We Must Diagnose Healthcare Security Chronic under-investment in security in many areas across the NHS means increased vulnerability to an evergrowing range of security and crime threats, writes Jim O’Dwyer. About the author Jim O’Dwyer of AEGIS Protective Services is a former Met Police man, now an expert witness in workplace-related violence and physical intervention and restraint; subjects he’s written about for us before. He’s a founder member of the Institute of Conflict Management; and chief instructor at Bournemouth Aikido Club. Visit aegisprotectiveservices. co.uk. Above and over the page: Manor Hospital, Walsall Photos by Mark Rowe Jim in brief n Security is chronically underfunded in the NHS. n This may be because investment in loss prevention has been linked to widely inaccurate estimates of losses. n Producing more accurate estimations of potential losses than exist is not beyond the Department of Health and it’s something that needs to be actioned without delay. 30 Traditionally in the NHS, expenditure on ‘security’ has been regarded by most NHS Trust Board members as an unwelcome expense rather than a ‘necessary’ investment. This sentiment has persisted because a persuasive ‘business case’ for appropriate investment (justified in terms of the probability of occurrences, the likely total cost of loss to be suffered and the potential reduction in those costs through investing in ‘security’ measures) has not been presented. A problem for ‘number crunchers’ is that no established methodology exists to enumerate the full extent of the impact of crime and security breaches in the NHS. So, it’s only possible to estimate total costs - and estimates are only estimates. If the estimates used are inaccurate, it presents difficulty deciding levels of investment in security (which are usually linked to the estimate of potential loss that could be eliminated). Without an accurate picture of the losses and the causes, how can NHS trust boards gauge how much to invest, or set meaningful targets for risk reduction? Cost of violence It’s often cited that violence costs the NHS in the region of £69m per year. However, that figure was just a rough ‘guestimate’ made by the National Audit Office in 2003. In the NAO report, A Safer Place to Work: improving the management of health and safety risks to staff in NHS trusts, it was estimated that the direct cost of work-related incidents was £173m per annum, (excluding staff replacement costs, treatment costs and compensation claims). The NAO then reasoned that since violence and aggression accounted for about 40pc of the incidents reported, a crude estimate of the ‘direct cost’ of violence in the NHS was likely to be at least £69m. However, this took no account of the human costs, such as physical and/or psychological pain NOVEMBER 2017 PROFESSIONAL SECURITY Pointers, please and increased stress, nor the impact on staff confidence, low morale, poor performance and productivity. The NAO also didn’t factor in payment of sick pay if the staff member has to take time off work; treatment costs, including counselling for staff; the extra costs of temporary or replacement staff; or fees for taking legal action. If a staff member leaves the profession, it translates to a loss of experience and the wasted expense of training them. Negative effect Research by Peter Finch, President of the National Association for Healthcare Security indicated that two per cent of NHS staff subjected to violent assaults left the NHS as a result. Now, when you consider that about 70,000 physical assaults on NHS staff are reported annually, it could translate to 1,400 trained and qualified NHS staff quitting the occupation every year! How much would it cost to replace them? The financial costs to the NHS resulting from violence at work also includes the negative effect on corporate image including, difficulties (and extra expense) recruiting and training replacement staff. There’s also the threat of HSE prosecution of the health body and penalties for failing to provide a safe system of working for employees. In addition, there is the growing threat of criminal prosecution (under section 37 of the Health and Safety at Work Act) and prison upon conviction of individuals (including managers), who, through consent, connivance or neglect are responsible for health and safety shortcomings (inappropriate staffing, inadequate training, instruction and supervision) that result in serious harm happening - and then there’s the associated costs of replacing those individuals, too! The NAO estimate that violence costs the NHS about £69m per year is just the tip of a very big iceberg! Note: The NHS Security Management Service were not tasked to deal with patient on patient or staff on staff violence (including bullying, harassment, stalking and mobbing). Cost of theft Like any large organisation, the NHS is a victim of theft. Experience shows that the NHS is targeted of organised criminal gangs working to source high value medical equipment for use in foreign countries. But, thieves (including some staff) also steal low value items too. Reported thefts have included: CT scanners, ultrasound scanners, foetal aid monitors and swine flu respirators, defibrillators, a specialist autopsy examination table, tractor, beds, ambulance satellite navigation devices, computers, lead from roof, nitrous oxide cylinders (‘laughing gas’), wheelchairs, uniforms, blankets, thermometers, pregnancy testing kits, prescription pads, stethoscopes, a post trolley; and kettle. Not an exhaustive list! In May 2012, NHS Protect published comprehensive guidance to NHS trusts on the security and management of assets and also launched a Security Incident ➬ www.professionalsecurity.co.uk p30,32 JimODnhs <strong>27</strong>-11.indd 1 12/10/2017 10:45
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