Life-saving lone worker protection

Tony Gray, head of safety and patient experience and LSMS at Northumberland, Tyne & Wear NHS Foundation Trust, talks to NHE following his trust’s recent win at the National Personal Safety Awards.

Staff working for specialist mental health and learning disability trusts are among those facing the highest risks of violence or aggression within the NHS, and trusts must plan carefully to reduce these risks and keep staff safe.

Northumberland, Tyne & Wear NHS Foundation Trust (NTW) is one of the biggest such trusts in the country, having formed out of the merger of three smaller organisations in 2006. It is a complex healthcare organisation employing over 6,000 staff, covering a population of 1.4 million people. It is in contact with more than 40,000 patients at any time.

In October, it won the NHS Protect Award for Contribution to Lone Worker Protection.

Tony Gray is head of safety and patient experience and one of three LSMSs (local security management specialists) at the trust. He told us: “We’ve won this award because of the co-working between ourselves as a trust, NHS Protect as the overseers of the national lone working contract, and Reliance Protect as the supplier of the Identicom devices.

“We’ve also managed to integrate a lot of our safety systems of work as a mental health organisation, which I know are separated at a lot of other trusts.”

Under this integration, from 2007-10, a central safety function was created incorporating incident management, health and safety, security management (including lone working), claims management and the central alerting system, and in 2011 complaints and PALS were integrated too. “We’ve pretty much got the whole gamut of risk and governance,” Gray told us. “I’ve been to national development workshops where the LSMS at another trust has stood up and said ‘the serious incident manager didn’t inform me about this incident’, or ‘the health and safety lead didn’t tell me’, or ‘I don’t have access to that system’.

“In this trust all of that information sits together. It makes this into a very complex role, but it gives us ‘smoke detection’ in the system – whether that be from incidents, complaints, claims, health and safety security management – that all comes under the safety and patient experience remit of NTW. It allows us a wider field of view of what’s going on within the trust.”

Lone workers

Lone workers are usually thought of as working out in the community, but Gray noted: “We can have lone workers on the ward; most of our violence happens in out inpatient settings, but we’ve got lots of safety systems in place.”

These include one of the NHS’s first drug dogs, trained by Northumbria Police but funded by NTW, which has also employed an ex-police service dog handler. Gray said: “We know – as every trust in the country knows – that there is an active problem with drugs on wards, just as in prison. Patients with active drug problems are brought in, and then you have the supply and demand following them – visitors bringing drugs in to try to maintain their addiction.”

The dog team is part of an “active intervention” to halt that – although the dog, Coco, has also helped patients, especially children, as a therapy dog.

Leadership and administration

Gray (pictured, third from left) told us: “The main thing I would say about our success is this: leadership.”

He praised the work of Gary O’Hare, director of nursing and operations. Gray said it was very important that those responsible for security management understand the clinical risk component of working alone.

Gray’s own role as an LSMS focuses on the urgent care services – the inpatient wards. They tend to be higher risk than the forensic services, where individuals know that if they don’t maintain their treatment regime, they go back to prison. Under the national lone working contract, an LSMS at each trust is expected to oversee the contract locally. Gray said that is often “not realistic” for security directors on top of their day jobs. So NTW employs a full-time lone worker safety administrator, Jill Telford (pictured, centre), whose post was singled out as best practice.

Gray praised Reliance Protect and its Identicom device (more about the device on page 74), saying: “It’s life-saving. We’ve got 1,200 staff, about 20% of our workforce, covered by this device. We’ve had red alerts involving weapons where we’ve had the three-minute response from the police and that’s really been life-saving.”

The recordings of those dangerous situations can also be used as an educational tool, Gray noted. Even where staff are buddied up, it is important both wear a device, Gray said. One serious incident saw staff get separated in a house, and it was the person at risk who had left theirs back in the drawer.

Gray said the trust expects to have about 1,500 devices eventually, with the contract likely to be extended next year. He has heard of trusts giving up their devices when the two-year ‘grace period’ funding from the DH ran out – and subsequently getting an improvement notice from the HSE. “We too have got a financial squeeze – we’re going through an efficiency programme, the same as every other trust,” he said. “But this is important.”

He had nothing but praise for his trust’s directors and executive team, who he said had supported safety improvements ever since its creation eight years ago.



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