Security staff at Waitemata District Health Board are being issued camera vests after a surge in reported violence including a nurse being strangled and staff members being punched in the face and one needing surgery after an assault.

A review is underway after 186 aggression incidents were reported by staff in June - an average of six attacks a day - up from 45 in June last year.

But Waitemata DHB says there has been no increase and the spike noted in the August Board report was due to "additional reporting".

However, several unions the Herald spoke to yesterday confirmed the severity of the issue, saying the "DHB are not taking it seriously enough".

Some of the incidents the unions described from the last six months at North Shore Hospital and Waitakere Hospital included:

• A nurse being strangled by a patient.

• A staff member needing surgery after being seriously injured by a patient.

• A security guard breaking his leg trying to de-escalate a violent patient.

• A patient punching five staff members at North Shore Hospital's ED.

• Patients punching holes in walls.

• Threats made by patients with weapons to staff.

• A health care assistant being kicked in the groin.

Public Service Association organiser Ian Gordon, who has been working with the DHB on this issue for the last 14 months, said PSA and New Zealand Nurses Organisation expressed their concerns in a letter to the Accident Compensation Corporation (ACC). The letter was copied to the DHB.

"We have raised, and remain significantly concerned, about the observed reported incidents of violence and aggression that are experienced by our members from patients.

"There have been a number of serious incidents and, while reporting continues to improve, the trend lines continues to rise sharply," the letter signed by Gordon and Andy Hipkiss from NZNO wrote.

Gordon said PSA and NZNO had been having regular meetings with the DHB but progress to get any action was very slow.

"The DHB are more focused on recording the incidents and less on prevention. We think there needs to be a lot more focus on how do deal with very violent people because it's not if but when this could become fatal."

But he said the letter seemed to be a wake-up call and the DHB had responded by increasing security guards on a temporary basis and introducing new safety gear.

As of September 1, security and traffic staff at Waitemata DHB started wearing
cameras on their vests as part of a plan to de-escalate potential incidents.

Body cameras are already being used by some prison officers, police and parking wardens for the same purpose.

Waitemata DHB's director of hospital services Cath Cronin said investment in proactive security measures aimed at de-escalating aggressive situations and made efforts to provide a safe environment for staff, patients and whanau.

"This includes use of CCTV cameras, security alert systems for hospital staff and community workers, and rostering a security guard in the Emergency Department.

"All staff are expected to complete the basic training package and frontline staff such as ED nurses have additional training," Cronin said.

Despite this, a statement from Waitemata DHB said the board rejected any suggestion that incidents of aggression towards staff had increased.

When staff report incidents there are a list of categories they can select and a category called "security incidents" involving staff and patients was not being included in the Board report, a Waitemata DHB spokeswoman told the Herald.

The spokeswoman denied that these missed figures, released to the board and public, were a misrepresentation as "they were still being reported" and "the Board was given other documentation."

But Gordon said due to a reduction in staffing numbers, a lack of security and a normality that it's "just the nature of the business" it was a problem that would continue to rise.

NZNO's Hipkiss said one of the reasons for the increase in incidents was due the emergency department becoming a "dumping ground" for people who are drunk, on drugs and struggling with mental health issues.

"Police are bringing them in with no warning and the ED staff are not trained to deal with it.

"We keep raising this issue but due to a tight budget and low staffing it's becoming a really serious issue."

The Herald approached the police for comment at midday yesterday and has yet to receive a response.

New Zealand Resident Doctors' Association national secretary Dr Deborah Powell said violence against staff was a major issue across all Auckland hospitals.

"I think you will probably see that the Auckland region is the worse and that's because demand has just gone through the roof."

An Auckland DHB spokeswoman said they were actively training staff in how to best work with people who are behaving in an aggressive or violent manner.

"We are in the process of considering whether new forms of equipment would be of benefit in helping reduce incidences of aggression and violence," the spokeswoman said.

Acting Minister of Health Jenny Salesa told the Herald in July her expectation was that, as the employers of hospital staff, DHBs took steps to ensure their employees could get on with their work in safety.

"Any violence in the workplace is unacceptable, particularly when it is directed at hard-working and dedicated hospital staff."