WITH demanding targets, stressful working conditions and long hours, NHS staff have a lot on their plates at the best of times.

Even with co-operative patients, hospital and ambulance workers are under pressure.

However, it is becoming disturbingly common for them to end up patients themselves, as they encounter rising levels of violence.

A report from the National Audit Office published last week revealed that there was a 13 per cent increase nationally in the number of incidents of violence and aggression in 2001-2002.

Staffing levels are at a critical level across the country, and the NHS can ill afford for workers to be off sick because of violence in the workplace.

The rise in the number of incidents has been partly attributed to better awareness of reporting, with staff being urged not to accept even verbal abuse at work.

However, despite the NHS zero tolerance campaign, and anti-violence policies put in place by hospital trusts, workers would appear to be more at risk than ever before.

Patients are becoming frustrated by longer waiting times and expect more from the NHS, and society is becoming more aggressive generally.

There is a feeling that, despite the rise in incidents, the latest figures do not tell the whole story.

Some staff still do not report incidents, either because they feel nothing will be done, or, as Worcester ambulance workers' UNISON representative Pete Green suggested, they simply feel they should cope with them as part of the job.

In a city like Worcester, health workers may not be exposed to the same levels of violence as those in the country's bigger cities, but Friday and Saturday nights bring the same problems everywhere.

Ambulance workers often bear the brunt of alcohol-related incidents as clubs and bars close in the early hours of the morning.

Hereford and Worcester Ambulance Trust ambulance driver Andy Kibble believes some ambulance workers are mistaken for police officers when they arrive at the scene, despite only going to help.

The regular violence and aggression has a considerable effect on staff, even if they are not physically injured.

"It affects the morale of staff," said Doug Holloway, assistant locality manager at Worcester ambulance station.

"When they go to incidents in the city centre, they don't know what's going to happen to them.

"We want the public to realise that we are out to help them. We're just here to help injured people."