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					Insight FAM special– Summer 2009

Protecting your NHS
                                                                                         Security Management Service




  Secure
 Winter 2010                                                      www.nhsbsa.nhs.uk/security




     First anti-terrorism seminar
            held in West Midlands
    Earlier this year, the two Local Security Management Specialists (LSMSs) for
    Wolverhampton City Primary Care Trust booked an anti-terrorism awareness event
    provided by the West Midland Counter Terrorism Unit for staff after attending a
    briefing session at their LSMS quarterly meeting.
    Mary Morgan and Russ Handy provide security management services for a wide range of staff groups
    across the PCT. As Mary explained, “The trust, which is 2,500 strong, also covers mental health, so it’s
    quite diverse. Russ and I broke down the areas into directorates for our groups – mental health, allied
    health professionals, primary care, estates & facilities, rehab, finance, etc – and asked managers for
    appropriate nominees to attend the event. Our own emergency planning officer was present, as well
    as their counterpart, the LSMS and security supervisor from our neighbouring trust”.

    Russ added, “Response was good from managers, meaning that a varied group of staff attended,
    from locality managers to housekeepers and estate workers. This was excellent as it meant there was
    a range of input into the session owing to the different roles and perspectives on the events shown in
    the presentation”.
                             Continued on page 2
Secure – Spring 2009
                                                     continued from front page
            EDITOR’S                                 First anti-terrorism seminar
             NOTES                                   held in West Midlands
                                                     The event was delivered by four officers from the
    Welcome to the latest issue of
                                                     West Midland Counter Terrorism Unit. They provided
    Secure newsletter, which brings
                                                     a very interactive session, encouraging staff to
    you the latest updates from the
                                                     participate in discussions within their groups about
    NHS Security Management Service
                                                     the scenarios shown.
    (NHS SMS). From a pilot exercise to
    measure the cost of lost and stolen              The day’s programme started at 10am with a
    NHS equipment to a round-up of                   welcoming speech from Neil Nisbet, who, as well as
    stories making the headlines, we                 being the trust’s director of finance and facilities,
    look at developments in all areas of             is also its security management director. The PCT
    the organisation’s work.                         provided lunch, and the session concluded at 1.30pm.
                                                     Mary and Russ also provided training packs for
    All of this activity relies on the close
                                                     delegates which included: the initial letter from
    working of NHS SMS staff and Local
                                                     Richard Hampton explaining the concept of Project
    Security Management Specialists
                                                     Argus, the programme for the day, the Project
    (LSMSs) in trusts across England.
                                                     Argus health workbook and the Counter Terrorism
    David Dixon, LSMS at South East
                                                     Protective Security Advice for Health document.
    Coast Ambulance Service, tells us
    about his job on page 3.
                                                         “As a direct result of the session,
    Linking LSMSs and the NHS SMS are
    four Area Security Management                        Mary and Russ began developing
    Specialists, who give us an insight                  a lockdown policy for the trust.”
    into their varied role on page 4.

    Finally, NHS Security Awareness                  The feedback forms completed at the end of the
    Month (SAM) is ongoing at the                    day confirmed that the session had been positively
    time of writing. If you’re an LSMS               received. As a direct result of the session, Mary and
    who would like to tell us how you                Russ began developing a lockdown policy for the
    raised awareness of NHS security                 trust. They asked for volunteers at the end of the
    issues during November or update                 event and had enough interested parties to set up
    us on any other areas of your work               a working group to develop the policy alongside
    generally, please email                          the trust’s emergency planning officer. The session
    cbdu@cfsms.gsi.gov.uk.                           also highlighted the need for the trust to update its
                                                     bomb and suspect packages policy and its building
                                                     operational policies (for no fewer than 32 sites!).

