Improving staff security in the NHS

James Elwes investigates how one NHS Trust is protecting its staff from the threat of violence in the NHS. On 20 January 2005 the Old Bailey heard how Mamade Chattun, a male nurse, was beaten to death in a South London hospital.

In the same week, another London man was attacked and killed while receiving treatment in the back of an ambulance. These two attacks have served to highlight the threat faced by NHS workers.

Last summer’s NHS Scotland Occupational Health and Safety survey – the first of its kind in the UK – revealed that two NHS staff in Scotland are attacked each hour, with nurses and midwives being most at risk. But a Bristol hospital is combating this violence and, it would seem, is winning.

The United Bristol Healthcare Trust has received an award for its record on improved security. This success is partly due to the on-site team of security specialists, which was introduced in 2002.

The team, headed by ex-military policeman Des Green, consists of 13 staff and four on-call police officers. There are also 97 CCTV cameras as well as areas which can only be accessed using a swipecard.

Making changes has been a fraught process at times.

“In 2000, the health minister introduced the NHS zero-tolerance campaign,” said Green. “This gave a responsibility to hospitals to report attacks, leading to an increase in numbers reported. Also, the definition of ‘an attack’ was broadened so that even abuse via the phone was included.”

By 2001 the number of attacks had risen to 722 and by 2002 to 794.

“We were under a siege mentality here and the situation was hugely exaggerated. Yes people had been attacked, but the numbers implied a greater problem than we actually had and the severity of the incidents was not necessarily reflected in those numbers,” said Green.

The zero-tolerance method of recording crime was scrapped on 1 January 2004 and numbers of reported attacks has dropped away dramatically. But despite the problems with the recording of attacks, Green and his staff are undeniably having a positive impact.

The introduction of Green’s new safety schemes in Bristol saw the number of attacks on staff fall sharply from 794 in 2002, to 647 in 2003 and reached a low of 411 in 2004.

Catching people in the hospital is one thing, but how can crime against the NHS be prevented in the long term?

Pete James, the head of health for Unison’s south west region, said: “We are support these measures and delighted to see they seem to be having some effect, but the other issue here is that the courts and the law don’t follow up the hospital’s measures.”

James fears that the clampdown on violence against NHS staff is not being proclaimed loudly enough, or backed up by law.

“People are going to carry on getting away with this unless there is action by central legislators,” he said. Meanwhile, Green continues to protect his hospital. Burglaries at the hospital have also been reduced and he said these are “in economic terms a great problem – especially the theft of flat-screen monitors”.

In 2002 there were 89 burglaries at the hospital but they were down to 37 in 2003, and 20 in 2004.

“In the last two and a half years we’ve used the handcuffs 28 times and four members of my staff have been assaulted. But 20 burglaries a year for an organisation our size?” said Green, “That’s fantastic.”