NHS staff are increasingly at risk from violence in the workplace - and the problem is costing the health service an estimated £69m per annum. Reliance Protect is helping a Trust in the North East with new Lone Worker devices.

The exact impact of violence in the workplace is not easy to calculate. “It certainly affects morale, performance, stress levels,” says Tim White, risk manager for NHS Newcastle and North Tyneside Community Health, “but there is little data to hand, and it’s very tricky to calculate the real impact. It’s difficult to quantify, and staff sometimes find it difficult to talk about these incidents in the workplace.”

The most recent figures from the National Audit Office suggest violence and aggression costs the NHS at least £69 million a year, not including the cost of coping with stress, low morale and high staff turnover. “At a local level, what we do know is that there is a greater awareness of reporting. And we’re now drilling down into the data, with more research to hand we should be able to find more supporting evidence,” says White.

Newcastle PCT is responsible for commissioning (buying) and providing health care services for the city’s 271,000 residents. It has around 900 community-based staff, the most at-risk category, in terms of aggression and intimidation. “Employee security has been on the agenda for a while but we started to formalise our approach in mid-2009 with an information gathering exercise. We sent a questionnaire to 300+ staff on their experience of violence and aggression, and conducted an audit of incidence data gathered over recent years. We knew it was an issue, and that there may be some under reporting of such incidents, so the questionnaire enabled us to reach those who maybe hadn’t reported such incidents. As expected, we found lots more going on that was previously reported. For some it was seen as part of the job, that intimidation and abuse goes with the territory.”

Zero tolerance
“A number of services were coming across aggressive and intimidating behaviour on a regular basis, mostly community based work,” says White. “Health visitors and district nurses would be the largest categories, but also reception areas and in-patient wards.”

He says there is an improved understanding of zero tolerance (towards staff intimidation). There is more training over and above conflict resolution based on the Suzy Lamplugh Trust approach and Zero Tolerance related incidents are closely monitored and reported to the Security Management Service where appropriate “Over the last quarter (January-March, 2010) we had 55 incidents reported, up from the previous quarter but we’d been expecting this due to the work being done over recent months to improve reporting. We’re encouraging more response; it will help us create a clearer picture of what’s happening. Just about all incidents involved verbal abuse.”

The findings have helped justify an investment from the board in lone worker security devices. “We took a proposal to the board in November of last year; they fully supported the roll-out of 300 devices to the most at-risk staff. Reliance ran a series of training sessions for up to 15 staff members from January to May.”

These small training sessions ensure each delegate has comprehensive knowledge of the solution and hands-on experience of using the device without taking large numbers of staff out of the field at any give time. The Reliance Protect devices are worn about the person. They are located using a mobile network and enable the wearer to discreetly alert a remote monitoring centre to a threat with a single press of a button, ensuring no suspicion is raised. By listening to and capturing everything that takes place during the incident, trained monitoring staff can respond appropriately, depending on the severity of the situation — including calling out the police, alerting colleagues/supervisors and archiving recordings as evidence for any legal action.

The user speaks into the device to provide remote monitoring staff with details of their precise location and appointment in advance. In the event of an emerging threat, they simply press the button to activate the red alert. If the worker is facing actual physical or verbal abuse, they press the red button. Red alert instantly opens an audible line through to the Reliance Monitoring Centre with appropriate response by a specially trained operator.

The red alert will also be activated if the device is forcibly removed from the user. Non-movement, impact and tilt sensors detect when the wearer appears to be in difficulty (for example if they are motionless for a specified time period due to a slip, fall or injury) and the device will automatically activate an alarm before entering a red alert state. Mobile phone network (GSM) or satellite positioning (GPS) fixes the user’s location.

“So far the feedback has been generally positive; it has been well-received, provided peace of mind and been simple and effective to put in place. Also, staff are encouraged to see that ‘something is being done.”

To view the full article published by Health Service Procurement Review click here.