Challenges:
With the aim of increasing confidence around safety for patients and staff on mental health wards a pilot project to examine the feasibility of using body worn video cameras was implemented. Further reasons for the study included national concerns over abuse in care settings and evidence that police forces using body worn video cameras had seen significant reductions in both complaints against them and their own use of force. In 2015 the CQC published recommendations about the use of covert recording in these settings but theTrust decided to explore the possibility of a more overt and transparent approach.
Actions:
Reveal trading as Calla supplied 12 Reveal cameras which were worn by the Prevention and Management of Violence and Aggression team and nursing staff on five psychiatric inpatient wards in Northampton. The training provided prepared staff to use the cameras effectively. There were very few technical issues with the body worn cameras though some refinement to the harness is required to improve comfort.
Both staff and patients considered that their use in an inpatient mental health setting was beneficial. Compared to the same period the year before there was a reduction in complaints and incidents during the duration of the pilot. The cost of equipment was £7,649 and storage of footage for three months was £569. Other costs were for staff time, 48.5 hours to set up and seven hours per week to maintain.
The main challenge to the successful implementation of the project was the level of engagement required with both patients and staff before the introduction of the technology itself. The main concern was that if patients and staff had not been engaged to such a degree concerns, myths and rumours about the devices and their use could have easily proliferated. Focus groups with service users and staff and surveys were carried out before, during and after the trial.
All wards were provided fair processing notices in the form of with posters which were displayed in areas of high visibility. These stated that: the cameras record video and audio information, but only when activated by the wearer; staff wearing the cameras will clearly let people know when they begin any recording; cameras will be activated if staff believe that safety may be compromised when responding to incidents; and all recorded data will be processed in accordance with the Data Protection Act 98.
The posters were regularly replaced if removed by patients. Staff verbally informed patients about the cameras by including prompts in morning meetings, patient experience groups and community meetings. Throughout the process there was no strong feeling against their use, the responses were consistently overwhelmingly positive.
Results:
• 68% of patients thought staff behaviour would change, 63% thought it would change patient behaviour.
• Just over a third of patients thought staff would behave more professionally, two fifths thought that patients may be less likely to be aggressive.
• Patients described the benefits as being: safety for everyone, respect for staff, better treatment for patients, accurate recording and clarifying situations in possible unjust accusations.
• Compared to the same period the previous year the need for emergency restraints (where there was a high or immediate risk of harm) went down from 41 incidents to 18.
Spread:
Following the results of phase one of the trial NHS England have visited the Trust and a Case Study is being completed to be shared nationally. The Trust has also begun to share the findings with local and national partners and the public. The pilot has now moved onto a second phase whereby a more lightweight product is being tested. Following phase two of the trial the feasibility of introducing the devices elsewhere across the Trust will be examined.
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