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Summer 09 Newsletter

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NEWSLETTER – SUMMER 2009

It’s nearly Christmas – well not quite - but the thought of it always raises morale! No doubt many of you are involved in fighting off swine-flu, dealing with the predicted heat wave, developing lock down strategies and considering the implications of introducing the Identicom Lone Worker Device ‘promoted’ by the SMS and struggled with calculations and SMS inconsistencies for Violence Against Staff figures, while holding down the routine of day-to-day security management and trying to retain as much of a full head of hair as possible.

The NHS faces difficult times over the next few years with little indication of the Government maintaining investment at existing levels. It will be very interesting to see if Trusts regroup or consolidate further to meet the increasing demands of MONITOR. No matter what happens, the recent drive to reduce violence against staff should remain a cornerstone of the protection of staff for the future. Although security management is becoming embedded into some Trusts, this is by no means the case everywhere, a great deal of work needs to be undertaken to ensure that it is. You will know from your own experiences that security management is often one of the first casualties in cost cutting reviews and consequently this is where we need to step up to the plate and take the lead in ensuring that the voice of security is not only heard in a positive and constructive manner and also in way that reflects the business priorities of the Trusts.

MEMBERS MATTERS

Terry Morris. After 18 years as the Security Manager at Southampton Hospital and as Chair for the South Coast Region, Terry Morris is retiring within the new few weeks. Terry, a former police crime prevention officer, was one of the original band of hospital security managers recruited in the early to mid-1990s and has accumulated significant experience in healthcare security experience. His most recent projects included provided security advice to building and refurbishment projects at Southampton. I am sure that all wish Terry and his wife the best for the future.

Peter Finch. It has recently been published that the American Society of Industrial Security has appointed Peter Finch (Sandwell & Birmingham) a Certified Protection Professional (CPP). This is a prestigious internationally recognised award that requires a significant amount of reading and research. Peter also studied last year for the Advanced Certificate in Environmental Design and Crime Prevention with City and Guilds and Oxford Brookes University (a course much sought after by ALOs who are not academically qualified to undertake their role).  We believe that Peter is the only member of the NHS with the CPP award and he was the first member of the NHS to study for ADCertED&CP.  Our congratulations, Peter.

IFSEC. Nick van der Bijl (Somerset Partnership), Des Green (Security consultant) and Simon Whitehorn (Birmingham & Solihull Partnership) gave a presentation on the implications of hospital lock down at a seminar at the International Fire and Security Exhibition. The overriding theme was that while it will be difficult for Acute/General hospitals to achieve total lock down, particularly with the fire regulations, it will probably be easier for mental health Partnerships although the usually wide dispersal of wards and units will make the exercise more complex.

Security Vibes.com

After our IFSEC presentation, Ben Chai of SecurityVibes UK interviewed the three presenters and Peter Finch on healthcare.

SecurityVibes.com is the first private online community created to further the exchange between CSOs (chief security officers) and other senior security officers. Under Chatham House rules, it offers an open platform to gather contributions from members of its community who wish to share their experiences, exchange their points of view on issues, discuss their visions of the future of security, and obtain help in a confidential manner, whilst promoting their own expertise in the field of IT Security and Compliance. See http://www.securityvibes.com.

Bridgwater Conference and the Bradley Report

Several NAHS members attended a conference organised by Nick van der Bijl entitled Offenders with Mental Health and Learning Disabilities. Who’s Problem? Co-incidentally, on the same day, Lord Bradley launched his review of people with mental health problems or learning disabilities in the Criminal Justice System.  The aim of the seminar was to bring together those who could be involved in bringing people with mental health or learning disabilities before the Courts in calculating the balance in meeting the needs of the individual, ensuring staff safety and finding the right way for patients who find themselves in the Criminal Justice System. Contributors included representatives from the health services, the Police, Probation, Crown Prosecution Service, Her Majesty’s Court Service and NACRO.

