Published: 24/03/2005, Volume II5, No. 5947 Page 24

Too few frontline staff believe they are being protected effectively against harassment, abuse and violence. That is the clear message emerging from this week's massive staff survey by the Healthcare Commission (news analysis, pages 14-15).

Less than half of staff believed their managers were taking the issues seriously enough - this at a time when more than a quarter were harassed or abused last year.

Lack of confidence is shown in the fact that only half of those affected say they reported incidents. No wonder the numbers of staff reporting stress and work-related illness remains so high.

It is important to look at the large percentage of 'do not knows' on these questions. Perception is vital: if staff do not know you are taking it seriously, you are not taking it seriously. Ambulance trusts perform particularly badly on this.

No decent manager dismisses these figures, but the danger is that a certain level of harm done to staff is accepted as part of a job in the modern NHS. That is not good enough: the challenge this year is to change those scores and show zero tolerance of abuse and violence.