Tag Archives: Pressure

Dementia risk to 50-year-olds with raised blood pressure – study

Fifty-year-olds with slightly raised blood pressure are at an increased risk of getting dementia in later life, a new study has suggested.

Study participants had a greater risk even if they did not have other heart-related problems, the research published in the European Heart Journal said.

The association between blood pressure and dementia risk was seen at aged 50, but not 60 or 70, the study found.

People aged 50 with a systolic blood pressure of 130 mmHg, which is between the ideal blood pressure range (90/60mmHg and 120/80mmHg) and that considered to be high (140/90mmHg), or above had a 45% greater risk of developing dementia, scientists said.

Those taking part in the study developed dementia at an average age of 75.

Dr Jessica Abell, paper author and a research associate in dementia and epidemiology at University College London, said the study looks in more detail at what is considered “midlife”.

She said: “Previous research has not been able to test the link between raised blood pressure and dementia directly by examining the timing in sufficient detail.

“In our paper we were able to examine the association at age 50, 60 and 70, and we found different patterns of association. This will have important implications for policy guidelines, which currently only use the generic term ‘midlife’.”

Prof Archana Singh-Manoux, honorary professor at UCL, led the research and said: “Our work confirms the detrimental effects of midlife hypertension for risk of dementia, as suggested by previous research. It also suggests that at age 50, the risk of dementia may be increased in people who have raised levels of systolic blood pressure below the threshold commonly used to treat hypertension.”

Researchers suggested a possible reason for the link could be resulting damage from silent or mini-strokes, which often have unnoticed symptoms and are linked to high blood pressure.

Dr Abell noted that the findings were from “observational, population-level research” and therefore “do not translate directly into implications for individual patients”.

The research analysed 8,639 people, part of the long-running Whitehall II study of more than 10,000 civil servants tracked since 1985.

Dementia risk to 50-year-olds with raised blood pressure – study

Fifty-year-olds with slightly raised blood pressure are at an increased risk of getting dementia in later life, a new study has suggested.

Study participants had a greater risk even if they did not have other heart-related problems, the research published in the European Heart Journal said.

The association between blood pressure and dementia risk was seen at aged 50, but not 60 or 70, the study found.

People aged 50 with a systolic blood pressure of 130 mmHg, which is between the ideal blood pressure range (90/60mmHg and 120/80mmHg) and that considered to be high (140/90mmHg), or above had a 45% greater risk of developing dementia, scientists said.

Those taking part in the study developed dementia at an average age of 75.

Dr Jessica Abell, paper author and a research associate in dementia and epidemiology at University College London, said the study looks in more detail at what is considered “midlife”.

She said: “Previous research has not been able to test the link between raised blood pressure and dementia directly by examining the timing in sufficient detail.

“In our paper we were able to examine the association at age 50, 60 and 70, and we found different patterns of association. This will have important implications for policy guidelines, which currently only use the generic term ‘midlife’.”

Prof Archana Singh-Manoux, honorary professor at UCL, led the research and said: “Our work confirms the detrimental effects of midlife hypertension for risk of dementia, as suggested by previous research. It also suggests that at age 50, the risk of dementia may be increased in people who have raised levels of systolic blood pressure below the threshold commonly used to treat hypertension.”

Researchers suggested a possible reason for the link could be resulting damage from silent or mini-strokes, which often have unnoticed symptoms and are linked to high blood pressure.

Dr Abell noted that the findings were from “observational, population-level research” and therefore “do not translate directly into implications for individual patients”.

The research analysed 8,639 people, part of the long-running Whitehall II study of more than 10,000 civil servants tracked since 1985.

Dementia risk to 50-year-olds with raised blood pressure – study

Fifty-year-olds with slightly raised blood pressure are at an increased risk of getting dementia in later life, a new study has suggested.

Study participants had a greater risk even if they did not have other heart-related problems, the research published in the European Heart Journal said.

The association between blood pressure and dementia risk was seen at aged 50, but not 60 or 70, the study found.

People aged 50 with a systolic blood pressure of 130 mmHg, which is between the ideal blood pressure range (90/60mmHg and 120/80mmHg) and that considered to be high (140/90mmHg), or above had a 45% greater risk of developing dementia, scientists said.

Those taking part in the study developed dementia at an average age of 75.

Dr Jessica Abell, paper author and a research associate in dementia and epidemiology at University College London, said they study looks in more detail at what is considered “midlife”.

