Care UK
Private Sector
Noted
Care UK expresses condolences and addresses the coroner's concerns regarding first aid quality at HMP Pentonville. They discuss training, national changes to resuscitation procedures, and staff safety, but ultimately do not support bodycams for nurses due to concerns about patient trust and rapport. (AI summary)
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Dear Madam,
Regulation 28: Prevention of Future Deaths report, Robert Ginn (died 29 November 2018)
Thank you for your Regulation 28 Prevention of Future Deaths Report issued to Care UK on 30 October 2019 following the inquest into the death of Mr Robert Ginn at HMP Pentonville.
Care UK would like to express its condolences to Mr Ginn’s family and friends.
Care UK is the main provider of healthcare services at HMP Pentonville.
You have directed your report to and myself. I am responding on behalf of Care UK.
I have addressed the issues you have raised at paragraphs 5.
The matters of concern are highlighted in bold with the response set out below each concern. I have set out the action taken in response to your report and the timetable for the action plan. Care UK are committed to ensuring that the lessons learnt following this inquest are not just implemented at HMP Pentonville but across Care UK’s services at other custodial sites where Care UK provide healthcare. I am therefore able to respond on the work that is being done on a national basis.
Matter of Concern: This is the fifth occasion in five years that I have written to Care UK about the quality of first aid at HMP Pentonville. Given that fact, I wonder whether consideration could be given to nurses wearing bodycams and activating these in emergency situations
Response: In order to deal with your concern, I have discussed the following matters:
The training that nurses who are involved in resuscitation receive; The national changes in respect of resuscitation that are being implemented at Care UK; Healthcare staff wearing body worn cameras.
The training that nurses who are involved in resuscitation receive
Our policy for the standards of training for employed staff within our Health in Justice service who respond to resuscitation is Intermediate Life Support (ILS) training, provided by Resuscitation Council accredited trainers. Although the requirement from the Resuscitation Council is that attendee’s repeat this on a 3 yearly cycle, we mandate that all Care UK employed staff complete this annually. Assurance around the compliance of this training is monitored via monthly performance dashboards and reported to Care UK’s Resuscitation Committee.
All of our healthcare staff provided by agencies are required to provide evidence of up to date resuscitation training to at least Basic Life Support standard.
The national changes that are being implemented at Care UK
An alert has been issued to all Care UK Heads of Healthcare advising them to seek and provide assurance that all staff holding the emergency radio have the physical fitness to undertake full resuscitation and that those responsible for carrying the emergency radio are, and feel, confident to, lead a resuscitation. This will be followed up by our governance managers to ensure compliance.
Going forwards, we will contract with our ILS training provider to deliver additional training sessions, including some prison scenario based training. These will be in addition to the annual re-certification sessions. We anticipate that this will be rolled out across our sites nationally over 2020. In addition our intention is to film some of these scenario-based training exercises for use at in-house training events and induction.
Following a death in custody where resuscitation has taken place on site, a request is made to the prison for the opportunity to view or receive a copy of any CCTV or body worn camera footage so that this can be reviewed as part of Care UK’s 72hr immediate review process and Internal Learning Review. This is to enable is to identify issues or concerns and to assist in improving clinical care and identifying training needs.
Healthcare staff wearing body worn cameras
It is our understanding that body worn cameras were introduced to improve safety for staff working within the prisons. We have been keen to explore what governance has been put in place around the use of body worn cameras in clinical situations and have had conversations previously with both NHSE and NOMs. We are concerned that there is a risk of judgements being made regarding clinical quality from a tool not designed for use in the situation, and by people unused to either resuscitation scenarios or prison environments and from what may be poor quality footage.
Prior to the conclusion of Mr Ginn’s inquest Care UK had already considered the impact of the use of body worn cameras on healthcare teams working in prisons. In several prisons where Care UK operate, our healthcare staff have been offered body worn cameras as a measure to increase their personal safety. However, this is obviously very concerning as body worn cameras cannot replace officers or provide the same level of order, discipline and protection that physical officer presence does - particularly in predictably ill-disciplined situations such as medication queues
Whilst we are aware of the use of body worn cameras in some NHS and secure environments (for the purpose of staff safety), we have considerable concerns about the potential impact on the essential rapport building required between clinicians and patients if our clinicians start wearing body worn cameras. It can be challenging to gain trust with our patients in prison for a variety of reasons. Our concern is that simply wearing body worn cameras – even if not always turned on –could impact on the confidence patients have in the confidentiality of their consultation. Thus cameras could have an adverse impact on a prisoner’s engagement with health services and possibly lead to poorer health outcomes rather than result in any improvements in the quality of their clinical care.
