The Andalusian Health Service (SAS) continues to work on the implementation of initiatives aimed at addressing aggressions and improving support and care for professionals who are victims of these acts. Among the measures, the implementation of security devices in healthcare centers stands out, with a total of 53,700 devices by the end of 2024. Of these, more than 4,400 were security cameras, in addition to over 35,000 alert devices in consultations and more than 7,500 individual alarms. Along with this, there is a significant focus on training and capacity building for professionals to be able to deal with these incidents.
In this way, a total of 136,754 professionals have completed the Control in Conflict Situations Course and 55,285 professionals have participated in the Prevention and Care Plan against Aggressions to Professionals of the public health system in Andalusia. In addition, 872 professionals have already been trained as ‘Guide Professionals’, a key figure with the objective of accompanying, advising on procedures, and supporting the worker who has suffered an aggression. It is also worth noting the editions of in-person workshops that are carried out in districts, healthcare management areas, and hospitals, which since they started in 2017 have had the participation of nearly 1,300 professionals.
All these awareness and knowledge measures of the Prevention and Care Plan for Aggressions, updated in 2020, with a clear message of zero tolerance, are allowing a better recording of the different incidents. In this way, along with physical aggressions, verbal aggressions of different intensities including shouts and insults are being counted, as well as aggressions carried out by patients with cognitive impairment or mental health problems.
The Plan also provides quick and efficient channels for the person who has suffered an aggression, whether verbal or physical, to not be alone moments after being attacked. Additionally, psychological support is provided for as long as necessary and legal advice for those who decide to report. Physical aggression or serious intimidation against healthcare professionals in the performance of their public function is considered a crime of assault by the courts, and sentences have been issued in various cases with penalties ranging from 12 months to 3 years in prison. In fact, in 2024, SAS lawyers provided 197 assists, obtaining 94 convictions, 34 of which were classified as assault crimes.
All these actions and many others included in the SAS Aggressions Prevention and Care Plan are always carried out under close collaboration and coordination between healthcare centers, Health and Consumer Affairs delegations, SAS central services, and the Ministry of Health and Consumer Affairs, providing continuous information to trade unions.
Aggressions registry data
According to the Centers’ Aggressions Computer Registry (RIAC), in 2024 there were a total of 362 physical aggressions (19.4% of the total) and 1,504 non-physical aggressions against professionals in public healthcare centers in Andalusia. Of the total recorded aggressions, 1,866, 47.48% took place in hospitals and 52.52% in Primary Care centers. Following the plan’s guidelines, cases of physical violence or serious threats caused by psychiatric patients or those with cognitive impairment are considered aggression; however, a system has been established for these cases to be filtered and receive differentiated treatment, both in the registry and in subsequent actions taken. Thus, of the total recorded aggressions, over 20% (20.3%) are committed by individuals with mental health problems or cognitive impairment, a percentage that rises to 51.6% when it comes to physical aggressions.
By provinces, Almería reported 20 physical aggressions and 141 non-physical; Cádiz 61 physical (282 non-physical); Córdoba, 36 physical (126 non-physical); Granada 45 physical (149 non-physical); Huelva, six physical (60 non-physical); Jaén, 24 physical (120 non-physical); Málaga, 69 physical (249 non-physical), and Seville, 101 physical (378 non-physical).
By gender, women are the most targeted (72.45% of the total); by professional profile, almost 80% of aggressions are directed at healthcare personnel, mainly professionals in medicine and nursing.
The Andalusian Health Service has invited professionals from various hospitals and healthcare centers throughout Andalusia to join on March 12th the European Day against Aggressions to Healthcare Professionals by reading the Institutional Declaration that was sent to centers last year, with the aim of demonstrating total and explicit commitment to professionals and zero tolerance against aggressions in this healthcare field through a common message.