She said: “Previous research has not been able to test the link between raised blood pressure and dementia directly by examining the timing in sufficient detail.

“In our paper we were able to examine the association at age 50, 60 and 70, and we found different patterns of association. This will have important implications for policy guidelines, which currently only use the generic term ‘midlife’.”

Prof Archana Singh-Manoux, honorary professor at UCL, led the research and said: “Our work confirms the detrimental effects of midlife hypertension for risk of dementia, as suggested by previous research. It also suggests that at age 50, the risk of dementia may be increased in people who have raised levels of systolic blood pressure below the threshold commonly used to treat hypertension.”

Researchers suggested a possible reason for the link could be resulting damage from silent or mini-strokes, which often have unnoticed symptoms and are linked to high blood pressure.

Dr Abell noted that the findings were from “observational, population-level research” and therefore “do not translate directly into implications for individual patients”.

The research analysed 8,639 people, part of the long-running Whitehall II study of more than 10,000 civil servants tracked since 1985.

Warning of pressure on London teenagers as suicide rate doubles

The rate of teenage suicides in London has risen four times as fast as in England and Wales as a whole, leading to warnings of a “pressure cooker of conditions” facing young people in the capital.

There were 29 deaths by suicide among 10 to 19-year-olds in 2015-16, compared with 14 in 2013-14 – an increase of 107%. In England and Wales, the number of such deaths rose by 24% from 148 to 184.

Figures released by the Office for National Statistics (ONS) to the Brent Centre for Young People in north London under the 2000 Freedom of Information Act show the overall number of suicides registered in London increased by 48% in the three-year period, compared with an overall 3% decrease in England and Wales.

The centre called for more investment in mental health services and education to prevent a “needless waste of young lives”.

Dr Maxim de Sauma, the chief executive of the centre, which supports more than 600 young people with mental health problems each year, said: “When young people with crippling or disabling mental health conditions are not given the support they need, it wastes lives.

“People are much more over-pressured here than they are in other parts of the UK. Parents are less able to prioritise difficulties because they are under a lot of stress. It goes on from one generation to another, so the damage is continuous.”

Valentina Levi, an adolescent psychotherapist at the centre, said it had been “flooded” with cases over the past year and she was worried frontline workers were only able to see a small number of young people at risk.

“In the last year, we have had double the amount of referrals as in the previous year, but we are still working with the same resources,” she said.

Levi also cautioned against a focus on stereotypes regarding the individuals concerned.

“It’s true that we are seeing, for example, young men who are from very deprived backgrounds, and of course there has been much talk lately about knife crime and its impact. But we also have to recognise that this is an issue across all groups,” she said.

“Another might be young women who are from middle-class backgrounds and who feel very isolated and under pressure for a range of reasons.”

Last month, Barnardo’s warned that Britain is facing a mental health crisis because resources for children are so stretched that some only receive help if they seriously self-harm or try to kill themselves.

Javed Khan, the chief executive of the children’s charity, said young people’s mental health had never been worse in the organisation’s 152-year history. Radical action was needed, he said, because funding cuts had forced charities to abandon vital services.

A spokesperson for the London mayor, Sadiq Khan, said: “These are deeply worrying figures. Sadiq wants London to be a place where people can speak openly about their mental health and the support they need.

“That’s why Sadiq has made the issue one of his priorities and is working hard through his Thrive LDN campaign to improve Londoners’ awareness and understanding of mental health, remove the stigma and achieve real improvements in access to support and care for those who need it.”

  • In the UK, Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is 13 11 14. Other international suicide helplines can be found at befrienders.org

Warning of pressure on London teenagers as suicide rate doubles

The rate of teenage suicides in London has risen four times as fast as in England and Wales as a whole, leading to warnings of a “pressure cooker of conditions” facing young people in the capital.

There were 29 deaths by suicide among 10 to 19-year-olds in 2015-16, compared with 14 in 2013-14 – an increase of 107%. In England and Wales, the number of such deaths rose by 24% from 148 to 184.

Figures released by the Office for National Statistics (ONS) to the Brent Centre for Young People in north London under the 2000 Freedom of Information Act show the overall number of suicides registered in London increased by 48% in the three-year period, compared with an overall 3% decrease in England and Wales.

The centre called for more investment in mental health services and education to prevent a “needless waste of young lives”.

