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 the 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 more than 35,000 alert devices in consultations and more than 7,500 individual alarms. Along with this, there is a significant push for training and capacity building for professionals to deal with these episodes.
In this way, a total of 136,754 professionals have completed the Course on Control in Conflict Situations and 55,285 professionals have participated in the Course on 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 that aims to accompany, advise on procedures, and support the worker who suffers an aggression. It is also worth mentioning the editions of face-to-face workshops that are carried out in districts, health management areas, and hospitals, which since their inception in 2017 have involved the participation of nearly 1,300 professionals.
All these awareness-raising and knowledge measures of the Prevention and Care Plan for Aggressions, updated in 2020, with a clear message of zero tolerance, are allowing for a better record of the different episodes. In this way, along with physical aggressions, verbal aggressions of different intensities including shouts and insults are being counted, as well as aggressions by patients with cognitive impairment or mental health problems.
The Plan also provides quick and agile channels for the person who suffers an aggression, whether verbal or physical, not to be alone moments after being attacked. In addition, 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 exercise of their public function is considered a crime of assault by the courts, and sentences have been handed down in different cases with penalties ranging from 12 months to 3 years in prison. In fact, in 2024, SAS lawyers provided assistance in 197 cases, obtaining 94 convictions, 34 of them 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 delegations, SAS central services, and the Department of Health and Consumer Affairs, providing continuous information to trade unions.
Aggressions Registry Data
According to the Registry of Aggressions in Centers (RIAC), in 2024 there were a total of 362 physical aggressions (19.4% of the total) and 1,504 non-physical aggressions to professionals in public health centers in Andalusia. Of the total reported aggressions, 47.48% took place in hospitals and 52.52% in Primary Care centers. Following the guidelines of the plan, cases of physical violence or serious threats caused by psychiatric patients or those with cognitive impairment are considered as aggression; however, a system has been established to filter them out and provide differentiated treatment, both in the registry and in subsequent actions. Thus, of the total reported aggressions, more than 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, Almeria recorded 20 physical aggressions and 141 non-physical aggressions; Cadiz 61 physical (282 non-physical); Cordoba, 36 physical (126 non-physical); Granada 45 physical (149 non-physical); Huelva, six physical (60 non-physical); Jaen, 24 physical (120 non-physical); Malaga, 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 different hospitals and healthcare centers throughout Andalusia to join on March 12th the European Day against Aggressions to Healthcare Professionals by conducting a reading of the Institutional Declaration that was sent to centers last year, with the aim of demonstrating full and explicit commitment to professionals and zero tolerance for aggressions in this healthcare field through a common message.