Image copyright CVUHB Image caption Cardiff's University Hospital of Wales has the busiest Welsh A&E unit

Hospital staff in Wales were physically attacked more than 18,000 times while at work, figures for the last five years have revealed.

The Freedom of Information data showed there were also 11,000 verbal assaults.

But, by comparison, there were fewer than 4,000 physical and verbal attacks on all other emergency service workers combined over the same period.

Groups representing doctors and nurses said the figures were unacceptable and a matter of concern.

Peter Meredith-Smith, associate director for employment relations at Royal College of Nursing in Wales (RCN), said: "The issue of aggression towards frontline NHS staff is longstanding.

"It may not necessarily mean its getting worse, it may be the reaction of the system is getting better, it may be the reporting is better, staff are being supported more to report these issues and address them.

"But it's clearly a matter of concern that frontline clinical staff are being subjected to this sort of behaviour on a regular basis."

'I don't come to work to be abused'

A nurse working in a south Wales emergency department, who was throttled by a patient, believes more needs to be done.

"I have been threatened a couple of times," said the nurse, who did not want to be identified.

"We know if the police are attacked, then it's zero tolerance, there is automatic prosecution.

"The posters go up saying 'zero tolerance' but I don't think there is. I think there has to be a concerted effort across the health boards across Wales.

"It can happen on a weekly basis, it can happen on a daily basis, it varies.

"I don't come to work to be abused, I come to work to care for the patients - the sick and ill."

Media playback is unsupported on your device Media caption Peter Meredith-Smith believes improvements are being made

Mr Meredith-Smith said there was a joint memorandum of understanding in place with the Welsh Government, Association of Chief Police Officers and NHS on how to help frontline staff and to deal with perpetrators.

He said there was evidence of improvements in protecting staff, but accepted there was "always more to do".

But Dr Phil Banfield, chairman of the BMA said the figures needed to be put into context.

"The misuse of alcohol has a significant impact on violence within emergency departments and it is clear that more needs to be done, outside of medical settings, to reduce rates of alcohol abuse," he said.

Dr Banfield added: "Additionally, assaults can occur when treating frail, older dementia patients or in those with severe mental health conditions.

"These incidents may be attributed to these patients being inappropriately admitted to acute settings because of bed shortages and gaps in social care provision, aggravated by staff shortages and resource shortfall."

He said: "We must move away from only blaming patients and look again at how the health and social care system may contribute to the reasons behind why assaults occur."

The Welsh Government said "significant progress" has been made to encourage reporting incidents so prosecutions can be brought as attacks "will not be tolerated".

Health boards' reaction

All health boards said staff are encouraged to report assaults and had received appropriate training.