Dr Maxim de Sauma, the chief executive of the centre, which supports more than 600 young people with mental health problems each year, said: “When young people with crippling or disabling mental health conditions are not given the support they need, it wastes lives.

“People are much more over-pressured here than they are in other parts of the UK. Parents are less able to prioritise difficulties because they are under a lot of stress. It goes on from one generation to another, so the damage is continuous.”

Valentina Levi, an adolescent psychotherapist at the centre, said it had been “flooded” with cases over the past year and she was worried frontline workers were only able to see a small number of young people at risk.

“In the last year, we have had double the amount of referrals as in the previous year, but we are still working with the same resources,” she said.

Levi also cautioned against a focus on stereotypes regarding the individuals concerned.

“It’s true that we are seeing, for example, young men who are from very deprived backgrounds, and of course there has been much talk lately about knife crime and its impact. But we also have to recognise that this is an issue across all groups,” she said.

“Another might be young women who are from middle-class backgrounds and who feel very isolated and under pressure for a range of reasons.”

Last month, Barnardo’s warned that Britain is facing a mental health crisis because resources for children are so stretched that some only receive help if they seriously self-harm or try to kill themselves.

Javed Khan, the chief executive of the children’s charity, said young people’s mental health had never been worse in the organisation’s 152-year history. Radical action was needed, he said, because funding cuts had forced charities to abandon vital services.

A spokesperson for the London mayor, Sadiq Khan, said: “These are deeply worrying figures. Sadiq wants London to be a place where people can speak openly about their mental health and the support they need.

“That’s why Sadiq has made the issue one of his priorities and is working hard through his Thrive LDN campaign to improve Londoners’ awareness and understanding of mental health, remove the stigma and achieve real improvements in access to support and care for those who need it.”

  • In the UK, Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is 13 11 14. Other international suicide helplines can be found at befrienders.org

Warning of pressure on London teenagers as suicide rate doubles

The rate of teenage suicides in London has risen four times as fast as in England and Wales as a whole, leading to warnings of a “pressure cooker of conditions” facing young people in the capital.

There were 29 deaths by suicide among 10 to 19-year-olds in 2015-16, compared with 14 in 2013-14 – an increase of 107%. In England and Wales, the number of such deaths rose by 24% from 148 to 184.

Figures released by the Office for National Statistics (ONS) to the Brent Centre for Young People in north London under the 2000 Freedom of Information Act show the overall number of suicides registered in London increased by 48% in the three-year period, compared with an overall 3% decrease in England and Wales.

The centre called for more investment in mental health services and education to prevent a “needless waste of young lives”.

Dr Maxim de Sauma, the chief executive of the centre, which supports more than 600 young people with mental health problems each year, said: “When young people with crippling or disabling mental health conditions are not given the support they need, it wastes lives.

“People are much more over-pressured here than they are in other parts of the UK. Parents are less able to prioritise difficulties because they are under a lot of stress. It goes on from one generation to another, so the damage is continuous.”

Valentina Levi, an adolescent psychotherapist at the centre, said it had been “flooded” with cases over the past year and she was worried frontline workers were only able to see a small number of young people at risk.

“In the last year, we have had double the amount of referrals as in the previous year, but we are still working with the same resources,” she said.

Levi also cautioned against a focus on stereotypes regarding the individuals concerned.

“It’s true that we are seeing, for example, young men who are from very deprived backgrounds, and of course there has been much talk lately about knife crime and its impact. But we also have to recognise that this is an issue across all groups,” she said.

“Another might be young women who are from middle-class backgrounds and who feel very isolated and under pressure for a range of reasons.”

Last month, Barnardo’s warned that Britain is facing a mental health crisis because resources for children are so stretched that some only receive help if they seriously self-harm or try to kill themselves.

Javed Khan, the chief executive of the children’s charity, said young people’s mental health had never been worse in the organisation’s 152-year history. Radical action was needed, he said, because funding cuts had forced charities to abandon vital services.

A spokesperson for the London mayor, Sadiq Khan, said: “These are deeply worrying figures. Sadiq wants London to be a place where people can speak openly about their mental health and the support they need.

“That’s why Sadiq has made the issue one of his priorities and is working hard through his Thrive LDN campaign to improve Londoners’ awareness and understanding of mental health, remove the stigma and achieve real improvements in access to support and care for those who need it.”

