Tackling Personal Safety Challenges in the NHS
Health & Safety and Security leaders within the NHS gathered at Peoplesafe headquarters to discuss personal safety challenges facing their staff.
The NHS is a healthcare marvel, juggling immense pressure with exceptional patient care. However, this dedication can create a dangerous tightrope walk for staff, where safety and wellbeing can become an afterthought.
Here’s a look at some key challenges participants at Peoplesafe’s NHS roundtable discussed that threaten staff safety.
Safety Challenges in a Clinical Setting
The NHS is renowned for its patient-centric approach, but prioritising care shouldn’t come at the expense of staff safety. A key topic that drew a lot of agreement from attendees was that the “can-do” attitude ingrained in NHS staff can be a double-edged sword.
Often, they feel compelled to put themselves at risk to complete tasks, even when facing unreasonable demands. This often stems from a cultural mindset that prioritises completing jobs over personal safety. The general consensus around the table was that staff need to be empowered to say no instead of putting themselves at risk.
Initiatives like “Not part of the job” campaigns, like the ones run by Guys and St Thomas’ NHS Trust, send a clear message: saying no to unsafe situations is not only acceptable, it’s essential.
The Unknown Factor
Clinical settings often deal with the unknown. A seemingly straightforward case can escalate due to unforeseen family dynamics. Mitigating these risks requires clear policies, protocols and robust training in de-escalation techniques.
Building rapport with patients is vital, but it can lead to complacency. Staff who get too comfortable can let their guard down, becoming more susceptible to aggressive behaviour or unexpected incidents.
Continuous vigilance and dynamic risk assessments are crucial. These assessments should consider not just the environmental hazards, but the patient’s emotional state and whether their medical condition has changed since a previous appointment.
Safety Challenges in Community Settings
Unlike hospital settings, community visits expose NHS staff to unpredictable home environments. Participants highlighted seeing a rise in the number of reports of weapons, dangerous dogs, and extended family being present. Each of these situations adds a layer of risk that places a responsibility on the individual to manage.
In the majority of Trusts, staff will be required to work in deprived areas, encountering patients facing significant social and economic challenges. While empathy is essential, these very circumstances can create safety hazards. Staff may be hesitant to report incidents due to fear of repercussions – they might even live in the same community as their patients.
Training on dynamic risk assessments, de-escalation techniques and clear protocols for managing aggressive situations is crucial.
Balancing Care and Safety
Removing care due to staff safety concerns is incredibly difficult, often restricted by human rights legislation. This creates a frustrating situation: where does tolerance end when it comes to verbal or physical abuse towards staff?
The group hypothesised the intrinsic link between a staff member’s level of tolerance and their experience. For example, a senior employee with more than 15 years of experience will perceive what is acceptable completely differently from a junior employee with less than 5 years of experience.
Therefore, each Trust must explicitly define tolerance in its policies when it comes to abuse. The ideal of “zero tolerance” for abuse against staff seems elusive. Striking a balance is key: ensuring a safe work environment for staff while continuing to provide essential care to those in need.
Where is the boundary of responsibility for personal safety?
Striking a balance between employer responsibility and staff accountability is crucial for creating a safe working environment. The NHS is an institution where staff dedication can sometimes overshadow personal safety.
The Employer’s Role
Participants expressed feeling that they have a clear responsibility to provide staff with the tools they need to stay safe. This includes:
- Comprehensive risk assessments: Identifying potential hazards in different work settings is essential. From lone working protocols to de-escalation training, these assessments inform safety procedures and guide staff in identifying red flags.
- Accessible safety technology: Personal protective equipment (PPE) and safety alarms should be readily available and staff should be trained on their proper use.
- Open communication channels: Staff need a safe space to report incidents and raise concerns without fear of judgment. A strong reporting culture empowers staff to identify issues before they escalate.
