Yobs who cause trouble on an A&E ward will get on-the-spot £80 fines in a new initiative launched by police and hospital bosses.
The three-month pilot scheme, the first of its kind in England, is being launched at the Royal Bolton Hospital, Greater Manchester.
More police will patrol the busy accident and emergency department to crack down on drunken patients who cause trouble or threaten staff.
Officers will give out the £80 penalty notice for disorder or even arrest culprits.
Hospitals have seen an increase in anti-social behaviour aimed at staff in accident and emergency departments.
Although more serious offences are dealt with by the police, this is the first joint NHS and police scheme where fixed penalty fines, already in use in town centres, will be used to deal with disruptive behaviour in A&Es.
Between April and September, 40 people were escorted from the Royal Bolton's A&E by security staff for unacceptable behaviour such as spitting, shouting, swearing, and being disruptive or abusive towards staff.
During the same period, A&E and security staff were verbally abused by 41 people.
Dr Richard Parris, consultant in accident and emergency medicine, said: "We feel this is the tip of the iceberg as staff don't always report incidents of aggressive behaviour towards them - many feel it is part of the job - but this is unacceptable and it has to stop.
"Nobody should have to put up with that kind of behaviour in their workplace and it also causes distress for other patients and visitors in the department."
