Smile, You’re on Camera

The Met Police have rolled out the use of Body Worn Cameras (1) across 30 of the 32 London boroughs, and they have had a great deal of success with them. They have said that the cameras have helped with the Met Police’s transparency (2). There are now plans for armed police officers to use them (2).

On the back of this success Guy’s and Thomas’ NHS Trust has started to use them with their security guards (3). This is in response to a 27% increase in reported “incidents” (3).

Body Worn Cameras have showed that they are useful with the police and proving useful for security staff but Northamptonshire Healthcare NHS Foundation Trust has rolled them out for nurses to use in Berrywood Hospital, a psychiatric unit (4). This is certainly going one step further.

The report of the pilot study, of the cameras usage, makes interesting reading, but has to be carefully read (5). The report is written in very positive terms, a casual read would easily give the impression that these cameras were perfect and solved all the unit’s “incidents”. But a closer read showed that these cameras are not the “perfect solution”, there were many problems with them, such as:

• ·         The cameras were not recording all the time, they had to be turned on to record an incident and then turned off (5). It relies on staff stopping and remembering to turn the camera on.
• ·         The cameras had to be worn, over clothing, on a special harness, (5) they don’t just clip onto clothing. They cannot be discreetly worn.
• ·         Staff had to be trained to use the cameras (5), a 90 minute training session. It seems they are not as easy as taking a selfie, and many staff found the training was not comprehensive enough.
• ·         The video has to be uploaded to a cloud server at the end of each shift (5).
• ·         These cameras are expensive. For just 12 cameras, the cost of equipment alone was £7,649 and the cost storage of the video for three months only was £569 (5). This doesn’t include the cost of staff time using them.
• ·         The cameras do not upload their film automatically, it has to be connected to a computer to do so. Also, the video is stored on a cloud server (5), how safe is that? How easily can it be hacked? In May this year, many, many NHS computers were the victim of a mess cyber attack (6).
• ·         The cameras seemed to have little impact on patient behaviour. During the pilot of them incidents of verbal abuse increased, actual violence increase, while the use of restraints decreased and complaints about the use of restraints also decreased (5).

They don’t seem the perfect solution to violence against staff that they are being painted as.

I work as a Community Nurse (Delivering nursing care in people’s own homes) and if my Trust introduced body worn cameras I would refuse to wear them, and my reasons why are very plain.

• ·         I would be very concerned that about them affecting my relationships with patients, patients feeling the camera was spying on them and it was breaching their confidentiality.
• ·         I also disclose personal details to patients from time to time, if I feel can help a situation, such as telling relatives of palliative patients that my parents have died from cancer. I don’t want this recorded with the potential for senior management to view it.
• ·         What would happen to the recordings? This year’s cyber attack isn’t the only time the NHS has had data breaches.
• ·         I don’t wear uniform, for safety reasons, and when I walking between patients’ homes, I don’t wear my work ID badge, because I don’t feel comfortable being identified as a nurse while out on the streets. These cameras cannot be worn discreetly.
• ·         The majority of our complaints are about visiting times or patients complaining nurses said or did something they did not. These types of incidents don’t usually have obvious “trippers” so when would I start to film?
• ·         These cameras are expensive, and I will argue the money would be fare better spent elsewhere providing patient care.
• ·         The Berrywood Hospital pilot hasn’t shown any reduction in verbal or physical violence so why should we be using them?

I am not naïve, I know violence against NHS staff is a raising, there are almost 200 assaults on NHS staff a day (7), and that I am particularly venerable working as a Community Nurse, half of Community Nurses (who took part in an RCN survey) said they’d been assaulted at work (8), but I don’t see body worn cameras as the solution. I can see why they are appearing popular to senior management, they are a quick and easy fix, a “simple” IT answer. But a closer examination shows that they do not provide that solution.

Whatever happened to the zero tolerance to assaults on NHS staff? In 2015/2016 there were 70,555 recorded assaults on NHS staff, these assaults resulted in 1,740 criminal prosecutions and 1,588 civil sanctions (9). 2.25% of all assaults on NHS staff resulted in a criminal prosecution. Punch a doctor or a nurse and you have a very good chance of simply walking away. That doesn’t happen if you punch a police officer. So “zero tolerance” has just become another NHS catch-phrase.

Where is the political will, in the NHS or parliament, to tackle violence against NHS staff? Is it too busy looking at shiny, new body worn cameras?

Drew Payne