Patient First, the UK's largest patient safety event, will return to London's ExCeL on 21-22 November 2017
The recent riots in England illustrate the evolving and sometimes random nature of crime and the way in which organisations’ security practices have to be able to adapt to meet these challenges. Health facilities are certainly not immune from such events; City of London hospitals have experienced damage in anti-capitalism demonstrations and, in the latest incidents, there were reports of a Birmingham hospital being threatened by rioters.
Healthcare sites reflect crime conditions in the community – even the most out-of-the-ordinary – and they have to plan accordingly. However, alongside these threats, they must also deal with specific types and patterns of crime linked to their unique role.
Nature of the environment
For example, healthcare facilities experience the same type of one-off thefts and burglaries as other organisations. However, they are also at significant risk of insidious, ongoing theft of targeted items and equipment, which can result in very significant losses over time.
One of the key issues here is the often transient nature of the populations moving through these premises – it is not practical or appropriate to be overly controlling in terms of access to public areas. One survey has suggested that 80 per cent of thefts in hospitals take place in areas in which members of the public can legitimately be present. This makes the effective integration of security measures in these locations particularly important.
Violence against staff is another significant threat for healthcare facilities. There were 56,718 assaults on NHS workers in 2009/10, which is a 3 per cent increase on the previous period. Recent reports estimate the annual financial cost of violence as being over £60 million – made up of factors such as sickness absence, staff leaving the sector, litigation, conflict resolution training and additional policing. The situation is not surprising given an equation that includes visitors who are distressed, angry, disturbed, or under the influence of drugs or alcohol, but effective management is clearly needed to protect staff and enable them to do their job properly. The NHS strategy document A Professional Approach to Managing Security in the NHS cites this as a priority area for action.
Incident hot sopts
There will be locations that are particular hot spots in terms of violent incidents, for example A&E and mental health facilities. Others may be more prone to acquisitive crime, such as places where drugs and prescription forms are kept. Others still have specific vulnerabilities that have to be taken into account, even though the risks are low, for example maternity units in relation to infant abduction.
The complexity of the situation means that there has to be a holistic approach to security. On the one hand it should be based on a thorough risk assessment, a comprehensive security plan, appropriate procedures and buy-in from staff. On the other, it requires effective integration of appropriate equipment and security personnel.
Every healthcare environment is different, and it is highly likely that a customised solution is going to be necessary, involving consideration of access control, CCTV, intruder alarms and security guards.
It is important to avoid the public access ethos spreading to places where entry should be restricted to authorised individuals, for example storage areas, pharmacies and office blocks.
Access control systems typically employ a code or a card. They can be stand-alone, for example to control access to a particular area containing valuable equipment or medication. Alternatively, they can be linked electronically to a number of entrances, often with a computer interface to enable central programming.
Large hospitals with complex requirements will need systems with easily adaptable security protocols that recognise staff seniority, areas of practice and likely hours of work. Flexibility is a priority, given that staff may frequently switch between different areas of an organisation. In a large hospital, there could quite easily be over 100 requests for access right changes every day.
Systems can be programmed to undertake additional tasks, for example recording who was in a particular zone at a particular time or activating an alarm if the number of staff in a particular area falls below what has been laid down as a safe level. Non-security related features can also be incorporated, for example a time and attendance system.
It is common for access control to be used in conjunction with CCTV. For example, on maternity wards visitors will often only be allowed access once their image has been viewed via a security camera. However, full integration of the two technologies is also available. For example, it is possible to set CCTV to start recording if there is an attempt at unauthorised entry. As such systems can link recordings to the access log, it is also easy to find desired footage.
CCTV cameras are used to provide surveillance of key areas within a site. Depending on specific requirements they can be monitored by on-site security staff or remotely via an alarm receiving centre or linked to a recording device to deter and provide evidence for later investigation of events. Cameras can roll continuously in real time, or be activated by access control or alarm equipment. The advent of digital camera technology and delivery of video via internet protocols has brought more competitive prices, a wider range of functionality and the ability of images to travel over much longer distances.
Recent feedback from hospitals on the benefits of new CCTV installations includes their role in defusing difficult situations in A&E departments when staff point out that cameras are present. They also make staff feel more secure, particularly those in the front line, and including reception staff who are often the first point of contact.
In addition to protecting buildings when they are unoccupied, for example, a GP’s surgery or offices during the night, alarms are a valuable way of protecting isolated and high risk locations. They can be linked to a remote alarm receiving centre with priority access to the local police control room or to an in-house control room.
Alarms can also be combined with panic button technology to enable a rapid response when someone is threatened.
Security teams are a key component of any strategy for protecting premises where there is large-scale public access. They not only deter crime, but also create a more reassuring environment for staff and visitors.
In addition, they play a key role in ensuring that security technology achieves its full potential, as there is little point having sophisticated and high-quality equipment in place if security personnel are not going to interact effectively with it, for example by monitoring CCTV and responding appropriately, investigating alarms, responding to panic button alerts, and making the right judgements when dealing with specific incidents.
Security procedures and technology will fall down if those working in the organisation do not apply them correctly and consistently. One important way of achieving buy-in from staff is ensuring that they feel their views and first-hand knowledge of working in specific environments has been taken into account. Those on the front line are often better placed than managers to identify where improvements are needed, and reputable security suppliers will welcome this type of involvement at the survey stage of designing installations and services.
They will also ensure that staff receive appropriate levels of product-based training so that they can use equipment properly.
Cost versus quality
Keeping costs down is a constant pressure for organisations, and never more so than in the current economic climate. This focus is also evidenced by increased use of e-auctions within the public sector, extending their application from relatively simple products to complex services such as security.
It needs to be borne in mind that over-emphasis on low price rather than best value (in terms of fitness for purpose, quality and reliability) can bring significant risks ranging from major preventable incidents leading to serious loss and injury (and the potential for legal action and reputation damage); to the type of cumulative losses arising from inadequate security; to having to deal with the fall-out from employing a sub-standard security supplier, in terms of the time and money required to rectify the situation.
A variety of different approaches can be taken to support cost-efficiency without compromising security, for example, maximising the effective integration of security personnel with technology; weighing up how and where monitoring is going to take place; avoiding over-specification; selection of equipment that can easily be upgraded at a later date with a software change if required.
Healthcare facilities need to be sure that suppliers are really capable of giving good advice, delivering quality solutions in line with the organisation’s needs and providing ongoing support. Independent certification by a United Kingdom Accreditation Service (UKAS) approved inspectorate is evidence that the supplier meets standards recognised by the industry and other interested parties such as the police. For example, NSI approved suppliers meet all relevant British and European standards, security screen all relevant staff, provide a high level of staff training and supervision, are comprehensively insured and are inspected every six months by professional auditors.
Healthcare security is undoubtedly complex, but a systematic, integrated approach is key to success as is taking professional advice from reputable suppliers who will be just as keen as their client to make security goals a reality.
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