Hundreds of incidents of violence and abuse against Welsh Ambulances staff were recorded last year, figures show.
The Association of Ambulance Chief Executives, which collected the data, warned low conviction rates and lenient sentences are "failing to deter offenders".
The figures show 449 incidents of violence, aggression and abuse were directed at Welsh Ambulance Services University NHS Trust staff in the year to March – down from 640 the year before.
Across the UK, there were 22,536 incidents of violence, aggression and abuse directed at paramedics and other ambulance workers in 2024-25.
It was up 15% on the 19,633 in 2023-24, and the highest number since comparable records began.
AACE said the figures meant at least 62 ambulance workers were abused or attacked each day.
It added reported incidents ranged from common assault to serious attacks involving weapons. The reports also included kicking, punching, slapping, head-butting, spitting, verbal abuse and sexual assault.
Anna Parry, AACE managing director said: "This appalling trend is worsening, with low conviction rates and lenient sentences failing to deter offenders.
"That's why AACE is actively engaging health ministers from all four UK nations to explore policy, prevention and response measures that can better protect our workforce."
She added the most recent NHS Staff Survey revealed 38% of operational ambulance staff experienced physical violence last year, however a quarter did not report it.
She said: "Frontline teams and call handlers are deeply impacted. Many leave their roles due to trauma or illness. Despite service-wide initiatives, incidents continue to rise, and the consequences are unsustainable."
While she welcomed new Crown Prosecution Service guidance to speed up convictions and proposals within the Police and Crime Bill to expand legal protection, she added "more must be done".
"Our data shows tougher sentences alone aren't enough. We see promise in restorative justice and diversionary measures for first-time offenders – approaches that educate and reduce reoffending.
"We also support consideration of a minimum mandatory sentence for assaults on emergency workers, sending a clear, uncompromising message."
A Welsh Government spokesperson said: "Ambulance workers provide life-saving care, every day and in often difficult circumstances – they deserve to be treated with respect. Any form of attack on them is completely unacceptable.
"We are working with the NHS Wales Anti-Violence Collaborative and the Welsh Ambulance Service Trust to eradicate physical or verbal assaults on staff."