The number of violent or abusive incidents against NHS staff has jumped by almost a third.

Figures from the Department of Health show there were 84,273 attacks against doctors, nurses and other staff in England between April 2000 and March 2001.

This compares to 65,000 reported incidents during the previous 12 months.

More and more nurses are reporting incidents of violence

Carol Bannister, Royal College of Nursing

However, the sharp rise could be due to changes in the way the statistics are collected.

In 1999, NHS employers varied on what they classed as a violent incident.

In one trust, a violent incident might include verbal abuse, while in another it might be excluded.

Zero tolerance

The Department of Health introduced new guidelines in 2000 to ensure the reporting process was the same across the NHS, introducing firm definitions of what constituted violent or abusive incidents.

Ministers have pledged to reduce incidents of violence against NHS staff by 20% by 2002. Those figures will be published next year.

The government launched a zero tolerance campaign to combat violence against NHS staff in October 1999.

Last year, Health Secretary Alan Milburn announced new rules under which persistently violent and abusive patients would face being banned from receiving NHS treatment for up to a year.

A Department of Health spokeswoman said the increase in figures in 2001 was partly due to better reporting of incidents.

"Historically there has been significant under reporting of violence directed at staff working in the NHS," she said.

"With support from the health trade unions, one of the key objectives of the government's NHS zero tolerance zone campaign has been to improve rates of reporting amongst staff."

Policy review

She added that officials were now looking at whether the guidelines on withdrawing treatment from violent and abusive patients now needed to be strengthened in light of the latest figures.

In addition, NHS Zero tolerance guidance will be updated to state that trusts should consider whether to bring a prosecution against an individual in cases where the Crown Prosecution Services decides not to.

The Royal College of Nursing said it was saddened by the figures.

Carol Bannister, RCN occupational health adviser, said: "We know that more and more nurses are reporting incidents of violence and must make sure they have all the help and support they need when such incidents occur."