What the 2025 NHS Staff Survey reveals about staff safety and confidence

Written by Jason Keeley, IKON Training Managing Director.

1 in 7 NHS staff experienced physical violence at work

One finding in the 2025 NHS Staff Survey stands out.

One in seven NHS staff reported experiencing physical violence while carrying out their work in the last year. More than one in four said they had faced unacceptable behaviour in the workplace. Among ambulance staff, the figures are higher still, with over half reporting abuse during their duties.

Violence and abuse directed towards NHS staff has become an increasingly visible issue across healthcare settings, and the survey findings provide important context for understanding the environments staff are working within.

These figures highlight something many NHS teams already recognise. Difficult interactions are a regular part of working life in healthcare.

Healthcare environments are emotionally complex places. Patients may be frightened about their condition. Relatives can feel anxious when information is delayed or unclear. People experiencing pain, confusion or cognitive impairment may struggle to understand what is happening around them.

In these situations, conversations can shift quickly. The survey findings reinforce how often NHS staff are required to navigate these moments while continuing to deliver care.

The survey does more than record incidents. It raises an important question. When tensions rise, do staff feel confident managing those moments safely?

Difficult interactions are part of everyday healthcare

The survey findings reinforce how frequently NHS staff are required to manage emotionally charged situations.

These moments rarely begin with confrontation. More often they grow from uncertainty or frustration. A patient may be seeking reassurance about their treatment. A relative may want clearer information after waiting for an update. Staff may be balancing competing priorities while trying to respond quickly.

In busy departments where demand is high, small moments can escalate if they are not recognised early.

Understanding these early signals makes a difference. When staff feel able to read the situation and respond calmly, tensions are more likely to settle rather than intensify.

Almost 40% of staff reported feeling unwell due to work-related stress

Another finding in the survey that adds important context.

Almost 40% of NHS staff said they had felt unwell because of work-related stress over the previous year.

Difficult interactions often occur when teams are already managing heavy workloads and emotionally demanding situations. Under pressure, even experienced professionals can find these moments harder to manage.

Under pressure, even experienced professionals can find these moments harder to manage.

Confidence therefore becomes an important factor. Staff who feel prepared are more likely to communicate clearly, recognise rising tension and maintain safe boundaries during difficult interactions.

What helps staff manage difficult moments more safely?

Across healthcare environments, certain capabilities consistently support staff during challenging interactions.

Recognising when a situation is beginning to escalate

Changes in tone, behaviour or body language often signal rising tension. Staff who are familiar with these early indicators are better placed to respond before situations deteriorate.

Recognising these signals early is often the difference between a situation settling and escalating further. This is why early intervention and the culture surrounding it are so important in healthcare environments.

We explore this in more detail in our article on creating a culture of early intervention in the workplace.

Communication that reduces uncertainty

Patients and relatives frequently become frustrated when information feels unclear or delayed. Calm explanations and active listening can help reduce anxiety and create space for conversations to stabilise.

Maintaining safe boundaries while supporting patients

Healthcare staff often work in close proximity to patients and visitors. Confidence in positioning, awareness and professional boundaries helps staff maintain safety without compromising dignity or care.

Confidence that develops over time

Skills used in difficult interactions strengthen through practice and reinforcement. Teams benefit when they share a common understanding of how to recognise and respond to escalation.

Learning that is revisited and reinforced tends to have greater impact than a single learning event.

What organisations can take from the survey findings

The NHS Staff Survey does more than record incidents. It provides insight into the environments staff are working within and the pressures they manage each day.

Healthcare will always involve moments of distress, uncertainty and heightened emotion. Organisations cannot remove those realities entirely.

What they can influence is how prepared staff feel when those moments occur.

Supporting confidence, shared approaches and practical skills can help teams navigate difficult interactions more safely for everyone involved.

Supporting staff confidence in healthcare environments

At IKON Training we work with NHS organisations across the UK to support staff in developing practical skills for managing conflict and aggression in healthcare settings.

Our focus is on recognising escalation early, communicating effectively under pressure and maintaining personal safety while continuing to support patients with dignity.

Healthcare will always involve moments of uncertainty and heightened emotion. The question organisations face is whether staff feel equipped and supported when those moments occur.

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