In his Report, Bradley sees that the lack of clear consensus of the definitions of mental health and learning disability as an impediment in deciding the most effective course of action. It follows that the NHS and others have some work to do to resolve this dilemma. Reinforcing the necessity of early intervention, which is stating the obvious, he recommends that:

  • Staff in schools be trained to identify mental health and learning disabilities
  • Youth Offender Teams include qualified mental health workers
  • Local Safer Neighbourhood Watches have a key role to play in identifying and supporting people involved in low level offending and anti social behaviour
  • Police officers and community support officers, at all levels, should develop formal training packages with local mental health Partnerships
  • Probation officers should receive training in mental health. Providing relevant community sentences and resettlement will take a little more time to resolve - not the least of which is identifying finance
  • The Crown Prosecution Service should review the use of Conditional Cautions
  • The Judiciary should receive mental health and learning disability training.

The Government responded to the Report by recognising that reforms are an absolute necessity and that public protection and the support and confidence of the public are critical in the overall initiative. Five key factors are essential:

  1. Clear national commitment
  2. Clear governance during the development of policies, commissioning and serviced delivery
  3. Unambiguous statements on short-, medium- and long- term expectations
  4. Measurable outcomes
  5. An integrated framework to enable the NHS and the criminal justice system to improve the disposal of those offenders who have meant health and learning disabilities

In essence, Bradley has challenged agencies such as Youth Offending Teams, public and private health services, National Offender Management Service, Police and the Criminal Justice System to develop a national strategy with four principal drivers:

  • Recognise that there is an issue that need to be addressed
  • Identify best practice and start developing at local level integrated working – although quite who defines ‘best practice’ remains something of a mystery. Fit for purpose is a better objective
  • Understand each other’s organisations, expectations and limitations.

Develop practices and identify measures that can be taken to help each other - starting with returning to the controlled sharing of information.

Her Majesty’s Courts Service, at all levels, has a crucial role to play in developing mechanisms to ensure that those with mental health and learning disability issues who enter the Criminal Justice System receive a fair hearing. Gone, with luck, are costly Psychiatric reports taking eight weeks to prepare and drawing no conclusions. Some Courts are already developing local psychiatric referrals in much the same way as the Probation Service deliver Pre-Sentence Reports. In terms of sentences, NOMS have a major role to identify imaginative community sentences and developing diversions.

Although the problem of some ‘bad, sad or mad’ being dealt a rotten hand has existed for centuries, some of the most vulnerable people in this modern 21st Century society remain in need of services and support. The Bradley Review has thrown the challenge down.   

SMS Conference. It seems that the SMS Annual Conference will centre on regulation with input from the usual suspects – NHSLA and their assessors De Norse Veritas, CQC, HSE etc. Not much change here from previous conferences! At last year’s Conference, Steve Phillips the DH lead on security matters agreed to write to Richard Hampton, Head of SMS informing him that resources for additional LSMS were available from PTC allocations. The letter still hasn’t appeared and consequently we now approach the second year of wasted opportunity to increase the numbers of LSMS employed by Trusts and further tackle the broad range of security issues that we deal with on a daily basis. Steve Phillips recently trawled SHAs to find out what LSMS resources a\re available within Trusts.  It would be good to think that this may be a preamble to a letter that may, finally, point out that resources are available for more LSMS. However, the cynic would suggest that this was merely a backside covering exercise in the event that health ministers ask questions about the use of security resources.  A wasted opportunity? Absolutely!

More beneficial would have been to also ask SHAs:

  • How many security officers they have in post?
  • Are they ‘in house’ or contracted?
  • How much is spent on capital security and on other security e.g. pay, lighting, maintenance. 

Surely, this would have given a much clearer picture of this aspect of security in the NHS than asking how many LSMS are in post.  For a start it would indicate how much security officer training would be required, how many would need to be trained, the cost and so on.

EXECUTIVE MATTERS

The NAHS Executive met at Southampton Hospital on 17 June. In brief, the following matters were discussed:

The NAHS Website. Nick Lee, our Webmaster, briefed the Exec on changes to the site.

  • Nick felt that if the NAHS needed to raise its profile, which it does, then one method is to invite security and car parking, and indeed any company that might have an interest in our work, to place a link on the NAHS site. This was agreed to be a good idea
  • Nick has been asked to create a folder entitled POWERPOINT for the storage of presentations

The next is being held on 16 September 2009 at Brighton and Sussex University Hospital.

