The promises of 'zero tolerance'have come to nothing, so is it time for an NHS police force to protect staff from attacks, asks Alison Moore

The government's pledge of 'zero tolerance' to those who attack healthcare workers hasn't done much for NHS workers involved in 65,000 violent incidents each year.

Staff are often in vulnerable positions, dealing one-to-one with distressed, angry and drunk patients. So has the time come for the NHS to have its own police force?

One man who thinks so is Chris Doherty, security services manager at King's College Hospital trust in south London.

His civilian security staff are featured in a Channel 4 documentary next week as they battle against the everyday problems of a big inner-city hospital.

Security staff at King's expect to have around 800 incidents reported to them this year.

Although most will involve verbal abuse rather than physical violence, they have already dealt with eight incidents involving knives, 11 assaults involving actual bodily harm and 35 more minor assaults.

A staff survey last autumn suggested that reported incidents may be the tip of an iceberg , with the true number of incidents close to 9,000. Accident and emergency is the obvious flashpoint, with the peak time for incidents around 1am - suggesting drink may have a great deal to do with it. But 'car park rage' is also common.

Mr Doherty points out that the royal parks, the railways system and harbours all have their own police forces. 'While we are keen to prevent criminal activity in parks and on trains, we appear to be disinclined to provide similar levels of support and protection to NHS workers, ' he says.

So what difference would having an NHS police force make? Mr Doherty points to the extra powers police officers have which would help them deal with incidents.

Civilian security staff only have the powers of an ordinary person in dealing with a crime.

'We will restrain people in A&E while waiting for the police. We will have a team of five security officers sitting on a person and they have to wait for the police to arrive with the handcuffs, ' he says. 'That ties up our staff.'

Greater powers would not only allow them to handcuff people and remove them to a secure spot earlier, it would free staff to deal with other incidents and reduce the disruption and distress caused to other hospital staff and patients.

Having a resident police force would also make it easier to follow up incidents, taking statements and initiating further action, sending a strong message about how violence is viewed by the NHS and offering reassurance and advice to staff and patients.

But Mr Doherty also thinks an NHS police force would encourage recruitment and retention of skilled staff.

Security services are currently either provided in-house - as at King's - or through a contract with a security firm. Such services are always living under a Damoclean sword of losing the contract, which can lead to low morale and even resignations. An NHS police force would offer job security for staff, high-quality training and career progression, and would also ensure that staff are properly vetted.

And, as he points out, 'policing' the NHS cannot be compared with watching over an empty building site or other jobs undertaken by security firms.His staff require tact, diplomacy and a sense of humour to deal with the varied situations they encounter - from worried patients angry at waiting times in A&E to a row over a parking space.

They are dealing with people who may be drunk and drugged, mentally ill, or simply worried and stressed.

A national system could also lead to an equitable provision of services across the country.Mr Doherty says he is lucky in that King's has made significant investments in both staffing and equipment, but this is not always the case in equivalent trusts.

But he admits extending such services outside hospitals to the broader NHS may be difficult.

Primary care services could not be adequately supported and might still need to call on their local forces, he agrees.

'But simply providing the same service for the NHS as is currently provided for the railways would mean five police officers and one civilian member of staff for every community and primary care trust in the UK, ' he says. 'The time has surely come to provide nurses, doctors and healthcare workers with an NHS police force.'