Rising expectations among hospital patients are being blamed for a 13 per cent increase in violent attacks on NHS staff.

The National Audit Office said that 95,500 incidents of violence and aggression were recorded in 2001/02, up from 84,500 in 1999/00.

Health minister John Hutton said that the government was committed to the NHS "zero tolerance zone campaign", launched in October 1999, which aims to stamp out violence against NHS staff.

Forum Response: GMB

Sharon Holder, national officer for health at the GMB, said: "It is unacceptable for any NHS worker to experience violence and aggression in the workplace.

"The support and training should include all support and ancillary staff because the report clearly identifies that anyone with direct interaction with patients is at risk.

"The porter, the clerical assistant and the person that serves tea are just as much at risk as others. To exclude them from the zero tolerance campaign puts them increasingly at risk of harm."

Kim Sunley, spokeswoman for health and environment at the GMB, added: "Far too often employers see violence as an acceptable part of the job but for our members, but being abused and threatened is far from acceptable and must not be tolerated.

"This report shows the level of incident going up instead of down. This trend must be reversed by all NHS trusts consistently applying zero tolerance and include all staff in proper training and support."

Forum Response: Royal College of Nursing

A spokesman for the RCN said: "The Royal College of Nursing welcomes today's findings in the National Audit Office report that progress has been made in protecting the safety of healthcare staff in the NHS and the acknowledgement that there is much more work to be done.

"The RCN itself has found that around one in three nurses have experienced some form of harassment or assault by their patients (2001-2002). Nurses are still reluctant to report violence as they do not feel confident action will be taken by their managers or police. The RCN is calling for improved support from managers and a consistent approach to prosecution.

"The RCN believes strongly that nurses have a right to be safe wherever they work and there must be greater improvements in providing staff with an environment where nurses feel supported and protected.

"In endorsing the government's zero tolerance zone campaign the RCN expects constant improvements to be made. In particular we will monitor how trusts comply with the recommendations of NAO report."