London Ambulance Service has highlighted the lasting impact of reported sexual abuse on staff, alongside its campaign figures.

The figures

The 462 reports were publicised in October and repeated in the service’s November campaign reporting.

Reported behaviour included sexual threats, unwanted touching, indecent exposure and explicit comments.

Importantly, the problem is not confined to ambulance crews. Telephone staff also experience sexual harassment while trying to help callers.

London Ambulance Service has a dedicated Violence Reduction Unit that supports employees, helps gather evidence and works with police and prosecutors.

The law: What changed on 30 October 2026?

The Employment Rights Act 2025 has strengthened employers’ responsibilities under the Equality Act 2010.

Two changes are particularly important.

1. Employers must take all reasonable steps to prevent sexual harassment.

Section 20 of the Employment Rights Act 2025 amended section 40A of the Equality Act 2010.

The previous requirement to take “reasonable steps” has been strengthened to “all reasonable steps”.

This is a proactive duty. Employers should identify foreseeable risks and take reasonable preventive measures before harassment occurs, rather than relying solely on procedures for dealing with complaints afterwards.

2. Employers can be liable for harassment by third parties.

Section 21 of the Employment Rights Act 2025 amended section 40 of the Equality Act 2010.

It introduces employer liability where an employee experiences harassment by a third party in the course of employment and the employer has failed to take all reasonable steps to prevent it.

Third parties can include patients, service users, tenants, customers, contractors and members of the public.

The provision covers sexual harassment and harassment related to protected characteristics within the scope of the Equality Act 2010.

Not every abusive or offensive incident meets the legal definition of harassment. However, other threatening or aggressive behaviour may still require action under health and safety law.

These provisions apply in England, Wales and Scotland, but not Northern Ireland.

What does this mean for employers?

The Equality and Human Rights Commission’s updated guidance makes clear that employers should consider risks associated with the work their employees undertake.

Depending on the circumstances, reasonable preventive steps may include:

• Assessing sexual harassment risks in different roles and working environments.
• Providing practical, behaviour-based training.
• Reviewing lone working arrangements where harassment risks have been identified.
• Establishing clear reporting and investigation procedures.
• Taking appropriate action when concerns are raised.
• Reviewing whether existing measures are effective.

The steps required will depend on the organisation, the risks and what it is reasonable for that employer to do.

Training is an important preventive measure, but training alone does not necessarily demonstrate compliance with the duty.

University Hospitals of Derby and Burton NHS Foundation Trust introduced a structured warning system to address intentional violence and abuse towards employees.

The trust reported more than 2,600 incidents of violent and aggressive behaviour during 2024–25.

Its staff survey also found that one in four respondents had experienced physical violence from patients, relatives or members of the public.

How the system works

The trust’s approach includes verbal warnings, written warnings and, in serious or repeated cases, panel consideration of exclusion from trust premises and withholding non-emergency treatment.

A yellow-card warning can be issued formally and recorded. Where behaviour continues, a panel considers the circumstances before deciding whether further restrictions are appropriate.

A red-card decision is not automatic.

The trust says its sanctions do not apply to vulnerable patients whose complex health needs lead to aggressive behaviour for which they are not at fault, including patients with no capacity or insight into their behaviour. These patients are supported differently.

Any restrictions must protect patient safety and essential care. This is not a blanket right to refuse necessary treatment.

The trust also uses a reporting and support pathway known as DARSE: Detect, Act, Report, Support and Evaluate.

The legal responsibilities

Under section 2 of the Health and Safety at Work etc. Act 1974, employers must ensure, so far as is reasonably practicable, the health, safety and welfare of employees at work.

This includes protecting staff from foreseeable work-related violence and aggression.

The Management of Health and Safety at Work Regulations 1999 require employers to assess workplace risks and put appropriate arrangements in place to manage them.

Regulation 3 requires suitable and sufficient risk assessments. Regulation 5 requires effective arrangements for planning, organising, controlling, monitoring and reviewing preventive measures.

Where abuse amounts to sexual harassment or harassment covered by the Equality Act 2010, the strengthened provisions introduced by the Employment Rights Act 2025 may also apply.

The important distinction is that not every incident of violence or verbal abuse is unlawful harassment under the Equality Act, but it may still present a significant workplace safety risk.

Why this matters beyond the NHS

Housing associations, councils, charities and other public-facing services regularly deal with difficult situations.

Some involve frustration or distress. Others involve deliberate threats, intimidation or repeated abuse.

Organisations need clear arrangements for responding appropriately while continuing to meet their legal, safeguarding and service responsibilities.

The NHS approach provides an example of how responsibilities, warnings, decisions and staff support can be connected.

It is not a system that should simply be copied into every workplace.