                                                     Mary said, “I would like to take this opportunity to
                                                     thank the officers who attended and delivered the
                                                     awareness training for their time and effort in making
                                                     the day a thoroughly enjoyable one for staff, who all
In this issue                                        felt that they learned something”.
 Area Security Management
  Specialists: what do they do?
 New camera technology at George
  Eliot Hospital
 Measuring the cost of lost and
  stolen NHS assets
 Media round-up




2                                              Protecting your NHS                          Secure – Winter 2010
                                                LSMS profile – David Dixon
                                                          sign of improvement – and confidence from those
                                                          at the ‘sharp end’ that it was worth their time to
                                                          report.

                                                          “I used my background in risk and incident
                                                          reporting to ensure that the records being made
                                                          of security incidents were as robust as possible, and
                                                          made sure we recorded details – of the incident,
                                                          the offender and the outcome – that weren’t
                                                          previously captured. As time went on, I could use
                                                          this new information and the trends highlighted as
                                                          a basis to make further decisions on the direction
                                                          of my long-term goals for the trust.

                                                          “The next challenge was moving to proactive
                                                          work, which meant peeking above the battlements
                                                          and making links outside of my trust – with the
                                                          police and other LSMSs, for example. It was
                                                          at this point that I was able to use and share
“I became the Local Security Management                   information I had gathered from reports, to
Specialist (LSMS) for South East Coast                    redefine agreements and highlight areas where
Ambulance Service (SECAmb) in                             all parties could improve. I was also able to use
September 2008, having worked as an                       this information to make contact with community
LSMS in a resilience role for the previous                groups in areas that, through incident reporting, I
year. This was part of my previous work in                could see were problematic for ambulance crews.
risk management and incident reporting                    “As part of my second Security Awareness Month, I
within the trust.                                         visited ambulance stations right across the area to
“Initially, my work was very reactive – primarily         meet with staff as they finished and started shifts.
tackling any security incidents on a day-to-day           My experiences highlighted the fact that progress
basis. The challenge was to take charge of these          was being made in the eyes of crews, as well as
issues and address them. We started getting               opening my eyes to those areas where further
successful convictions for assaults, thefts and           work would be most beneficial.
criminal damage and I continued the work I’d              “Because of the way in which we, as an ambulance
already started to raise awareness of my work             service, respond to patient need – by going to
in SECAmb. This is something I have embraced              patients, rather than providing an environment for
from the beginning as I feel it is important that         them to come to us – as well as being spread over
staff know there is someone they can go to with           such a wide area (SECAmb covers a geographical
concerns and for advice on security matters, and          area of 3,600 square miles and serves a resident
who can also help them if they are ever a victim          population of 4,500,000) and the emergency and
of violence or other abuse at work. Consequently,         time-critical nature of the work we do, my security
I made (and still make) every effort to have a            management work within the trust has always
visible presence around the trust and to be as            been extremely varied and challenging.
approachable as possible. One of the ways I do this
is by putting regular articles in the trust bulletins.    “There is still a long way to go to achieve the
                                                          objective of providing a secure environment
“As reporting of security incidents increased,            to ensure the highest standards of care for
people’s attitudes changed. They realised that they       patients, but progress is undeniably being made
didn’t have to tolerate behaviour that they had           – something I find immensely satisfying to be a
previously put up with as ‘part of the job’. As a         part of, both within my trust and in the wider
result, not only did reporting of assaults increase       NHS. Although every moment of it has been an
but also reporting of previously underreported            extensive challenge, I would be lying if I said I
verbal abuse and threats. Although this obviously         hadn’t enjoyed it greatly, and I look forward to
increased my workload vastly, it also showed that         another year of it in 2011.”
progress was being made and I considered it a