Also discussed were the NAHS proposals for the future security strategy of the NHS SMS.  A review of strategy is likely to be undertaken this summer and we have been formulating our proposals in readiness for the impending announcement.  Our proposals will be published once the consultation process is underway.

REGIONAL MATTERS

Western Region. The Western Region held its first meeting for some months at Somerset Partnership NHS Foundation Trust in Bridgwater, Somerset. This Region includes several representatives from Welsh hospitals, who do not receive the same guidance and support from the SMS. At the AGM, the following nominations were made to the NAHS Executive:

  • Regional Chair - Nick van der Bijl
  • Vice Chair    - Des Green

South Coast Region. With the departure of Terry Morris, the following have been elected to the Region Executive:

  • Chair – Mark Dunnett (Brighton and Sussex University)
  • Vice Chair – Steve Davies (West Sussex PCT)
  • Phil Tarling – Secretary (Royal Hampshire)

The Northern Region. The Region is scheduled to meet at Leeds University Hospital on 31 July.

CONSULTATIONS

Public Nuisance. Mark Dunnett has been leading the NAHS response on the public Consultation on the Provisions to Deal with Nuisance or Disturbance Behavioiur on NHS Premises in England under Sections 119-120 of the Criminal Justice and Immigration Act 2008. Essentially, the NAHS does not believe there is a necessity for this provision because existing legislation already exists. Interestingly, although this is a consultation, the SMS is developing training programmes for authorised officers and appropriate NHS staff to assist authorised officers in using the power of removal.  It is intended that the NAHS response will be circulated to the Membership. Submissions are to be made to the Department of Health by 4 August 2009. 

Security Officer Training Standards.  Unfortunately, the NAHS has not been included in the development of that most important matter - Security Officer Training Standards, even though it was the NAHS that developed security officer training and many of its members are in healthcare facilities equipped with large security organisations. A draft document concerning security officer training standards put together by NHS SMS and Skills for Security has been circulated.  While no comments were invited Peter Finch (Sandwell & Birmingham) has nevertheless made some interesting comments, including the need to include training for criminal damage and arson; the need to include the clinicians ‘duty of care’ in respect of restraint; the need for further guidance concerning restraint itself; and the need to ensure the correct terminology for bombs/improvised explosive devices is used.  Peter also reiterated his concerns that many security supervisors are unlikely to have the basic knowledge required to underpin the vocational training of security officers and that this should be addressed before rolling out the training programme.

VIOLENCE AGAINST STAFF (VAS) STATISTICS

The VAS returns for 2008/09 produced confusion when it appeared that there had been a policy change from the Tackling VAS Explanatory Notes 2007 and previous VAS returns. Did you know that the VAS return is voluntary return until the SMS changed the rules.  These stated that the data required only include physical assaults on NHS Staff and Contractors by patients, service users or other members of the public. For the first time, staff on staff assaults was required. While serious in their own right, there was concern that Security was drifting into the HR/Line Management domain and that the figures could skew the figures upwards and provide another reason for a Health Minister not to attend the annual SMS conference. Unfortunately, there was no clear explanation from the SMS when there was change in policy and the rationale for it and why the information was not shared during the quarterly LSMS ‘training’ meetings. In many respects, it was a chaotic situation induced by the SMS at a time when LSMS were being expected to collect VAS statistics. 

Fitness for Interview – A Medical Opinion

Has anyone experienced this sort of comment from doctors about fitness for interview and capacity assessment?

There are a range of opinions and views amongst consultants, which ranged from this being a role for a police surgeon to this being part of a psychiatrist’s role. There is also an impression that there had not really in the past been much of a call for this to occur, so sorry I feel I am not much further forward in trying to clarify matters for you. These and other related issues are quite thorny.  

THE MENTAL CAPACITY ACT

The Department of Health is becoming concerned about the application of the Mental Capacity Act, in particular the belief among some traditionally-minded doctors, nurses and care workers that they can make judgements about vulnerable users without reference to the Act’s safeguards. Discussions are underway with the Quality Care Commission to determine measures that might need to be taken to resolve this lapse, which could include disciplinary action.

Conceivably security could be drawn into the equation, particularly for those deployed in mental health partnerships where ‘Does the patient have capacity?’ should be among the very early stages of any investigation. 

