workers do not formally report verbal abuse, threats, or physical attacks. However, official data from the latest annual anonymous NHS Staff Survey, published in March, demonstrates a significant rise in incidents.
More than 766,000 NHS employees responded to the survey, with almost one in seven reporting that they had experienced physical violence from a patient or a member of the public over the previous year. The figure represents the highest rate of physical violence recorded in the staff survey in three years.
The second major issue undermining hospital safety is the inadequate provision of mental health services across the health service. Patients experiencing severe mental health crises are staying for days inside emergency departments due to a critical lack of assessment suites and inpatient beds.
Although patients with mental illness are rarely violent in most circumstances, A&E departments are noisy, overstimulating, and completely unsuited to their care. Arriving distressed, agitated, or intoxicated, patients often wait hours in overcrowded corridors for specialist mental health assessments.
Official figures highlight a substantial drop in mental health capacity over the last decade. In the 2010-11 financial year, England had 23,447 NHS mental health beds, but by 2024-25, that total had fallen to just under 18,000 beds.
Stabbings of Healthcare Staff
The growing dangers facing hospital workers are illustrated by recent violent attacks inside NHS facilities. Three months ago, an A&E doctor in his 50s was stabbed several times at Hillingdon Hospital in west London.
A 27-year-old man was subsequently charged with causing grievous bodily harm with intent, possessing an offensive weapon, and stealing knives following the attack at the west London facility.
In January of last year, a nurse at the Royal Oldham Hospital in Greater Manchester was repeatedly stabbed with scissors by a patient who had been admitted for a mental health assessment. She suffered life-threatening injuries, required emergency surgery, and spent the night in intensive care.
Galloway stressed that every doctor and nurse reading about these attacks recognizes that they or their colleagues could be next. Violent incidents traumatize elderly and frail patients on trolleys and fundamentally alter how safe staff and patients feel inside hospital wards.
Security Measures and Demands for Reform
At Galloway's own hospital, a 24-hour security team acted quickly to remove the violent patient following the corridor attack. The hospital is also implementing metal detectors at entrances to scan arriving patients and alert security if anyone carries suspicious items.
However, Galloway pointed out that round-the-clock security cover, staff training, and immediate availability vary widely across NHS hospital trusts. Measuring 5ft 8in, Galloway admitted that without dedicated security protection, healthcare staff are left feeling vulnerable to violence.
Galloway has written directly to Health Secretary Yvette Cooper to demand mandatory safety upgrades across all NHS emergency departments. His demands include visible 24-hour security personnel and secure entrances with metal detectors to prevent weapons from being brought into hospitals.
He also called for consultation rooms designed with two exits to prevent staff from being cornered, easily accessible panic alarms, and heavy furniture replaced with items that cannot be used as weapons. To address root causes, Galloway urged the government to reinstate police custody doctors, build dedicated emergency mental health facilities separate from A&E, and increase NHS mental health bed numbers.