Secure– Winter 2010                          Protecting your NHS                                           3
                               Area Security Management
                              Specialists: what do they do?
Area Security Management Specialists                     to do something doesn’t mean you feel confident
(ASMSs) have been part of the NHS                        applying it to a real-life situation. I’ve gone
security management structure since                      through an exhibit list with an LSMS before to help
                                                         them progress a case”.
November 2004, but how much do you
know about what they do?                                 Unlike LSMSs, ASMSs are employed directly by the
                                                         NHS SMS, but their role is quite distinct from those
ASMSs are often described as the operational
                                                         of other NHS SMS staff. They do, however, link
link between the network of Local Security
                                                         into all of these other roles in some way – liaising
Management Specialists (LSMSs) in health bodies
                                                         with all departments from policy and operations
and the NHS Security Management Service (NHS
                                                         to media and communications. They also feed
SMS) centrally. Although it is true that without
                                                         back into all areas of the NHS SMS, ensuring
ASMSs, there would be no consistent means of
                                                         that operational work is used to drive revision of
translating national priorities into local action,
                                                         national policy, systems and procedures.
defining their role as one of coordinating and
networking is to underestimate it.                       Paul Gilderdale, ASMS for the North East,
                                                         Yorkshire and East Midlands regions, explains:
As well as taking an overview of LSMS work across
                                                         “Any new policies, guidance, training or
their share of the NHS SMS regions, each ASMS
                                                         communication materials that are developed
fulfils a wide range of other responsibilities.
                                                         in the NHS SMS centrally or affect NHS security
These are strategic as well as operational; ASMSs
                                                         management generally have an impact on our
do not simply mirror LSMS work at a regional
                                                         work. The new CJIA powers [introduced by the
level, although they do provide LSMS guidance
                                                         Criminal Justice and Immigration Act 2008],
and support where necessary. Chris MacDonald,
                                                         guidance on lockdown for NHS trusts, and the
the ASMS for London and the South East, says:
                                                         NHS lone worker service are recent examples – we
“There’s a huge scope in the ASMS role. As well
                                                         are the first point of contact for LSMSs with any
as coordinating the LSMS network to arrange
                                                         queries on interpreting guidance or implementing
quarterly and other meetings, we ensure that
                                                         policies operationally. However comprehensive
individual LSMSs receive the specific assistance they
                                                         the policy document, the detail is always down to
need, whether that’s help with work-planning,
                                                         interpretation, and that’s what we can help with.”
writing quarterly reports or accessing training, for
example”.                                                “We also set the direction for LSMS work
                                                         regionally – and to do that, we need to be able to
Nick Martin, ASMS for West Midlands and Eastern
                                                         see it in the context of everything else going on in
regions, adds: “It’s important that LSMSs don’t feel
                                                         the NHS SMS. That’s why we want to know about
isolated after their training – and being trained
                                                         all communications between the organisation