SOCIAL NETWORKING WEBSITES AND THE ABUSE OF INDIVIDUALS

Social networking sites are integral to many people. However, there have been instances when they have been used to make comments about the NHS and individuals. While comments are positive, others are negative and are abusive of individuals.

Human Rights. The Human Rights Act 1998 contains the following provisions relating to this sort of activity:

  • Article 8 (Respect for Private and Family Life) sets out that everyone has the right of respect for private and family life, his home and his correspondence. The only interference right is in the interests of public safety, the protection of health or morals and the rights and freedoms of others.
  • Article 10 (Freedom of Expression) permits the right to hold opinions and to receive and impart information and ideas without interference from a public authority. However, it also carries the responsibilities listed in Article 8.
  • Article 14 (Prohibition of Discrimination) states that the other rights within the Convention shall be secured without discrimination on any ground such as political or other opinion.

Defamation. Defamation is defined under the 1996 Defamation Act as the publication of a statement either as spoken (slander) or written (libel) form that, in the opinion of right-thinking members of the community, lowers the reputation of the defamed. Sueing is expensive, even with legal funding, is the payment of damages. Government departments cannot sue for defamation, largely because the costs of bringing such actions are not in the public interest. It is also unclear where the NHS fits into the equation because of the ambiguity that Trusts may be considered as government bodies.

Terms and Conditions. The best option may be to approach the Internet Service Provider. For instance, Facebook contains a ‘Statement of Rights and Responsibilities’ which governs the relationship between the users and the site with the implicitly agree to this statement:

3. Safety: this includes commitments from users:

  1. You will not bully, intimidate, or harass any user,
  2. You will not post content that is hateful, threatening, pornographic…’
  3. You will not use Facebook to do anything unlawful, misleading, malicious, or discriminatory’.

5. Protecting Other People’s Rights

‘We respect other people’s rights, and expect you to do the same.’

  1. You will not post content or take any action on Facebook that infringes someone else’s rights or otherwise violates the law’.
  2. We can remove any content you post on Facebook that we believe violates this Statement.

 13. Termination:

‘If you violate the letter or spirit of this Statement, or otherwise create possible legal exposure for us, we can stop providing all or part of Facebook to you…………’

 Solutions? While the freedom of expression is difficult to regulate, consideration must be given to the level of damage actually caused.  Application for an Anti-Social Behaviour Order is worth considering, although to the extent that social networking communications is held to constitute harassment has yet to be tested. On the other hand, graffiti can constitute harrassment. It might be appropriate to contact the social network provider and ask them to remove the offending material from the site, although this must be balanced against retaliatory communications and a turf war. It may be more effective to monitor the communications and support given where appropriate.

MOBILE PHONE DIRECTORY

There has been considerable interest in a company called Connectivity launching the first UK Directory Enquiries service for mobiles. Peter Foy (Leeds University) has provided this briefing about it.

The requester submits details of the forename and surname and town of an individual to a website. If the person is listed, Connectivity will send a text message to that individual giving details of the requester so that they may make contact – they wish. There is a cost to the requester of £1 for each SMS sent. The directory is made up from various sources, including companies who collect mobile telephone numbers from customers in the course of doing business and have been given permission by the customers to share those numbers. This emphasises the importance of being aware of your personal data security at all times in order to safeguard your privacy.

The company website www.118800.co.uk is unlike traditional directory enquiry services because Connectivity does not disclose a subject’s phone number to a requester. No personal data is disclosed via the search facility on the website and they will not sell details of individuals on the directory. A list of FAQS is on http://www.118800.co.uk/faqs.html#the-service

To become ex-directory:

  • Text the letter ‘E’ to 118800 from the mobile phone you want to be made ex-directory
  • Address your requirement on 0800 138 6263.

Vodafone customers, who include the NHS, said that customer telephone numbers or contact details are not supplied to any directory service provider except where the customer has specifically requested that their details are shared. Vodaphone is not involved in the set up or operation of Connectivity's 118 800 service, however phone number information may have been supplied to the service from third party sources or customers may have supplied their own phone numbers themselves. Concerned consumers can contact PhonepayPlus, which regulates premium rate and directory enquiry services.

As always, the National and Regional Execs welcome comment.

Nick van der Bijl - Chairman - NAHS