Research published by UNISON in June 2026 raises serious concerns about the safety of social workers carrying out home visits.

The survey, involving almost 1,800 social workers, found that abuse was common during both lone and joint visits.

The findings

The figures reflect the experiences of survey respondents. They are not a national estimate of abuse affecting every social worker.

UNISON also found that 92% of respondents said their employers regarded lone home visits as normal practice.

Staff shortages and increasing service demands were frequently identified as reasons for more lone visits.

The problem with unreported abuse

Incident reporting is an important part of workplace risk management.

But what happens when employees stop reporting threats because they believe nothing will change?

Managers may be unaware of repeated problems involving particular individuals, addresses or activities.

Risk assessments may then be based on incomplete information, leaving other colleagues without important warnings.

The research also identified online harassment, demonstrating that work-related abuse can continue after a visit has ended.

These findings have clear relevance for housing officers, social care workers, council employees and charity staff.

The legal responsibilities

The Health and Safety at Work etc. Act 1974 requires employers to protect employees from foreseeable risks, including work-related violence, so far as is reasonably practicable.

Under regulation 3 of the Management of Health and Safety at Work Regulations 1999, employers must assess the risks associated with work activities.

For home visits, this means considering the circumstances of the visit, previous incidents, available risk information and whether lone working is appropriate.

Regulation 8 also requires appropriate procedures for serious and imminent danger, while regulation 10 requires employees to receive relevant information about risks and preventive measures.

There is no general legal requirement for every home visit to involve two employees. However, where a risk assessment identifies that lone working is unsuitable, employers must put appropriate precautions in place.

The Employment Rights Act 2025 is also relevant where staff face sexual harassment or harassment by third parties that falls within the Equality Act 2010.

The strengthened duty to take all reasonable steps to prevent sexual harassment means employers should consider risks arising from visits to people’s homes, not only incidents occurring on their own premises.

An investigation by Inside Housing, published in August 2025, revealed the extent of violence and abuse recorded by housing providers during 2024.

The figures

The investigation also reported a 20% increase in recorded incidents among the local authorities compared with 2023.

These figures relate to the organisations that supplied information. They do not represent every housing provider or local authority.

The recorded categories include verbal and sexual incidents as well as physical assaults.

Inside Housing also identified improved reporting as one factor contributing to the increase.

This is an important distinction. More reports can reflect greater levels of abuse, improved reporting confidence or a combination of factors.

What should housing employers be looking for?

Incident records should help organisations recognise patterns.

For example, are particular addresses associated with repeated threats? Have several employees experienced intimidation from the same person? Are certain activities, such as rent arrears visits, enforcement action or discussions about anti-social behaviour, generating repeated concerns?

This information should inform risk assessments, staffing decisions, communication arrangements and training.

The legal responsibilities

Several pieces of legislation are relevant to protecting housing staff.

Health and Safety at Work etc. Act 1974, section 2

Employers must ensure the health, safety and welfare of employees at work, so far as is reasonably practicable. This includes protecting staff against foreseeable work-related violence.

Management of Health and Safety at Work Regulations 1999, regulations 3 and 5

Employers must assess risks and establish effective arrangements to manage, monitor and review workplace safety measures.

Employment Rights Act 2025, sections 20 and 21

Since 30 October 2026, employers must take all reasonable steps to prevent sexual harassment of employees.

Employers can also be liable for harassment by third parties where they have failed to take all reasonable steps to prevent it.

For housing associations, third parties may include tenants, residents, visitors, contractors and members of the public.

The third-party provisions apply to harassment covered by the Equality Act 2010, not every instance of rudeness, disagreement or verbal abuse.

Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR)

Certain injuries arising from work-related violence must be reported to the relevant enforcing authority.

These include specified injuries and physical injuries that prevent an employee from carrying out their normal work for more than seven consecutive days (excluding the day of the incident), subject to the reporting requirements.

Not every threatening or abusive incident is reportable under RIDDOR. However, employers should still record and investigate relevant incidents through their own procedures.

Staff may understand how to report an incident, but that alone does not mean they feel protected.

Effective workplace safety depends on more than written procedures.

Employees need access to relevant risk information, clear arrangements for obtaining assistance and confidence that their concerns will be taken seriously.

Managers need to understand their responsibilities, act on reports and check whether existing precautions remain suitable.

The Employment Rights Act 2025 has also strengthened employers’ legal responsibilities to prevent sexual harassment and introduced new third-party harassment protections.

Together with existing health and safety legislation, these duties reinforce the importance of identifying foreseeable risks, putting appropriate precautions in place and reviewing whether they work.

The question for every employer is straightforward: If a member of staff reported a serious threat tomorrow, would everyone involved know what to do next?