I was a rapid response solo paramedic in London for over 25 years of my long career in the NHS. For too long, it has become almost acceptable for ambulance personnel to be the target of violence or abuse. It was a prevailing theme in my 35-year career as a paramedic. It clearly has stood the test of time very well! During this time, I ran a national campaign for the provision of body armour in response to the then escalating level of assault to front-line ambulance personnel in the UK.
Threat of assault
Body armour was only part of a package of measures designed and proposed to facilitate a safer working environment for our 999 ambulance personnel.
My mantra over the years was that you could never eliminate the threat of assault; you could only mitigate against that threat.
During my rapid response career in London, I was fortunate enough to work for a trust that did embrace the concept of body armour for their paramedics, with provision on a ‘made to measure basis’ for each member of staff.
Need for more than just body armour
Despite retiring from the NHS 10 years ago next month, it appears that nothing has changed. In fact, the situation appears to be getting worse!
Recent statistics highlighting the depressing truth of 55 ambulance workers being attacked or abused every day within our 14 NHS UK ambulance services. Reading this data prompted me to revisit this all too familiar, depressing and unacceptable subject.
Body armour, conflict resolution training, good reporting procedures, and digital personal radios, complement each other in creating that safer working environment; surely the holy grail for anyone working in the challenging, unpredictable and, all too frequently, dangerous theatre of emergency pre-hospital care?
Debunking the exaggeration argument
I want at this juncture to debunk an overhyped narrative from the detractors of body armour. It would often come up in conversations, that the likelihood of being stabbed in the line of duty was, and still is, mercifully low.
The flaw in this argument is that body armour is a multi-faceted piece of personal protective equipment (PPE); it provides not only excellent knife resistant protection; it is also an effective preventative tool from the associated risk of blunt force trauma; more commonly associated with assault on ambulance crews.
I found wearing the body armour was invaluable during the occasional scenarios where I was called to deal with patients who had become violently agitated. Working side by side with police officers who routinely wear this type of PPE, was simply a far safer environment to work in, thanks to the blunt force trauma protection from this PPE.
By 2006, The Emergency Workers Act had passed into law. It was effectively superseded in 2018 by the Assaults on Emergency Workers (Offences) Act, thereby creating a new aggravated offence of an assault against a member of the emergency services.
Assault incident rate is rising alarmingly
Either the deterrent isn’t sufficient, or the conviction rate isn’t high enough. Why else would the incidences of assault, abuse or aggression on ambulance workers continue to rise to over 20,000 in 2024/25?
According to the NHS, the ambulance service in England receives around 10-11 million calls annually. The Scottish Ambulance Service is currently handling 14,000-15,000 emergency incidents a week.
Need to act now
If our ambulance service management really is seriously committed to addressing this escalating threat to our highly trained and dedicated staff, they should revisit this issue as a matter of urgency.
If something isn’t done soon to address the escalating threat of violence to ambulance crews, I fear that one day, in the not-too-distant future, an ambulance man or woman will not return home after their shift on the front-line.
A more radical approach to the contentious debate of the provision of body armour for our 999 lifesavers is long overdue. Surely, this is the very least that could be done to acknowledge the debt society has to this emergency service.
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