The Chair of the Association of Ambulance Chief Executives (AACE) Jason Killens has written to the ministers responsible for ambulance services in England, Scotland, Wales and Northern Ireland seeking to explore what further national policy interventions could be developed to help combat the growing number of violent assaults against ambulance workers in the UK.
It comes following the gathering of new data that shows UK ambulance services now have the highest rate of reported incidents of violence, aggression and abuse directed at their people ever recorded - with 22,536 incidents across the fourteen UK ambulance services in the 2024-25 financial year, an increase of almost 15% on the previous year.
This means that every single day, at least 62 ambulance people will be abused or attacked – almost three an hour - with reported incidents including kicking, punching, slapping, head-butting, spitting, verbal abuse and sexual assault, and ranging from common assault to significant serious attacks involving a multitude of weapons. On top of this many assaults go unreported, so the true figure is higher. Worryingly, female ambulance workers are three times more likely than the NHS average to be subject to assault at work and male ambulance workers twice the NHS average.
These concerning statistics come after the March 2025 publication of the NHS Staff Survey which revealed that 38% of frontline operational NHS ambulance staff have been physically attacked or been the victim of physical violence at work in the last twelve months, but only 76% reported it to their NHS trust managers – meaning many people do not even report these assaults. Additionally, 52% of frontline operational NHS ambulance staff said they experienced at least one incident of harassment, bullying or abuse from patients / service users, their relatives or other members of the public.
The data from AACE - which represents the UK public ambulance sector – reveals that the summer months were when the most incidents of violence and aggression were reported, with summer 2024 recording the highest number of incidents on record, with 6,093 reported. Alcohol is the most prominent factor in assaults against ambulance staff, followed by drugs and people in mental health crisis. Race and sexuality have also increased as exacerbating factors in these assaults.
As a result, AACE is using spring – when incidents traditionally start to escalate - as an opportunity to highlight the profound impact of this abuse on the everyday lives of ambulance staff, while encouraging the small minority of people who might commit these offences to have greater respect for the people who are trying to help them when they are most in need.
Jason Killens, AACE Chair and Chief Executive of the Welsh Ambulance Services University NHS Trust said: “These figures are truly shocking and reflect a pattern of increased violence, aggression and abuse directed at hard-working ambulance people who are there to help people in their times of greatest need. Frontline staff as well as call handlers are affected by this horrendous abuse and this unacceptable behaviour has a major long-term impact on the health and wellbeing of ambulance people who are simply trying to do their jobs and help save lives.
“This situation is now so serious that we are seeking to engage with UK health ministers at the highest level to explore new interventions that could help deter potential perpetrators of these attacks. We would also underline again that it is vital that the judiciary uses all available legislation to ensure appropriate sentences are handed out consistently to those found guilty of committing these horrific crimes against our workforce.”
The AACE data shows that there has been a significant increase in reported incidents of violence, aggression and abuse against ambulance staff over the past four years. In 2021/22 the total figure was 15,430. In 2022/23 it rose by 2.7% to 15,857 but in 2023/24 the figure rose by 23.8% to 19,633. The 2024/25 figure of 22,536 is the highest figure ever reported, an increase of 14.8% on the previous year.
Anna Parry, Managing Director of AACE said: “These new figures are beyond worrying and underline the upsetting fact that ambulance employees face the very real possibility of being subject to violence or abuse each time they start a shift, which is just unacceptable. This can have a significant and lasting impact on wellbeing and can sometimes even lead to people leaving the ambulance service. Our ongoing #WorkWithoutFear campaign is shining a light on this alarming issue and raising awareness of the negative impact of this behaviour on our people, while a significant amount of work is ongoing within ambulance services to help better protect our workforce.”
As a result of the escalation in violence and abusive incidents, NHS ambulance services have prioritised the safety of their people and are undertaking several initiatives alongside the #WorkWithoutFear campaign to try and effect behavioural change among those who might carry out these assaults or become abusive, while providing employees with as much support as possible to reduce the incidence of assaults. This includes:
- Dedicated violence prevention teams established within each NHS ambulance service.
- Body worn video cameras have been introduced to all English NHS ambulance services.
- The establishment of a centrally coordinated violence dataset that enables each ambulance service to report the type and frequency of assaults in a more consistent way, giving a greater foundation and better understanding of the prevalence and reasons behind violence and aggression directed at ambulance people.
- A successful ‘restrictive interventions’ training programme giving ambulance people safer ways to protect themselves and patients in potentially volatile situations.
- Counselling and other forms of talking therapy and support for employees who have been subjected to violence and aggression; the sector continues to work hard to find new and innovative ways to provide better post-incident support for its people.
The public can pledge their support for the AACE anti-violence campaign by using and sharing #WorkWithoutFear on social media and by visiting www.