Staff Responsibility
However, the employer’s role doesn’t end with providing tools. Staff also have a responsibility to:
- Use safety technology: It’s part of the tool kit. The Trust has invested in tech to improve safety. Staff wouldn’t attend an appointment without all the necessary medical equipment and safety technology needs to be considered equally essential.
- Actively participate in training: Engaging with safety training and practising procedures ensures staff can react effectively in potentially dangerous situations.
- Apply everyday safety practices: The same safety awareness we exercise in our personal lives – like being mindful of surroundings and avoiding poorly lit areas – needs to be carried over into the workplace.
- Report incidents: Reporting all incidents, near misses, and concerns helps employers identify trends and improve safety measures.
Setting the Tone
Organisational culture plays a crucial role in encouraging responsible safety practices. A culture that prioritises safety through open communication and positive reinforcement motivates staff to take ownership of their safety. Conversely, a culture that downplays risks or discourages reporting can lead to staff neglecting safety protocols and overlooking safety concerns.
Moral Obligation
The tricky issue of legal and moral obligation towards staff was raised by the group when considering the boundary of responsibility. UK health and safety law clearly sets out an employer’s duty when it comes to workplace health and safety.
There is however, a considerable grey area when it comes to an employer’s ethical duty towards safety. Participants debated whether safety protocols ought to be extended beyond working hours, particularly to encompass the commute: a work-adjacent time period that employers are not technically responsible for.
Although the group was unable to arrive at a definitive answer, it sparked intriguing conversations about how far people were willing to go to ensure staff started work safely and arrived home safely at the end of the day.
NHS Toolbox to Tackle Safety Challenges
NHS Trusts face a constant battle to ensure staff safety. Even when investment is made in services and solutions, like Peoplesafe, usage can be less than desirable and represent a real challenge for safety and security leaders. Through discussion, the group explored various options to tackle these safety challenges.
Leveraging Service Managers
A key strategy is to empower Band 7 and 8 staff to champion safety. They are the middle layer with the ability to drive the successful adoption of policies and processes within their teams and service areas. It is their job to be responsible for the safety of their teams.
Using their knowledge and experience, service managers can train and mentor junior members, equipping them with the confidence and skills to protect their personal safety effectively.
Service managers need to ensure staff feel comfortable raising concerns and reporting near misses without fear of reprimand. If they own the safety compliance of their people, they will enforce the safety agenda and ensure that systems are being used effectively. With this level of attention, any problems can then be escalated.
Making Safety Second Nature
Just like face masks were essential during the COVID-19 pandemic, Peoplesafe should be seen as a vital piece of PPE.
Encourage staff to consider Peoplesafe as an intrinsic part of their medical kit – something unthinkable to leave behind when interacting with patients. Similar to a blood pressure cuff or ear thermometer, Peoplesafe becomes an essential tool for every healthcare professional.
Address Non-Compliance
Often, safety only becomes a priority after an incident occurs. Fostering a proactive style and addressing non-compliance requires a multi-pronged approach:
- Remind staff of dangers: An accident-free record isn’t a guarantee that an incident won’t happen. Revisit risk assessments to emphasise potential dangers and encourage proactive use of the safety technology.
- Highlight success stories: Showcase incidents where Peoplesafe helped ensure staff safety.
- Understand staff concerns: Organise facilitated discussions (e.g. focus groups) with sceptical staff to understand their reasons for not using the technology.
Most participants confided that they were facing the challenge of complacency and apathy. One suggestion for overcoming this was to involve an external organisation. Jayne King from Guys and St Thomas’ NHS Foundation Trust explained how they enlisted the help of Suzy Lamplugh Trust to offer impartial advice and implement their safety expertise.
By implementing a combination of these strategies, NHS Trusts can create a culture of safety where staff feel empowered and equipped to navigate the challenges of their roles.
Ultimately, protecting staff is not a burden, it’s an investment. A confident and secure workforce can deliver better care, creating a healthier and safer environment for all.
