In England, violence and abuse against ambulance staff have been increasing annually, with many incidents not leading to prosecution, and causing harm to staff and costs for the ambulance service. To address this issue and ensure frontline staff feel supported, a national pilot project trialling body-worn cameras (BWCs) in ambulance services across England was introduced in 2021 by NHS England.

RAND Europe was commissioned to conduct an evaluation of this project. Over a three-year period (2021 to 2024), we conducted a literature review, two surveys with ambulance staff, two site visits to ambulance stations, analysis of the NHS Staff Survey, analysis of data on BWC use and reporting of incidents, and interviews and focus groups with frontline staff, ambulance trusts project managers, NHS leaders, members of the public and trade union representatives.

Our findings suggest that BWCs are just one small part of a broader system of policies and practices aimed at reducing violence and aggression. Their effectiveness depends on the specific circumstances in which they are used, such as workplace culture and supportive management, which are often beyond the programme's control. Local factors can either enhance or hinder the impact of BWCs, leading to uneven and variable outcomes over time, which is to be expected in such complex systems. Therefore, to answer the question 'do BWCs reduce violence against staff?' we looked at the broader conditions under which BWCs are more likely to be successful and provided recommendations to enhance these conditions.