  • In the UK, Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is 13 11 14. Other international suicide helplines can be found at befrienders.org

The new GCSE exams pile on pressure and kill off passion for learning | Keza MacDonald

Reading teachers’ and students’ accounts of the immense stress and mental health issues caused by the introduction of the new GCSE exams this year is heartbreaking. “The new GCSEs have broken my best students, left some with serious stress-induced illnesses, and isolated the majority, leaving them completely apathetic towards their own learning,” said one teacher. A student reports: “I have seen the mentally toughest people crack and it’s painful to watch. People crying over being unable to do a maths question. Is this what we want as a nation, to be put under this mental stress?”

Exams are not exactly known for making teenagers happy, but the misery should at least lead to something useful at the end of it. GCSEs as they previously stood were so forgiving that their usefulness was often called into question – but instead of reforming them, former secretary of state for education Michael Gove decided to take them back to the days of the O-level. The new GCSEs emphasise tough, stressful end-of-year examinations over coursework and regular testing: teacher friends tell me that even in subjects where the content of the syllabus hasn’t changed enormously, the way that students are tested on it has become much more stressful.

If the aim is to gift England’s young people with “the broad, deep and balanced education which will equip them to win in the global race”, as Gove claimed, then why are we returning to the educational principles of 30 years ago rather than teaching them the flexibility and resilience that they need to thrive in the modern world? Why are we asking them to sit three separate 75-minute geography exams and forcing them to revise until the early morning, instead of giving adolescents space and opportunities to develop the skills and talents that interest them?

The problem here is not that the new exams are harder. It is that they are all-consuming. Nobody of any age should be pulling 70-hour work weeks just to keep up. Where previously students were able to bring copies of set texts into the English examination, now they must memorise quotes from a couple of novels, a Shakespeare play and a selection of poems. What does this kind of memorisation actually teach people? In the age of Google, how is it useful outside of an exam room? Why test students on their ability to retain information rather than understand it?

There is another significant difference between O-levels and the new GCSEs: not everybody had to take O-levels. In the 1970s, many people left school for jobs at 16, and only 8.4% of the population attended university. Now we are destroying teenagers with stress at 16 and then again two years later with A-levels, with the aim of eventually getting them university degrees that are increasingly expensive and decreasingly useful.

Students don’t always discover their passions in the classroom. I was a textbook product of a nice middle-class high-achieving school: I worried sick over my exams, passed them all, but then ended up leaving school just before I turned 17 to work on a video games magazine because I had spent all my spare time playing games and making websites. My parents despaired – but ask any of my millennial peers whether the exams and qualifications that we were told to stress over were useful when the economy collapsed in 2008. To survive, we had to hustle – and the school system, as it was, emphatically did not teach us that.

On my beat covering the video games industry, most of the young people I meet developed the skills and talents that they need for their job – art, music, coding and game design – as a hobby, because school didn’t support them. Why, then, are they just making GCSEs harder instead of adapting them to teach things people need in the modern world? Why aren’t we broadening the range of subjects and adding more vocational options for students instead of getting them to memorise poems?

I’m not saying that adolescents should be spending their time in school doing whatever they want. But there should be time left outside of school to pursue other things, whether it’s music or video games or making YouTube videos or just being teens. Exams might be a necessary evil, but there should be time and space left over for young people to live their lives and discover their passions, instead of piling so much schoolwork on them that they are having panic attacks and migraines en masse.

Keza MacDonald is video games editor at the Guardian

Rise in assaults on staff reveals intolerable pressure on NHS

The revelation of the sharp increase in attacks on NHS staff highlights a problem which is serious, global and growing.

The survey by the Health Service Journal and Unison showed assaults in 2016-17 were almost 10% up on the previous year, driven by big increases in hospitals that were missing treatment targets or seriously in debt. Staff in mental health trusts were more than seven times more likely to be attacked than those in other trusts.

The World Health Organization says health workers are at a high risk of physical violence all over the globe, and estimates that between 8% and 38% of staff in different countries suffer at some point in their careers. A study by the International Council of Nurses concluded that healthcare workers were more likely to be attacked at work than prison guards or police officers, and that female nurses were most at risk.

On top of these attacks during day-to-day work, healthcare staff dealing with health emergencies such as wars are in enormous danger. WHO figures indicate that over the two-year period to 2015, 959 such healthcare workers were killed and 1,561 injured across 19 countries.)

