Can body cameras protect NHS staff and patients from violence? | Hélène Mulholland | Society

The idea that mental health nurses light up a used camera to film violent incidents in child care may seem controversial, but Jenny Allen, a user of services in Northampton, is an advantage.

Allen, who has been in and out of the hospital for 15 years, said cameras have helped create a safer environment and reduce "critical points" in theaters. "I think staff and service users are moderating their behavior when the camera is turned on. It's a win-win, really. This is not punitive, it is just trying to help defuse the situation. "

Body-worn cameras are already widely deployed in the police and prisons. And while some NHS trusts have entrusted them to security staff, their health care potential is only beginning to be recognized. In January, the government committed 8 million pounds by 2023-24 to test the paramedics' body cameras as part of a campaign to reduce aggression against NHS personnel and speed up prosecution.

Cameras have been tested in the area of ​​mental health at the NHS West London Trust and at Berrywood Hospital, which is part of the NHS (Northamptonshire Healthcare NHS Foundation) foundation.

In 2014, nurses first tested the use of body-worn cameras in two wards of the Broadmoor Hospital, a high-security psychiatric hospital located in Crowthorne, in Berkshire. The sequence provided evidence in support of prosecutions initiated as a result of violent incidents and a slight reduction in the number of badaults against staff was also found. In addition, there was a "significant reduction in antisocial and aggressive behavior," according to a spokeswoman for the West London NHS Trust, which runs Broadmoor.

The idea was echoed by Lindsay Bennett, head of NHFT's Prevention and Management of Violence and Aggression. "We wanted to learn from the camera images and see if we could better help those in crisis because we need to improve, everyone needs to improve," she says. "If we observe an incident, can we learn from it and make it safer for everyone? That's all for us. We want to keep everyone safe. Violence and restraint exist in the NHS. We know there is a problem, because statistics show it. But we can escape to a point where we have to be restrained when we learn the trigger signs. "

In 2016, NHFT – a society based on mental health, learning disabilities and community trust – conducted a 12-week feasibility study in five mental health departments of the Berrywood Hospital of Northampton, with the help of 12 cameras. The limited data collected gave a mixed picture: violence decreased in three districts but increased in two, with a slight overall increase over the same period of the previous year; verbal abuse has also increased. Low-level restraints have increased in two neighborhoods and have been reduced in two, but emergency restraints – used in situations where the risk of harm is high or immediate – are more than divided by two. . A survey of staff and patients revealed that cameras made people feel safer. Their use, the study concludes, "is acceptable for both patients and staff." The costs, he added, could be offset by reducing the number of complaints, incidents and restrictions, but additional research is needed for support.

Cameras continue to be used in all five rooms, but camera "responders" have witnessed incidents in the hospital. Last summer, another feasibility study – this time four months – was piloting a smaller camera specifically designed for clinical environments that has just completed and the results are being badyzed.

Andres Patino, deputy director of adult mental health services (south) at NHFT, said that informing a patient that he was behaving in an unsafe manner and that a recording about to begin could often suffice. "As soon as you press this button, you see a de-escalation." The cameras have a front screen to display what is being recorded. The nurses carry the camera throughout their service but only turn on it when an incident occurs and inform the patient.

The footage is encrypted and can not be edited until it is uploaded to a secure cloud account. Only authorized trust personnel can access the footage and any changes made are tracked. The footage is kept for 31 days unless a request is made to keep it longer.

To date, the police have officially requested the footage twice: the footage processing process is identical to that used for the evidence captured on the CCTV footage of the trust in the main parts. from the hospital.

Service users may also ask staff to turn on the camera if they are not happy with the situation. They may ask the staff to review the images, but at the moment – because of concerns about the impact that this could have on a patient – they can not do it themselves unless they make a special request. request under the Data Protection Act, to which an organization has one month to respond.

For Allen, who participated in the consultation process, improving staff accountability is rewarding. She says she was injured after being brutally manipulated by two staff members a few years ago. "That's another reason I really support because there were footage out there, I could have proven what happened to me," says Allen.

Trust has now bought 49 small cameras. About half is already used in Berrywood and the rest will go to the in-patient health center at St Mary's Hospital in Kettering. Additional research is planned.

In the London NHS Trust, another pilot project was conducted in seven mental health services at St. Bernard Hospital (the pilot project was conducted at three sites), in the Lakeside Mental Health Unit and in mental health unit of Hammersmith and Fulham. Tom Ellis, a senior lecturer in criminal justice studies at the University of Portsmouth, explains that a four-month badysis of data shows that restraining devices requiring tranquillizing injections have gone from fourteen to four, through compared to the same period of the previous year, indicating a reduction in the severity of the incidents. He also noted a marked reduction in verbal abuse in women-only neighborhoods.

Jim Tighe, local security management specialist at the West London NHS Trust, says cameras have made employees feel more confident. "We used the [footage] on several occasions for serious incident reviews and it was very helpful to see and hear clearly what happened. This can help reduce the length of an investigation because you have this independent witness, "he says.

But how do cameras affect the relationship between nurses and patients? Catherine Gamble, professional head of mental health at the Royal College of Nursing, says research in this area is needed. There are issues of respect for privacy and dignity to consider.

"Violence against caregivers or patients is never acceptable," she said. "While there is some evidence that the presence of body-worn cameras can promote safety and reduce the number of attacks, there is little research in this area." Gamble points out fears that video cameras could be a cheap substitute for adequate staffing levels and stated that "they should not be considered a substitute for ensuring the safety of staff."

Alison Cobb, a specialized policy advisor for Mind, a charity dedicated to mental health, says patients need to be well informed, given the "obvious concerns" about privacy and dignity. Although measures to increase the transparency and accountability of services and to limit the use of restraints are welcome, other factors to reduce the use of restraints need to be examined, including better training of staff and improvement of the environment of the room.

Is it ethical for nurses to turn on the camera of a patient in distress? "I think so," says Tighe, "because you can learn from this situation. This may have a more positive result for the service user at the time and for the staff member involved. "