77,000 physical assaults on NHS staff per year. Most happen in front of cameras that are not watching.

The NHS recorded 77,000 physical assaults on staff in 2022/23. A&E departments, psychiatric wards, mental health units and reception areas account for the majority, but incidents occur across the full estate. Most happen in areas with CCTV coverage. The cameras record what happened. They are not configured to detect what is about to happen.

Pre-aggression in healthcare follows observable patterns: escalating vocal behaviour, pacing, narrowing proximity to staff, arm and posture changes. Security teams and ward staff are trained to recognise these signals, but they cannot maintain that monitoring across a large A&E department simultaneously while also responding to patients.

Restricted area access is a separate but related problem. Clinical areas, medication rooms, equipment stores and server rooms require controlled access. Tailgating through secured doors, loitering near access-controlled zones and unusual movement patterns in restricted areas are all detectable signals that standard access logging does not capture.

Patient safety monitoring in wards, particularly for vulnerable patients at fall risk or patients at risk of self-harm, requires a level of continuous attention that staffing ratios cannot sustain. Detection that alerts staff to a stationary or unusual-posture patient provides a response layer that passive recording cannot.