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Multiagency cooperation makes NHS a safer place

Multiagency cooperation is key to dealing with security breaches against NHS staff and property, according to a healthcare law specialist.

Gerard McEvilly, a barrister specialising in crime and healthcare litigation for Hempsons and former Head of the NHS Legal Protection Unit, said that violence against NHS staff - highlighted in BBC's Panorama documentary "GBH on the NHS" - was not an issue which NHS trusts could tackle alone.

"Multiagency cooperation is paramount to making the NHS a safer place for staff to work and for patients to receive care," said Gerard. "Whether dealing with an isolated incident, or repeat offenders, cases will not progress if there is insufficient evidence and trusts, the police, CPS, local authorities, social services and education are not working together."

"Individuals who behave in an antisocial manner towards the NHS, will often behave in a similar manner elsewhere and collaborative working with other authorities enables evidence from all these authorities to be used so that when taking action against the individual the case is stronger. Prosecution is one tool that trusts can rely upon in appropriate cases but they also need to be aware of other sanctions so that they can effectively deal with the various security issues they face on a day-to-day basis."

The NHS Counter Fraud and Security Management Service had made significant inroads in dealing with security issues in the NHS since their inception, said Gerard, and the soon to be implemented Security Incident Management System will be crucial to improving the security of property and assets, drugs, prescription forms, hazardous materials and maternity and paediatric units.

"Trusts should appoint an NHS local security management specialist, responsible for all security matters and charged with forming constructive working relationships with local police, the CPS and other agencies.

Trusts do have at their disposal numerous ways of dealing with violent offenders and ways to regulate the behaviour of those who regularly act in an antisocial manner, while using NHS services. These included:

  • Immediately reporting any violent incidents to the police and encouraging staff to cooperate fully with any subsequent police investigation or CPS prosecution, offering all possible assistance.
  • Requesting reviews of decisions not to proceed with a case.
  • Conducting private prosecutions for assault and/or public disorder offences, which can be a significant deterrent to other individuals and sends out a powerful message to staff that their employer will not tolerate such behaviour.
  • Advising any staff member injured in a violent incident of the availability of the Criminal Injuries Compensation Scheme.
  • Using antisocial behaviour contracts, warnings or banning letters for repeat offenders: these can be used against patients or visitors who regularly assault, threaten or verbally abuse staff, other patients or other visitors and extends to cases of harassment, stalking, threatening letters and calls.
  • In more serious and escalating cases, liaising with local police and local authority antisocial behaviour units to seek an ASBO.
  • Considering private criminal or civil proceedings under the Protection from Harassment Act, Malicious Communications Act or Communications Act.
  • Participating in local crime and disorder reduction partnerships and multi-agency public protection arrangements, which provide a statutory framework for inter-agency cooperation in managing violent and sex offenders.

"There is no doubt that violence against staff is a problem within the NHS, but it is only one of the many challenges that trusts face on a day-to-day basis. Trusts need to be aware of all sanctions available to them in dealing with those individuals intent on causing security breaches. There is no doubt that multi-agency cooperation is crucial."