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Sector - HEALTH

The Safe Healthcare initiative is an innovative and coordinated model to address violence and harassment in the health sector, leading to to collective agreements in the hospital sector and an approach that helps employers and employees to reduce aggression and violence in the workplace. It arose from a concern about rising levels of aggression from third-parties in hospital settings. The project is run by Foundation for the Labour Market in Hospitals (StAZ), which works on the basis of joint approaches amongst hospital employers' and trade unions. Safe Healthcare has introduced standards on Safe Healthcare training, the introduction of registers so that workers can make reports confidentially, as well as effective ways to respond to victims and perpetrators, and support and aftercare. Safe Healthcare is based on a methodology that can be customized to different hospital settings. Social dialogue between the project and unions at the national level and between employers and unions at hospital level has been critical to the success of Safe healthcare. Safe Healthcare has worked closely with the police and public prosecution service, dating back to an initiative in one hospital in 2001 in cooperation with the North Holland North police, where tools were developed to prevent violence and aggression towards staff and address the problem that many hospital staff saw TPVH “as part of the job”. Based on the success of the project a national pilot was implemented in fourteen hospitals, and by 2016 nearly all Duty hospitals had adopted the Safe Healthcare model. The first step is to draw up agreements between the institution and the police, municipalities and the Public Prosecution Service; when someone does not comply, they receive a warning and, if necessary, an access ban. In addition, an important pillar of the Safe Healthcare is the bottom-up approach, whereby employees are involved in analysing the problems, indicating priorities, devising suitable measures and establishing rules of conduct and standards. Employee involvement has been a very positive part of the project on the basis that they can contribute their expertise to finding solutions. Other factor leading to the success of the initiative has been the engagement from and and support of line managers, management and the Board of Directors, and along with resources and an internal project leader. A regional approach has, since 2020, provided permanent follow-up and all regions will continue to meet twice a year to keep momentum, continue discussion and taking up of actions including establishing agreements with police departments. It is anticipated the consultations will be completed in all ten police regions by 2022. Activities include the organisation of workshops, Guidelines via the website and sharing good practices in areas such as dealing with medical confidentiality. A training programme, including a Safe Healthcare Training handbook, provides a step-by step guide and tools for hospitals to take a systematically approach to reduce aggression and to create an environment where staff, patients, clients and visitors can work and stay safely. It includes a model for agreements with, among others, the police and the Public Prosecution Service, along with rules of conduct setting out behaviours that are unacceptable and what can happen if a patient, client or visitor breaks the rules. A Safe Healthcare handbook (summary available in English) covers steps to prevent aggression, what someone can do when faced with aggression, after and aggressive incident, and best practices.


The 2010 agreement of the Association of Netherlands Municipalities (VNG) and municipal trade unions contained a new section on policies to reduce harassment and violence, with a focus on prevention and risk assessment, the appointment in municipalities of a harassment and violence coordinator, ‘persons of confidence’, the adoption of best practices and procedures, and an incident reporting system.

Sector - HEALTH

In the hospital sector, the CBA for Hospitals 2009-2011 recommended a number of measures to prevent violence including risk inventory that gives special attention to ‘tackling work pressure, aggression, physical strain and violence’. In the health sector unions have highlighted the need to do more tackle sexual harassment by third-parties (clients and patients).

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