Health Service Focus

The right policies and the right technology to keep lone workers safe

NHE talks to Dennis Hunt, health, safety and security manager at Hertfordshire Partnership University NHS Foundation Trust.

Dennis Hunt, health, safety and security manager at Hertfordshire Partnership University NHS FT, was recognised at the National Personal Safety Awards 2014 for his personal contribution to keeping staff safe at work.

Hunt, who is also one of two local security management specialists (LSMSs) at the trust, told us why he was so determined to improve staff safety.

“It’s the very nature of our job. We provide services to people with mental health or learning disabilities in a range of settings, and as well as having our service users in inpatient areas – where there is a separate alarm system and panic alarms that staff carry on their belts – there’s a nucleus of workers who do lone working. We much prefer to treat service users in their own home environment; we believe they recover quicker than being put on a ward. So mobile working, which 10 years ago was just coming onto the scene, is now a given.”

The trust has 2,800 staff and more than 30,000 services users a year, across more than 80 locations. It offers community services, acute and rehabilitation services, and learning disabilities and forensic sciences. As well as its main Hertfordshire patch, it also provides services from bases in north Essex and Little Plumstead in Norfolk, so staff can find themselves in isolated and rural areas at any time of day in an emergency.

Lone workers

Traditional lone worker strategies, such as buddying up and keeping ‘whereabouts boards’ up-to-date, have more recently been complemented by specialist technology.

Since 2010, the trust has been using the Identicom lone worker devices from Reliance Protect, which are styled discreetly to look like identity badges.

The badges are issued to individual lone worker staff assessed by the trust as being at high-risk – separate processes are used to keep low-risk and medium-risk staff safe.

High risk staff are likely to come across ‘red alert’ situations more often, Hunt said. These mental health practitioners will encounter service users who are in crisis and who may need to be detained under the Mental Health Act. Community assessment teams, who visit people in their own homes, may also have to support service users and their families in difficult circumstances.

Hunt said: “We don’t say to someone, you’ve got this device on you and you become Superman or Superwoman. It’s not a magic shield against violence and abuse. But when they’re out on their own, this device gives them an extra layer of reassurance, of being able to summon the police and emergency services if they need to.

“We tell staff not to get into the mindset of thinking they’ll only use it when they’re in someone’s home, for example. When they get up in the morning, they should put that device on, as far as I’m concerned. When they finish work at night, they should click it off and put it on charge.”

Responding to red alerts

The trust started with 190 devices from 2010, but on renewing the contract for a further three years, it upgraded to the latest GPS-enabled model and now has 620.

In four years, there have been eight genuine ‘red alerts’. When that function is enabled on the device, Reliance Protect staff at the 24/7 contact centre in Leeds can listen in to what is happening. They can then contact police on behalf of the trust, via a unique reference number (URN) rather than standard 999 channels, ensuring the call goes straight through to the relevant desk sergeant, who will immediately dispatch help.

Although two-way communication is possible, Hunt’s trust took the view that hearing voices coming from a badge could make some incidents worse and cause further distress for patients and service users with mental health problems, so it is just one-way.

After each red alert incident, Hunt organises follow-up meetings to check on the staff member’s state of mind and satisfaction with how the incident was handled, and publicises information to the rest of the trust to ensure lessons are learned. Hunt said he thinks these in-depth debriefings and their results are one of the factors that impressed the NHS Protect judges at the National Personal Safety Awards (Marsha Dennis, Andrew James and John Rodriguez of NHS Protect), organised by the Suzy Lamplugh Trust. Embedding such a large number of new devices so quickly also won praise.

In seven of the eight red alert incidents, help arrived within three minutes. On one occasion though it took more than 20, and a subsequent investigation by Hunt found that was because of unclear instructions about the address, with the postcode not clear. Hunt therefore decided to issue staff with phonetic alphabet cards to ensure there is no miscommunication.  All red alerts are discussed at the quarterly health, safety and security committee meeting, jointly chaired by the trust deputy CEO, who is executive director for quality and safety, and the Unison branch secretary. “This demonstrates the importance of the duty of care the trust takes for its employees and shows senior management involvement,” Hunt said.

Staff still have a responsibility for their own safety, of course, and are expected to keep colleagues and managers informed about their whereabouts, and take common-sense safety precautions like reversing into parking spaces in case they need to get away quickly.

Culture change

Reliance Protect provides nearly 50,000 devices across hundreds of NHS organisations as the accredited supplier of NHS Protect’s framework Lone Worker Service, which it won again last year.

NHS Protect’s aim with the framework is to protect NHS staff and resources from activities that would otherwise undermine the effectiveness of the NHS and its ability to meet the needs of patients and professionals. Ultimately, this helps to ensure the proper use of valuable NHS resources and provide a safer, more secure environment in which to deliver and receive care.

As Reliance Protect is a framework supplier, trusts do not have to go through a lengthy procurement process of their own to get hold of the devices.

User usage sheets issued monthly allow Hunt and team managers to ensure staff are using the devices correctly. Hunt admitted a “culture change” was necessary to show staff the value of the devices, and that they were not about tracking or performance management or spying – just safety.

Each member of staff undergoes a two-hour face-to-face training programme, and five days to get used to the device before it goes live. This allows them to get used to leaving the ‘amber messages’ for potentially dangerous incidents or calls, updating Reliance Protect on their whereabouts and situation.

‘Our most valuable asset’

Andrew Wellings, the trust’s head of facilities and maintenance, wrote in the nomination: “Dennis in my opinion is an unsung hero. He does not look for glory but is dogged in his approach to ensure staff use lone worker devices to reduce violence to staff in the trust and this is backed up by the yearly reduction of violence in our sites.”

The trust has also had longstanding recognition from the Royal Society for the Prevention of Accidents, having won nine consecutive ‘gold’-level awards. If it hits that standard again at next year’s awards, it will receive the special ‘President’s Award’.

At the 2014 awards, it was one of only two NHS trusts (along with Oxford Health) to get the ‘Gold Medal’ award for achieving five to nine consecutive gold awards.

“Staff are our most valuable asset and we need to look after them as well as we can,” Hunt told us.

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