MORE than 20 acts of violence and aggression are recorded every day against NHS staff in Wales - and health bosses must do more to help protect their employees, according to a new report.

NHS trusts spend more than £1 million a year training staff to deal with the threat of violence, but difficulties with sharing information on known offenders, and in releasing staff for training are causes for concern, says the Wales Audit Office.

It has warned, too, that the number of incidents could be higher because of under-reporting, while comparisons are difficult due to the different sizes of Wales' 15 NHS trusts, and the different definitions they use of violence and aggression.

Gwent Healthcare Trust reported 882 cases out of almost 8,000 Wales-wide during 2003/04, the latest available figures.

This was the fourth highest incidence in Wales. Cardiff and Vale, the biggest trust, reported 1,683 incidents over the same period.

Half of all incidents of violence and aggression occur in the mental health, general medicine and learning disabilities sectors and overall, nurses, midwives and health visitors suffer most, according to the report, entitled Protecting NHS Trust Staff from Violence and Aggression.

In Gwent, £183,128 has been spent in the three years to 2004/05 on training staff to deal with violence and aggression, out of a total of £3.1m Wales-wide over the same period.

The report singles out for praise Gwent Healthcare Trust's development of an online personal safety training package, allowing staff to complete their training at a time convenient for them, and useful for courses with no physical components.

The report recommends that the Assembly and NHS trusts strengthen their arrangements for reporting and recording incidents.

Once robust systems are in place, levels of violence and aggression should be monitored. Access to staff training should also be improved. Auditor General for Wales Jeremy Colman said improving staff safety is already a high priority for the Assembly and trusts.

"But improvements need to be made to the handling of incidents, the provision of training, and inter-agency working, so NHS staff in Wales can continue to carry out the vital work they do, without fear of intimidation and attack," he said.