Many NHS staff in this region have been the victims of abuse from patients and relatives, according to a major survey.Morale has also fallen at the region's ambulance trust, where staff say they do not understand their roles and where they fit in, and communication with senior management is poor.

Many NHS staff in this region have been the victims of abuse from patients and relatives, according to a major survey.

Morale has also fallen at the region's ambulance trust, where staff say they do not understand their roles and where they fit in, and communication with senior management is poor.

But at other trusts locally, job satisfaction is high and working conditions are improving.

Hospitals and health workers locally have some of the highest rates of violence or abuse from patients and relatives.

Staff at James Paget University Hospital in Gorleston, Queen Elizabeth Hospital in King's Lynn and West Suffolk Hospital in Bury St Edmunds were all more likely than the average to say they had suffered violence in the past year.

Fourteen to 15pc had been victims of violence, compared with 12pc nationally.

The Norfolk and Norwich University Hospital was average on violence levels, but 27pc of staff had suffered harassment or abuse from patients or relatives, which puts it in the worst fifth in the country.

NHS Norfolk was in the worst

fifth of primary care trusts for violence from patients or relatives. Ambulance staff suffer most violence, with 24pc reporting violence and 39pc harassment or abuse in the East of England - slightly below the national ambulance trust average.

The annual NHS staff survey was carried out between October and December by 160,000 workers from all 390 NHS trusts in the country. It is run by watchdog the Healthcare Commission and is one of the largest surveys of staff in the world.

The East of England Ambulance Trust did particularly poorly. On the 37 key measures, the trust was worse than the average of other ambulance trusts on 24, average on 11 and better than average on just two. Where the same question was asked in 2007, performance had generally got worse.

Staff were more likely than average to say they were thinking about leaving, and just 6pc said there was good communication between workers and senior management, compared with 10pc at other ambulance trusts.

Human resources director Seamus Elliott said: “The trust will now put together an action plan to address key matters arising from these results to help improve working lives, as these can have a positive impact on patient care.”

There are also concerns about the state of ambulances. In this region, 52pc of ambulance staff said vehicles were not in a good state of repair and 45pc said their vehicles were not a safe place to work - worse than the national figures.

Healthcare Commission chief executive Anna Walker said: “There are real lessons to be learnt from

this survey about leadership, management and teamwork.”