Security in EDs IntroductionAnecdotally, emergency departments (EDs) are increasingly having to manage violent, aggressive or agitated patients. In addition, EDs must prevent patients from absconding when they are deemed a risk to themselves or others. Are you aware of the Webley case? In Webley v. St. George’s Hospital NHS Trust & Anor, (14 Feb, 2014), the acute trust was held liable for the serious injuries sustained by a mental health patient who absconded from the ED. For more information about this case, click here. RCEM is concerned about the variability of provision and standards of security in circumstances where patients may require restraint and we want to find out more about the national picture. We plan to work with NHSE and bodies in devolved nations to improve this. We want to hear your views and experiences. Please complete this survey to help us get a clearer picture of how security risks and services operate in your emergency department. All information received will be anonymised. Thank you for your participation. Dr Hilary Connor Emergency Medicine Consultant RCEM Mental Health Committee Question Title * 1. If you were to call for security for a violent patient in your ED at midnight, what response would you get? Prompt, ample security team capable of safe restraint in good time Prompt, ample security team who support but are not able to restrain 1-2 security officers who support but are unable to restrain Delayed or no security response, we have to call the police Other (please state) Question Title * 2. Do your security team receive training in supervision of mental health patients? Yes No I don't know Describe what that training is e.g. online MAST, face to face Question Title * 3. Do your security team restrain patients when requested to by a clinician? Always Sometimes Never Question Title * 4. In the event of a patient needing restraint for sedation, who performs the restraint? Police (when patient escorted under Section 136 of MHA) Security ED medical and nursing staff Mental health liaison staff A combination of the above (state who) Question Title * 5. Which of the following are trained in control and restraint? ED nurses ED doctors ED Health care assistants ED based RMNs Mental health liaison team members Other Comments e.g. what bands/grades are trained? Question Title * 6. Do you think clinical staff should receive training in control and restraint? Yes No Question Title * 7. Do your security service wear body cameras? Yes No Question Title * 8. Do you think that hospital security should wear body cameras? Yes No Question Title * 9. For patients arriving under a section 136 of the MHA, do you allow the police to leave? Yes No Question Title * 10. Are security part of the team that performs initial assessment (sometimes called RAT) in the ED? Yes No Question Title * 11. If you allow the police to leave: Always Usually Sometimes Rarely Never Security will attend promptly if requested Security will attend promptly if requested Always Security will attend promptly if requested Usually Security will attend promptly if requested Sometimes Security will attend promptly if requested Rarely Security will attend promptly if requested Never There delays to releasing the police due to lack of security services There delays to releasing the police due to lack of security services Always There delays to releasing the police due to lack of security services Usually There delays to releasing the police due to lack of security services Sometimes There delays to releasing the police due to lack of security services Rarely There delays to releasing the police due to lack of security services Never Question Title * 12. In relation to patients requiring 1:1 observations, this is carried out by: Always Usually Sometimes Rarely Never The police (if a patient is on a S136) The police (if a patient is on a S136) Always The police (if a patient is on a S136) Usually The police (if a patient is on a S136) Sometimes The police (if a patient is on a S136) Rarely The police (if a patient is on a S136) Never Security Security Always Security Usually Security Sometimes Security Rarely Security Never Health Care Assistants Health Care Assistants Always Health Care Assistants Usually Health Care Assistants Sometimes Health Care Assistants Rarely Health Care Assistants Never ED nursing staff ED nursing staff Always ED nursing staff Usually ED nursing staff Sometimes ED nursing staff Rarely ED nursing staff Never Question Title * 13. In the last 12 months has your ED ever felt unsafe due to agitated or violent patient behaviour? Yes, frequently (daily or weekly) Yes, sometimes (monthly) Yes, occasionally (a few times a year) No, not at all Question Title * 14. In the last 12 months has your ED had any critical incidents or SIs in relation to agitated or violent patients? Yes No Number of incidents Question Title * 15. Please share the nature of the incident if you feel it is appropriate to do so. Please do not include patient/relative/staff-identifiable information. We will anonymise your response by Trust and respondent. Question Title * 16. Please share the name of your ED. We will only use this to count the numbers of EDs that respond, your response will be anonymised. Question Title * 17. Any other comments Done
