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Sector - HEALTH

The Health Services Executive (HSE) and the unions in the health sector have jointly agreed a range of initiatives on the prevention of violence and harassment at work, including TPVH. TPVH has become more serious in recent years and although data is limited, reported incidents to OSH National Incident Management System show that more than half (55%) of the incidents reports in 2020 were behavioural hazards, which include violence and harassment. The initiative dates back to the National Strategy on the Prevention and Management of Work-Related Aggression and Violence (2008), drawn up in response to increasing levels of TPVH in the Irish health service, drawn up by a Working Group involving experts and unions representing all groups of health workers (SIPTU, PNA, INO, IMO) in line with the 2005 Safety, Health and Welfare at Work Act. On the basis of the national strategy, a policy and risk assessment tool on lone working (2007) and a detailed policy and guidance (HSE ‘Policy on the Prevention and Management of Work-Related Aggression & Violence, 2018) were drawn up. The 2018 HSE policy, which involved consultations with unions through the National Joint Council, provides detailed guidance for the HSE, managers and employees on how to manage work-related aggression and violence with a focus on prevention and risk assessment and management. Managers received guidance and training about their obligations under the policy and their roles in carrying out a risk assessment in clinical and non-clinical settings to identify work-related aggression and violence hazards, and to put in place control measures to eliminate or control the risks. In addition, managers have to ensure that employees most at risk are given training and provide support to victims, including access to support services, such as occupational health and confidential counselling services provided by the HSE’s employee assistance programme. The policy includes practical resources, including an audit tool and a sample risk assessment tool. All incidents have to reported and are managed in accordance with the HSE Incident Management Framework, which forms a part of the HSE Integrated Risk Management Policy. In addition, further guidance was produced on risk assessment for training on the prevention of work-related aggression and violence during the COVID-19 pandemic, in the form of a risk assessment prompt sheet, issued in June 2021. Additional information has been drawn up by the National Health and Safety Authority on preventing TPVH in the health sector. Employees are given responsibilities to attend training and report risks, concerns and incidents to their managers. In clinical settings clinical risk assessment are included in the organisation’s risk management framework and this includes the assessment of risks of aggression and violence and the provision of a care plan and risk assessment on service users posing a risk of violence. This should be reviewed regularly as part of the care planning process. Non-clinical risk assessments are carried out by managers in consultation with staff and take account of work tasks, interaction of the health care work with the service user, the organisation of work and the working environment and the training and experience of health workers. Obligations are also put on managers to ensure that on-site security staff are aware of the risks and control measures to manage aggression and violence, and service level agreements with security firms must include local aggression and violence procedures. Specific guidance is also given to managing aggressive phone calls in helping staff to understand that service users may be stressed, while finding a balance between the rights of the health worker and the rights of the service user. In the event of an abusive call, specific guidance is given, for example, with guidance on ways to manage aggression, such as keeping calm, not taking what the caller says personally and letting them have their say, if aggression persists by informing the caller that their language offensive and you the call will be ended if it does not stop, making a note of the call and reporting incidents to immediate managers.

Sector - HEALTH

The Irish Nurses and Midwives Organisation has called for new measures to address the problem of heightened levels of TPVH against health care staff, including improved security, inspection and employers’ responsibilities for worker safety. In 2022, the national Health and Safety Authority (HSA) agreed to establish a new occupational health division with responsibility to address workplace violence and harassment. The INMO (2021) reports that in the last year, 90% of their members reported being mentally exhausted during or after work, and that violence and harassment and inadequate safety protections add to the burnout.

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