  4                                           Protecting your NHS                            Secure – Winter 2010
and LSMSs. For example, we have oversight of              “Putting a national memorandum like this into
all queries directed to the Legal Protection Unit         practice is complicated by the number of separate
by LSMSs. We want to know the latest activity             CPS areas within any given region in England.
in specific areas of NHS SMS work as well as any          For example, in my Eastern region, I deal with six
developments in NHS security management more              separate CPS areas and police forces, and another
widely.”                                                  four in the West. It’s important that we have a
                                                          clear understanding of how the NHS SMS can
This breadth of knowledge makes the ASMSs                 best work with both the police and the CPS for
“the NHS SMS’s corporate memory,” as Nick puts            any given area in the country. That’s why we’ve
it. “But corporate knowledge is only part of it,”         been developing local agreements, based on the
points out Gary Blackhurst, ASMS for the North            national memorandum, that include the police as
and South West regions. “Understanding the                well as the CPS and NHS SMS”.
frontline issues in the NHS is essential – we’re also
the NHS SMS’s avenue to the local NHS”.                   The first of these tripartite agreements was drawn
                                                          up in Suffolk, and Nick has since been working
                                                          with the CPS, police and NHS trusts to develop a
“Much of the NHS SMS’s work                               similar agreement in Norfolk.
is about ensuring consistency                             Understanding the workings of the police service
[...], working with other                                 and criminal justice system is key to the ASMS
organisations to agree national                           role, not only to enable effective joint working
                                                          at a regional level, but also to ensure that each
protocols and procedures that                             ASMS has a thorough understanding and personal
can then be applied locally. The                          experience of the role of the LSMS in this context.
ASMSs develop contacts within                             This is a natural fit for the ASMSs, who all have an
                                                          investigative background.
their own areas of responsibility
to translate these national                               Chris worked in the Metropolitan Police, running
                                                          investigations into wildlife smuggling. He also
agreements into effective local                           ran security companies, mostly overseas, before
arrangements.”                                            moving into security consulting for a range of
                                                          corporate clients. Paul was in the Department
                                                          of Work and Pensions investigating organised
With only four ASMSs and 375 accredited LSMSs             crime. Before he became an ASMS, he studied to
in trusts across England at the last count, this part     become an accredited counter fraud officer as
of the role has enormous scope geographically             well as gaining a Masters in Security and Crime
as well as in terms of content. Managing security         Risk Management, specialising in managing
in such a vast and disparate organisation as the          workplace violence. Gary’s background includes
NHS is a challenge in itself, and one that all the        nine years’ policing experience and 22 years as
ASMSs are always looking to resolve. Much of              a security advisor in the NHS, in mental health,
the NHS SMS’s work is about ensuring consistency          acute and primary care environments. Nick was
in security management by promoting a joined-             a police officer in the Metropolitan Police for 15
up approach, working with other organisations             years, before moving to the private sector where
to agree national protocols and procedures that           he spent another 15 years in various fraud and
can then be applied locally. The ASMSs develop            security roles, managing teams engaged in fraud
contacts within their own areas of responsibility to      prevention and detection, security management
translate these national agreements into effective        and investigations.
local arrangements.                                       All this is an excellent background for the ASMSs’
For example, a memorandum of understanding                close liaison with the Legal Protection Unit (LPU)
between the NHS SMS and the Crown Prosecution             – another important interface with the NHS SMS.
Service (CPS) was launched in 2006 to ensure the          This specialist team of legal case officers has been
effective prosecution of cases involving assaults on      authorised by the Secretary of State for Health
NHS staff. The ASMSs then contacted all the Chief         to conduct prosecutions in cases where NHS staff
Crown Prosecutors in England to discuss how the           have been assaulted by patients or visitors on NHS
memorandum could be implemented effectively –             premises (or elsewhere if the incident is related
something that is not always straightforward, as          to their employment in the NHS). ASMSs act as a
Nick explains:                                            conduit for legal advice and guidance on a range


Secure– Winter 2010                          Protecting your NHS                                           5
of matters, ensuring that LSMSs are aware of all        This is, in a nutshell, what ASMSs do on a day-to-
relevant developments in legal and procedural           day basis. They use local knowledge to enhance
information.                                            security at a trust level while fulfilling a strategic
                                                        role at board level to ensure that the combined
Or, as Paul puts it: “ASMSs interpret new security-     efforts of the security management directors,
related initiatives and legislation, and the policies   non-executive directors, and LSMSs for the health
of the NHS SMS, into operational sense for LSMSs,       bodies in their area meet the requirements of the
as well as acting as a filter for the LPU, directing    national security management frameworks.
LSMS queries to them as appropriate”. These
queries can relate to a vast range of information:      As Paul explains: “LSMSs report directly to SMDs
legislation such as the Data Protection Act, the        and our aim is always to maintain this structure
Freedom of Information Act and, most recently,          – we implement the security strategy through
the Criminal Justice and Immigration Act; local         SMDs and deliver the strategy through LSMSs”.
trust security procedures such as NHS security alerts   Gary adds: “There’s also something of a mentoring
and acceptable behaviour agreements for abusive         or ‘HR’ element to our role – as well as advising
patients; and operational protocols such as for         LSMSs on their work we’re sometimes also asked
CCTV and access controls.                               to advise security management directors on
                                                        managing LSMSs to get the most out of the role”.

