CCTV to be used ‘pro-actively’ by trusts to combat abuse

All providers of mental health, learning disability and autism services were ordered to review safety and asked to feed back to NHS England’s national team. The request was made in a letter from national director Claire Murdoch  sent in response to abuse allegations aired by BBC Panorama and Channel 4’s Dispatches.

The review is taking place alongside NHSE’s launch of a £36m three-year quality programme. This aims to identify providers and systems needing support, commission a culture and leadership development programme for all trusts, and produce a new model for safe inpatient care.

Results of trust-level reviews, seen by HSJ, show at least five providers aim to use CCTV more “pro-actively”, as a tool for boosting safety. 

Nottinghamshire Healthcare said it had sought legal advice on using CCTV to review episodes of seclusion or restraint. Senior nurses will review CCTV of incidents to ensure use of force was proportionate and justified, it added.

Tees, Esk and Wear Valleys Trust — accused of multiple failures in the care of three teenagers who died at the same unit in 2019 and 2020 — wrote in its review that it intends to use CCTV recordings to help staff learn from what did and did not work in clinical settings.

A spokesperson added: “CCTV is used within our trust with the specific purpose of supporting clinical practice and providing a safe environment for patients, staff and visitors. 

“The provision of CCTV enhances and complements the care provided by clinical teams that aims to reduce risk and provide patients with safe and effective care.”

Berkshire Healthcare said it was already using CCTV recordings to address concerns, complaints and HR-related issues. This would now be extended to monitoring restraint, with leaders reviewing random incidents on CCTV each month.

Lancashire and South Cumbria Foundation Trust chiefs said they were reviewing standards, policy and practice in relation to CCTV and are exploring how it could be used pro-actively to support high-quality care.

A spokesperson said CCTV is primarily used for safety purposes, adding: “Trust CCTV is operated within the framework of legal and regulatory requirements, meaning that footage is not continuously monitored and is only accessed in line with strict criteria, such as the need to review a serious incident or investigate a safeguarding matter or allegation.

“In addition, we may use CCTV pro-actively with the aim of improving quality of care, in conjunction with programmes of improvement, for example where reviewing a sample of incidents could be used to inform staff or organisational learning.”

Surrey and Borders Partnership wrote that it is considering regular use of CCTV in reviews of incidents, while Gloucestershire Healthcare said it already uses CCTV to monitor sites at risk of closed cultures.

Use of video monitoring systems has in the past proved controversial. In 2021, Camden and Islington FT was forced to stop using filming system Oxevision, used by 23 NHS trusts, within patients’ bedrooms after women and staff complained constant surveillance was harming sexual abuse survivors. LSCFT said it does not currently plan to use CCTV inside patients’ rooms.

National guidelines on video-based patient monitoring systems suggest its sole purpose is to support staff and patient safety. They say organisations should provide clear and concise information on systems to staff and service users.

Proposals to use CCTV as a safety tool come alongside a range of other measures planned by trusts to prevent abuse and tackle closed cultures.

Many trusts outlined plans to encourage greater weekend and evening working for ward managers — an issue highlighted by Ms Murdoch when questioned about BBC Panorama’s allegations about the Edenfield Centre in Greater Manchester.

Greater focus on patient voice, better leadership visibility, freedom to speak up arrangements, boosting staff training, and reducing restrictive interventions were among other key themes explored across multiple reviews.