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Posted By David Mains
Hi,
I work in a healthcare environment and I am currently reviewing our approach to the above.
Any mechanism that we look at within our organisation has potential implecations due to the Data Protection Act, Human Rights Legislation and Caldicott Guidelines.
It would appear, from the legal advice that we have recieved, that any system that we use will have major resource implecations for us due to the legal requirements involved. I understand that the individual has rights but my main concern is for the safety of our employees.
I was wondering if any members have views or experience of introducing tagging systems in the public sectors and any examples of how this can be achieved in a relatively pain free way?
Regards,
David.
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Posted By Bill Elliott
David, I shall watch this thread with interest to see what develops but how do you propose tagging a violent or aggressive individual consensually? I cannot see such individuals wanting to cooperate. If you tried to tag without consent you would be committing an assault. It is a very difficult area but NHS guidance currently (Zero Tolerance) advocates "Red Card" approach ie three strikes and you're out. Clearly such an approach may also introduce the very violence and aggression you are trying to control.
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Posted By Bryn Maidment
David
For 5 years we've been flagging patients on our PAS system. This course of action was agreed by the Trust Board and simply implemented. Any person who acts agressively or is physical has an incident form completed on them. They receive a warning letter from the Chief Exec and they receive a flag. Any staff inputting their name simply gets a window alerting them to the fact that the person is 'known' for something and they need to refer to their patient notes. Working on colour coded borders for the windows now - red for violence, yellow for abuse, green for infection risk etc.
Interestingly enough the arguments against tagging seem to come from the civil rights, social care groups who seem to be more concerned about the aggressors than the victims. The NHSLA have backed our stance up too. Human Rights Act, Data Protection etc are taken into account, quite rightly so, but do not stop you from taking action necessary to protect your staff.
More advice on this is in the "withholding treatment" guidance on the zero tolerance website. The long overdue guidance reaffirms our stance on banning patients from receiving treatment (from us). Currently 12 patients banned, 42 on a 'yellow card' and a substantial reduction in aggression and violence.
Sounds like a result!!
Hope this helps.
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Posted By Bryn Maidment
Just read Bill's response!
Intrigued that tagging constitutes an assault.
Also the 'consensual' bit shouldn't be read as having to gain their explicit verbal or written consent.
Our warning posters (which are everywhere) and letters clearly illustrate to them what they can , and will, expect to happen when they are aggressive or physical. The NHSLA have indicated that this is enough to satisfy them - at the end of the day they'll be paying out for any successful claims so if they're happy , we are.
I have to say that our strong stance is backed up by plenty of training for staff and a contract with the Met Police for 'aggressive' (their words, not mine!)responses to aggressors at our hospital.
The choices are stark - proactively manage potential and actual violence robustly, at some risk of Human Blah Act claims which can be defended, or allow aggressors to assault, intimidate and abuse people who are trying their best to help, to the degradation of our Health Service.
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Posted By Bryn Maidment
Sorry but having just re-read Bill's thread is it conceivable that Bill is talking about physical electronic tags such as those attached to the ankles of people out on bail etc?
If so that puts a whole different perspective on the response. I can't think of any sane person in a hospital wanting to adopt such a scheme but it would be an interesting concept if the ankle tag was attached to a length of stout chain with a breaker ball on the end of it. Hmm! something to try next year perhaps.
3 strikes and out? No way! Physical assaults are each looked at individually and 30% have resulted in an immediate withdrawal of treatment. After a written letter, one more abusive or threatening incident results in a ban. Robust and brave management it's called!
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Posted By Bill Elliott
I like Bryns approach - and yes I was referring to physical tagging - seems I read it wrong though I rather fancy a length of stout chain etc. Tee Hee
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Posted By John Webster
Without my specs today, I first read that Bryn's trust had been FLOGGING patients for the past 5 years. No wonder they have been so successful!!
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Posted By David Mains
Thanks for the responses.
I apologise for any confusion over the term 'tagging'. This is how the proposal was put to me but flagging is the commonly used term and it also stops any confusion. As long as John is wearing his specs!
We have been told that we should not ban first offenders although personally I think it depends on the seriousness of the offence.
The zero tolerance scheme is only for England & Wales although I have spent some time on their website and it does provide some useful advice and case studies.
Here in Scotland, the Scottish Executive have issued some press releases that grab the headlines but at the moment do not give enough guidance. There may also be issues around refusing treatment when the nearest hospital may be more than 20 miles away.
I completely agree that the first concern should be with the safety of the staff and not the rights of individuals however the legal eagles will win.
We will move ahead with this, it will just take longer to get the necessary systems in place as there appears to be no other way of doing it.
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Posted By Jim Walker
I read somewhere about a dog training device that is a collar that slowly throttles the dog when it misbehaves.
My wife used to work in A&E and am well aware of the constant abuse these people put up with. I would thoughly support the practice of using such a device. Maybe worth considering Bryn?
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Posted By Bryn Maidment
So, throat constrictors, flogging, electronic tagging and attaching big heavy weights (via stout chains) to abusers are all on my 'to do' list for the next financial year. I'll let you know if I get these past the PC scabs who vet my business plans.
On a serious note, my Trust pre empted the DoH guidance by some 4 years and it took 2.5 yrs from conception to implementation. But the payback was seeing abusive oiks banned, jailed (6 to date)and dealt with . More importantly was the feedback from staff who genuinely feel they can come to work without fear of abuse. The resultant reduction in incidents was also notable.
As long as your trust understands the implications of any strong course of action and embrace the benefits as well as accepting / mitigating those risks, then do it. Clearly, not a decision to be taken lightly, or without a lot of planning, implementation and involvement of NHSLA, yr Board, Police, PCT, staff groups etc.
If I can be of any assistance please e.mail me .
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