                                                        Communication is clearly central to the ASMSs’
“ASMSs [...] use local knowledge                        remit, as it’s not only LSMSs for whom they are
to enhance security at a trust                          called upon to translate policy into practice. All
                                                        the ASMSs are trained to speak to the media and
level while fulfilling a strategic                      respond to requests for interviews. They are also
role at board level...”                                 the first point of contact for regulators such as the
                                                        Care Quality Commission, the Health and Safety
                                                        Executive and other stakeholders.
And, as the tools available to security management
specialists continue to develop, so the demands on      If you have a query for one of the ASMSs, you can
both ASMSs and LSMSs also diversify. For example,       reach them using the contact details below:
the recent introduction of the security incident        email chris.macdonald@cfsms.gsi.gov.uk or
reporting system (SIRS) placed new demands              telephone 07771 572560
on them in terms of the staff training and data
entry required to implement the system within           email gary.blackhurst@cfsms.gsi.gov.uk or
trusts. While the end result – a fully integrated       telephone 07917 077589
risk management and reporting system – will
                                                        email nick.martin@cfsms.gsi.gov.uk or telephone
ultimately reduce the effort on the part of NHS
                                                        07713 654691
bodies, the role of ASMSs and others in the
NHS SMS operational team during the ongoing             email paul.gilderdale@cfsms.gsi.gov.uk or
development and roll-out of SIRS is significant.        telephone 07917 077579
SIRS also offers a useful illustration of the
interaction of local and national security
management information that is key to the role
of the ASMS. By receiving and collating data from              Correction
numerous trusts across the NHS, SIRS allows local
findings to inform prevention and deterrence                   The November 2009 issue of Secure
work across the health service. But its value at a             stated that Peter Finch, LSMS at
local level is equally important, enabling individual          Sandwell and West Birmingham
trusts to monitor the types of security incident on            Hospitals NHS Trust, was the first
their premises, spot trends, run reports, generate             person in the NHS to secure the title of
security statistics, compare their performance                 Certified Protection Professional (CPP).
against the national picture and ensure that                   We have since been advised that others
resources are targeted in areas of the greatest                in the NHS may have already received
need.                                                          the title and we apologise for this error.




  6                                           Protecting your NHS                             Secure – Winter 2010
                                               New camera technology at
                                                   George Eliot Hospital
  (l-r) Sean Mitchell, Paul Sylvester, PCSO Marjory Shaw and Graham Richardson




                                                            Security staff at the George Eliot Hospital in
                                                            Nuneaton have been working with Warwickshire
                                                            Police to introduce body-worn cameras that can
                                                            be used to record footage when security staff are
                                                            called out to an incident.
                                                            Any footage recorded can be submitted for use as
                                                            evidence in court should this be required in the event of
                                                            a prosecution. The cameras are only activated when a
                                                            member of the security team is required to attend a specific
                                                            incident and do not record at other times.

                                                            The trust’s Local Security Management Specialist, Sean
                                                            Mitchell, said the devices were being introduced in a bid to
                                                            increase feelings of security amongst everyone who uses the
                                                            hospital, as well as to deter people from committing crime
                                                            on the premises and, specifically, to drive down assaults on
                                                            NHS staff.

                                                            Sean said: “We’re really pleased to be using this new
                                                            equipment and hope that it will further contribute to
                                                            making the hospital a safer environment for everyone. We
                   Security officer Graham Richardson
                   with a camera and viewing screen         do not tolerate abuse and aggression on the site, and the
                                                            introduction of these devices will further support this.”




Secure– Winter 2010                                      Protecting your NHS                                         7
                                     Measuring the cost of lost and
                                                stolen NHS assets




The NHS Security Management Service (NHS SMS) is carrying out work to calculate the
financial cost of NHS equipment and other assets that are lost and stolen.
The organisation’s Risk Measurement Unit (RMU) is conducting the pilot exercise to identify the nature,
scale and cost of these losses by gathering previously uncollated theft and asset loss data from NHS
health bodies. The items included were stolen or borrowed from NHS health body premises or misplaced
on the premises.