A global study by the University of South Florida found that attacks on nurses tended to be concentrated in emergency departments and geriatric and psychiatric units. What unites these areas is that staff are working with patients who are in pain or distress, anxious and likely to feel that they have lost control of their lives. The author pointed out that geriatric and psychiatric patients are more likely to have poor impulse control.

This study uncovered striking differences across the world, with the highest rate of attacks occurring in the “anglo” countries, which included Australia, Canada, England, Ireland, New Zealand, Scotland and the US, at a rate almost double that in the Middle East. Underreporting may be a factor, but the difference appears stark.

Nurses working in Asia and the Middle East are more likely to be attacked by relatives and friends of the patient, showing how prevention strategies need to be tailored to local circumstances.

Of course, if there is violence all around you, it will come into the hospital. In the first six months after the Henry Ford hospital in Detroit installed metal detectors, staff confiscated 33 handguns, 1,324 knives and 97 chemical sprays.

The emotional and physical impact on staff who have been attacked includes headaches, loneliness, irritability, anger, insecurity, sadness, low self-esteem, sleeping disorders, stress and depression. Staff can become fearful of patients and it can cause difficulties with colleagues and family. The psychological impact is often magnified by the feeling that their profession is not respected. Many need time off work. Some simply quit.

Patients also suffer. It takes extraordinary professionalism to refuse to allow an awful experience with one intoxicated patient to cloud judgment about the next, while there are serious risks inherent in a loss of empathy for psychiatric patients.

The marked increase in violence in the trusts in England under financial and performance pressure hints at how a fraught, tense working environment can put staff and patients on edge. It is easy to understand how combining long waits for patients with stressed staff trying to run a system only kept on the rails through frantic activity creates an atmosphere where tensions and frustration escalate to assaults.

Potentially even more traumatic are attacks on staff working in the community, often alone. At least in a hospital someone will come to your aid. A Royal College of Nursing survey revealed that half of community nurses felt vulnerable, one in 10 had been assaulted and less than a quarter said their managers always knew when they were working alone.

The government must face up to the issue of staff being attacked. It needs to start collecting data on assaults again (having stopped last year) and recognise that – just as much as financial returns or performance figures – it reveals where the NHS is under intolerable pressure.

Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views

If you’re looking for a healthcare job or need to recruit staff, visit Guardian Jobs

Rise in assaults on staff reveals intolerable pressure on NHS

The revelation of the sharp increase in attacks on NHS staff highlights a problem which is serious, global and growing.

The survey by the Health Service Journal and Unison showed assaults in 2016-17 were almost 10% up on the previous year, driven by big increases in hospitals that were missing treatment targets or seriously in debt. Staff in mental health trusts were more than seven times more likely to be attacked than those in other trusts.

The World Health Organization says health workers are at a high risk of physical violence all over the globe, and estimates that between 8% and 38% of staff in different countries suffer at some point in their careers. A study by the International Council of Nurses concluded that healthcare workers were more likely to be attacked at work than prison guards or police officers, and that female nurses were most at risk.

On top of these attacks during day-to-day work, healthcare staff dealing with health emergencies such as wars are in enormous danger. WHO figures indicate that over the two-year period to 2015, 959 such healthcare workers were killed and 1,561 injured across 19 countries.)

A global study by the University of South Florida found that attacks on nurses tended to be concentrated in emergency departments and geriatric and psychiatric units. What unites these areas is that staff are working with patients who are in pain or distress, anxious and likely to feel that they have lost control of their lives. The author pointed out that geriatric and psychiatric patients are more likely to have poor impulse control.

This study uncovered striking differences across the world, with the highest rate of attacks occurring in the “anglo” countries, which included Australia, Canada, England, Ireland, New Zealand, Scotland and the US, at a rate almost double that in the Middle East. Underreporting may be a factor, but the difference appears stark.

Nurses working in Asia and the Middle East are more likely to be attacked by relatives and friends of the patient, showing how prevention strategies need to be tailored to local circumstances.

Of course, if there is violence all around you, it will come into the hospital. In the first six months after the Henry Ford hospital in Detroit installed metal detectors, staff confiscated 33 handguns, 1,324 knives and 97 chemical sprays.

The emotional and physical impact on staff who have been attacked includes headaches, loneliness, irritability, anger, insecurity, sadness, low self-esteem, sleeping disorders, stress and depression. Staff can become fearful of patients and it can cause difficulties with colleagues and family. The psychological impact is often magnified by the feeling that their profession is not respected. Many need time off work. Some simply quit.

