Emergency department doctors at two Auckland hospitals are warning someone could be killed or seriously injured if security is not improved.

The senior doctors at North Shore and Waitākere hospitals have written to their bosses this month, pleading again for a dedicated security guard.

Their union said on a single day earlier this year, a doctor was punched, a patient in a wheelchair was punched, and police brought in a man in a spithood, but security often had to come from elsewhere in the hospital.

In the letter, the doctors, known as SMOs, said the violence and aggression experienced by front-line staff was getting worse.

“SMOs believe death or serious injury from a violent incident in NSH [North Shore Hospital] and WTK [Waitākere Hospital] EDs is an imminent short-term risk,” they said.

They asked for a dedicated security team to try to reduce the risk, something they — and nurses — had repeatedly asked for.

Currently, each hospital is covered by a team of up to five guards. The doctors said they valued them highly.

“However, at present, this security service is not adequately resourced and often not available to respond immediately to incidences of violence and aggression at the EDs,” they said.

Association of Salaried Medical Specialists executive director Sarah Dalton said the assault on the doctor happened earlier this year, but violence and aggression were now a daily occurrence.

The doctor had stepped in as an agitated patient headed to the ambulance bay, where several elderly and sick patients were waiting.

“The doctor went to see if they could get that patient back and make sure that any vulnerable patients were kept safe by shutting a door, so the patient then turned around and punched the doctor,” Dalton said.

They were not seriously injured but were very shaken and went home early.

One medical staff member told RNZ they could not understand why the security request was not being granted by Te Whatu Ora.

“The lack of action, the lack of believing us, is quite breathtaking,” she said.

“[They] seem to accept that working in ED is a violent place, part of the job, and we should just suck it up. They have decided it is an operational risk that is acceptable.”

Dalton said a dedicated security guard should be a “no-brainer”.

In a statement, a Te Whatu Ora spokesperson said they were taking the concerns seriously and were looking at more funding for security.

“We hope to be in a position very soon to introduce a new security staffing model that will address the concerns raised by senior doctors,” he said.

“In the meantime, the public can be assured it is safe to seek care when needed.”

Doctors and nurses have been asking for full-time security at the hospitals since last year after a growing number of assaults and aggression directed at staff and patients.

Last year, a patient at North Shore Hospital punched someone who had been brought in by ambulance, a stranger, knocking her to the ground.

Earlier this year, a man drove his car at the packed department, crashing into safety bollards outside the door.

In August, it was revealed staff at the two hospitals hit panic buttons or called security thousands of times in seven months.

In the letter to Te Whatu Ora, the doctors said a dedicated, round-the-clock security service would be a strong deterrent to aggressive behaviour, could help deescalate behaviour and would ensure staff and patients were treated with respect.

Only a fraction of incidents were reported, they said.

By Rowan Quinn of rnz.co.nz