The aim is to develop more comprehensive arguments for resource allocation to protect these items. The
initiative is also part of the NHS SMS’s wider commitment to ensure the security of property and assets
belonging to the NHS, or privately owned property on NHS premises.

To date, no comprehensive national data collection of this type has been attempted and no formal
research undertaken in this area. There are no centrally collated figures and almost all information
relating to theft and asset losses are held locally at health body level.


“...the NHS SMS is looking to support further work in this area by
producing a detailed report of findings relating to theft incidents and
general losses...”

The NHS Litigation Authority (NHSLA) has records of claims from some NHS health bodies for theft
incidents to the value of £20,000 and above, but this does not accurately demonstrate the true nature
and scale of theft and asset losses.

Rather than looking to produce a definitive survey, the NHS SMS is looking to support further work in
this area by producing a detailed report of findings relating to theft incidents and general losses from a
small sample of health bodies including primary care trusts, strategic health authorities and ambulance,


  8                                          Protecting your NHS                           Secure – Winter 2010
mental health, acute and foundation trusts
across England. The report also aims to identify
examples of security weakness whereby
privately owned property is stolen or lost while
on NHS premises.

The RMU has been gathering information on
losses in three categories: discovered/reported
theft or asset losses, which have been discovered
and reported as a security incident to the LSMS,
the police and the NHSLA (if appropriate),
and internally using local reporting systems;
discovered/unreported thefts or losses, which
have been reported as security incidents
internally but not reported to the LSMS, police
or NHSLA; and undiscovered/unreported thefts
or losses, which have not been recorded as
specific security incidents – the nature and scale
of these losses are unknown because they are
never formally reported.

Although finding examples of undiscovered/
unreported thefts and losses has proved
difficult, preliminary research shows examples of
losses due to risk areas such as:

    •	 NHS equipment appearing in the
       public domain – e.g. on eBay – without
       decommissioning documentation

    •	 unexplained/undefined losses appearing
       on asset registers (above and below the £5,000 threshold)

    •	 self-authorising procurement procedures, whereby the procurer orders and retains goods for
       personal use

    •	 purchasing or re-ordering equipment because it is assumed missing or stolen when it has in fact
       been ‘borrowed’ by another department or ‘misplaced’

    •	 asset tracking problems, whereby goods ordered do not make it to end users due to ‘incidents’
       occurring between goods-in stores and distribution teams

    •	 regular purchase orders being submitted for items or equipment with reasonable shelf-lives,
       suggesting irregularities

    •	 inventory shrinkage identified through stock checks.

The exercise is scheduled to conclude at the end of the year. Local Security Management Specialists can
contact the RMU with comments or suggestions on the exercise, examples of thefts or asset losses, advice
on which departments or publications to approach for data, or recommendations on areas to focus on –
please email risk@cfsms.gsi.gov.uk.




Secure– Winter 2010                        Protecting your NHS                                         9
                                                           Media round-up
     Throughout 2010, the work of the NHS Security Management Service (NHS
     SMS) and Local Security Management Specialists has been highlighted across
     the media. Below is a round-up of some of the stories receiving the most
     coverage.
                               New guidance given on care record violence markers




                       NHS secures hospital order and restriction for violent patient




10                                   Protecting your NHS                   Secure – Winter 2010
                                                                Media round-up
                                       Criminal Asbo to halt UK’s worst ‘hospital hopper’




  CONTACT SECURE
    NEWSLETTER
  Please contact the NHS Security
  Management Service if you would
  like to contribute to Secure by
  promoting your area of work, or if
  you have any comments about the
  newsletter generally.

  You can email alexandra.limia_
  dieguez@cfsms.gsi.gov.uk
  or call 020 7895 4533.

  Alternatively, you can email the
  Communications and Business

  space
  Development Unit:
  CBDU@cfsms.gsi.gov.uk.




Secure– Winter 2010                       Protecting your NHS                               11

				
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