Impact of COVID on violence against healthcare – report published by ICN, ICRC, IHF and WMA

Survey results show that the COVID-19 pandemic has worsened violence against healthcare, with a documented increase of incidents in many countries.

Health personnel and their patients, as well as healthcare facilities and ambulances, are subject to persistent acts of violence in all regions of the world. The results of a global survey conducted in 2021 reveal an increase in reported incidents since the COVID-19 pandemic began. Close to 60% of the respondents perceived that there has been an increase in reported cases of violence against healthcare since the start of the pandemic. The survey also identified successful approaches taken by healthcare providers to lower incidences of violence against healthcare.

The International Council of Nurses, the International Committee of the Red Cross, the International Hospital Federation, and the World Medical Association carried out a joint survey from May to July 2021 to understand the perceptions of violence against healthcare during the first year of the COVID-19 pandemic and to identify good practices implemented in prevention, reduction or mitigation of violence, with a focus on (but not limited to) those measures implemented during the early stage of the pandemic.

From raising awareness about violence on health personnel at the community level, to the development of new legislations to protect them, the survey shows that solutions can be found. Frequent under-reporting of incidents of violence indicates that awareness-raising is needed among the health personnel themselves. A better and more robust system of reporting, monitoring, and analysis of data is necessary for a better understanding of the magnitude of the violence phenomenon and appropriate decisions in response.

The survey also shows the importance of improving relations between the health personnel and patients and their family members, who are perceived as the main aggressors. The display of ethical and accountable behaviour is a factor, but the training of health personnel on communication skills for de-escalating potential violent situations was perceived as the most popular measure.

The full survey report can be downloaded here.

On publication of the report, Dr Otmar Kloiber, Secretary General of the World Medical Association, remarked:

“The outcome of the survey provides a valuable insight into the persisting violence phenomenon in the health sector. Through the variety of strategies developed to prevent and tackle violence, the study highlights the remarkable resilience of health personnel, its ability to innovate in the face of attack, always with a view to providing the best care to patients. However, this does not absolve States and other actors concerned of their responsibility to engage in firm and coordinated policies to prevent violence and protect health care.”

International Council of Nurses Chief Executive Officer Howard Catton said:

“This report highlights that the threats, aggression and violence nurses and other health personnel face have got even worse during the pandemic. For years, ICN has been calling for action to protect and safeguard healthcare staff, but still nurses are at risk at work, and that is completely unacceptable.

Respect for nurses’ rights is not just about what employers and governments say: it is about what they do to protect nurses when those rights are abused or ignored. Concrete action is needed to end impunity and reverse this trend. Employers and governments have a duty to care for their staff and to investigate and sanction when attacks on healthcare occur.

The report has examples of successful strategies, including great work from nurses in Italy, who implemented training on communication competencies, mental health and psychosocial support, and successfully lobbied for a new law to address violence against healthcare professionals, and from the Taiwan Nurses Association, who supported the implementation of standardised rules for reporting untoward events which have been put in place nationally. ICN wants to see similar strategies implemented widely around the world to put an end to nurses having to go to work in fear for their personal safety.”

Maciej Polkowski, Head of Health Care in Danger Initiative, International Committee of the Red Cross added:

“The importance of this report is that it brings forward concrete suggestions for action that speak to the reality of many health care providers around the globe, who unfortunately face violence all too often in their daily work. One can see with this survey that aggressions and threats against health workers are clearly a problem of our times, which cannot be further overlooked if health systems want to better care for the health personnel and deliver better health outcomes.

The ICRC and its Health Care in Danger Initiative are committed to addressing violence against health care also by promoting enhanced resilience of health services, prevention of violence and mitigation of its effects. In the Health Care in Danger website, anyone can access free information and supportive material to learn more about what to do, complementing the points lifted by the experience of the health organizations who answered the survey.”

Ronald Lavater, CEO of the International Hospital Federation, concluded:

“No matter the context. No matter the reasons. Attacks against healthcare workers, hospitals and ambulances are not acceptable. Health systems can only function when both workforces and facilities are secure and protected.

We recognize the importance of collaboration with other leaders in the international community to respond to the serious issues in today’s healthcare environment. The IHF is proud to work in partnership with the ICRC, ICN and WMA to gain deeper understanding of the scale of the problem and to share real-world solutions to highlight the necessity of prevention and mitigation of violence against healthcare.”

Download the press release here