Patients also suffer. It takes extraordinary professionalism to refuse to allow an awful experience with one intoxicated patient to cloud judgment about the next, while there are serious risks inherent in a loss of empathy for psychiatric patients.

The marked increase in violence in the trusts in England under financial and performance pressure hints at how a fraught, tense working environment can put staff and patients on edge. It is easy to understand how combining long waits for patients with stressed staff trying to run a system only kept on the rails through frantic activity creates an atmosphere where tensions and frustration escalate to assaults.

Potentially even more traumatic are attacks on staff working in the community, often alone. At least in a hospital someone will come to your aid. A Royal College of Nursing survey revealed that half of community nurses felt vulnerable, one in 10 had been assaulted and less than a quarter said their managers always knew when they were working alone.

The government must face up to the issue of staff being attacked. It needs to start collecting data on assaults again (having stopped last year) and recognise that – just as much as financial returns or performance figures – it reveals where the NHS is under intolerable pressure.

Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views

If you’re looking for a healthcare job or need to recruit staff, visit Guardian Jobs

Rise in assaults on staff reveals intolerable pressure on NHS

The revelation of the sharp increase in attacks on NHS staff highlights a problem which is serious, global and growing.

The survey by the Health Service Journal and Unison showed assaults in 2016-17 were almost 10% up on the previous year, driven by big increases in hospitals that were missing treatment targets or seriously in debt. Staff in mental health trusts were more than seven times more likely to be attacked than those in other trusts.

The World Health Organization says health workers are at a high risk of physical violence all over the globe, and estimates that between 8% and 38% of staff in different countries suffer at some point in their careers. A study by the International Council of Nurses concluded that healthcare workers were more likely to be attacked at work than prison guards or police officers, and that female nurses were most at risk.

On top of these attacks during day-to-day work, healthcare staff dealing with health emergencies such as wars are in enormous danger. WHO figures indicate that over the two-year period to 2015, 959 such healthcare workers were killed and 1,561 injured across 19 countries.)

A global study by the University of South Florida found that attacks on nurses tended to be concentrated in emergency departments and geriatric and psychiatric units. What unites these areas is that staff are working with patients who are in pain or distress, anxious and likely to feel that they have lost control of their lives. The author pointed out that geriatric and psychiatric patients are more likely to have poor impulse control.

This study uncovered striking differences across the world, with the highest rate of attacks occurring in the “anglo” countries, which included Australia, Canada, England, Ireland, New Zealand, Scotland and the US, at a rate almost double that in the Middle East. Underreporting may be a factor, but the difference appears stark.

Nurses working in Asia and the Middle East are more likely to be attacked by relatives and friends of the patient, showing how prevention strategies need to be tailored to local circumstances.

Of course, if there is violence all around you, it will come into the hospital. In the first six months after the Henry Ford hospital in Detroit installed metal detectors, staff confiscated 33 handguns, 1,324 knives and 97 chemical sprays.

The emotional and physical impact on staff who have been attacked includes headaches, loneliness, irritability, anger, insecurity, sadness, low self-esteem, sleeping disorders, stress and depression. Staff can become fearful of patients and it can cause difficulties with colleagues and family. The psychological impact is often magnified by the feeling that their profession is not respected. Many need time off work. Some simply quit.

Patients also suffer. It takes extraordinary professionalism to refuse to allow an awful experience with one intoxicated patient to cloud judgment about the next, while there are serious risks inherent in a loss of empathy for psychiatric patients.

The marked increase in violence in the trusts in England under financial and performance pressure hints at how a fraught, tense working environment can put staff and patients on edge. It is easy to understand how combining long waits for patients with stressed staff trying to run a system only kept on the rails through frantic activity creates an atmosphere where tensions and frustration escalate to assaults.

Potentially even more traumatic are attacks on staff working in the community, often alone. At least in a hospital someone will come to your aid. A Royal College of Nursing survey revealed that half of community nurses felt vulnerable, one in 10 had been assaulted and less than a quarter said their managers always knew when they were working alone.

The government must face up to the issue of staff being attacked. It needs to start collecting data on assaults again (having stopped last year) and recognise that – just as much as financial returns or performance figures – it reveals where the NHS is under intolerable pressure.

Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views

If you’re looking for a healthcare job or need to recruit staff, visit Guardian Jobs