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Violence in the workplace is a major issue for healthcare providers. As a way to help staff manage, reduce or prevent violence from occurring, NHS Improvement asked RAND Europe to conduct an analysis of de-escalation training to support the development of this type of training within health settings. The study focused on individual skills-based training to help reduce workplace violence and assessed whether de-escalation training is effective in managing violence towards NHS staff, benefits and key methods used to provide training, key types of training and its content, and factors of success in deploying training. To answer the research questions the research team conducted a rapid evidence assessment (REA) of de-escalation training literature. Given the availability of existing reviews evaluating the efficacy of de-escalation training in healthcare settings, our approach was to perform a review of existing de-escalation training reviews and other individual skills-based approaches to aggression management within the last 10 years (2009–2019). The study found that training may help staff manage patient violence and aggression although de-escalation training may not in itself reduce the number of violent or aggressive incidents. Additionally, evidence shows de-escalation training contributes to a significant reduction in lost workdays, improved staff retention, reduced complaints, and reduced overall expenditure. Given these limitations, using comprehensive approaches to managing violence in the NHS may be more effective than de-escalation training alone. The quality of available evidence on de-escalation training is limited. Any efforts towards implementing de-escalation training would benefit from the inclusion of evaluation in their design.

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It is estimated that about 30 per cent of the global population is considered to be physically inactive. Such inactivity is of high concern when the physical and mental health benefits of physical activity are well established, and that research shows that regular physical activity is associated with lower onset rates of a range of disease conditions. Research also illuminates the stark fact that physical inactivity is associated with more than 5 million deaths every year. With the global rates of physical activity diminishing, and the associated costs to humankind increasing as a result, the insidious and dangerous nature of such global inactivity is becoming increasingly exposed. In recognition of this, and in order to explore how these high levels of physical inactivity drive cost in economies, the Vitality Group asked RAND Europe to conduct an economic analysis of the potential economic benefits associated with getting people to be more physically active. Using a multi-country computable general equilibrium (CGE) macroeconomic model, RAND Europe examined the potential global implications of insufficient physical activity and changes of physical activity levels at the population level across different countries. The overarching aim of the study was to explore the main economic costs of physical inactivity and to identify the key benefits to improving activity rates. By presenting this data via the three modelled scenarios, the consequence of higher inactivity compared to improved activity rates may be better understood.