Thus, following due consideration and debate, Care UK’s position remains that we neither support the filming of resuscitations by officers nor the wearing of body worn cameras by nursing staff. We have communicated this to NHSE and HMPPS
We trust that the above response provides the information that you require but please do not hesitate to contact us if Care UK can provide any further information to address your concerns.
Regulation 28: Prevention of Future Deaths report, Robert Ginn (died 29 November 2018)
Thank you for your Regulation 28 Prevention of Future Deaths Report issued to Care UK on 30 October 2019 following the inquest into the death of Mr Robert Ginn at HMP Pentonville.
Care UK would like to express its condolences to Mr Ginn’s family and friends.
Care UK is the main provider of healthcare services at HMP Pentonville.
You have directed your report to and myself. I am responding on behalf of Care UK.
I have addressed the issues you have raised at paragraphs 5.
The matters of concern are highlighted in bold with the response set out below each concern. I have set out the action taken in response to your report and the timetable for the action plan. Care UK are committed to ensuring that the lessons learnt following this inquest are not just implemented at HMP Pentonville but across Care UK’s services at other custodial sites where Care UK provide healthcare. I am therefore able to respond on the work that is being done on a national basis.
Matter of Concern: This is the fifth occasion in five years that I have written to Care UK about the quality of first aid at HMP Pentonville. Given that fact, I wonder whether consideration could be given to nurses wearing bodycams and activating these in emergency situations
Response: In order to deal with your concern, I have discussed the following matters:
The training that nurses who are involved in resuscitation receive; The national changes in respect of resuscitation that are being implemented at Care UK; Healthcare staff wearing body worn cameras.
The training that nurses who are involved in resuscitation receive
Our policy for the standards of training for employed staff within our Health in Justice service who respond to resuscitation is Intermediate Life Support (ILS) training, provided by Resuscitation Council accredited trainers. Although the requirement from the Resuscitation Council is that attendee’s repeat this on a 3 yearly cycle, we mandate that all Care UK employed staff complete this annually. Assurance around the compliance of this training is monitored via monthly performance dashboards and reported to Care UK’s Resuscitation Committee.
All of our healthcare staff provided by agencies are required to provide evidence of up to date resuscitation training to at least Basic Life Support standard.
The national changes that are being implemented at Care UK
An alert has been issued to all Care UK Heads of Healthcare advising them to seek and provide assurance that all staff holding the emergency radio have the physical fitness to undertake full resuscitation and that those responsible for carrying the emergency radio are, and feel, confident to, lead a resuscitation. This will be followed up by our governance managers to ensure compliance.
Going forwards, we will contract with our ILS training provider to deliver additional training sessions, including some prison scenario based training. These will be in addition to the annual re-certification sessions. We anticipate that this will be rolled out across our sites nationally over 2020. In addition our intention is to film some of these scenario-based training exercises for use at in-house training events and induction.
Following a death in custody where resuscitation has taken place on site, a request is made to the prison for the opportunity to view or receive a copy of any CCTV or body worn camera footage so that this can be reviewed as part of Care UK’s 72hr immediate review process and Internal Learning Review. This is to enable is to identify issues or concerns and to assist in improving clinical care and identifying training needs.
Healthcare staff wearing body worn cameras
It is our understanding that body worn cameras were introduced to improve safety for staff working within the prisons. We have been keen to explore what governance has been put in place around the use of body worn cameras in clinical situations and have had conversations previously with both NHSE and NOMs. We are concerned that there is a risk of judgements being made regarding clinical quality from a tool not designed for use in the situation, and by people unused to either resuscitation scenarios or prison environments and from what may be poor quality footage.
Prior to the conclusion of Mr Ginn’s inquest Care UK had already considered the impact of the use of body worn cameras on healthcare teams working in prisons. In several prisons where Care UK operate, our healthcare staff have been offered body worn cameras as a measure to increase their personal safety. However, this is obviously very concerning as body worn cameras cannot replace officers or provide the same level of order, discipline and protection that physical officer presence does - particularly in predictably ill-disciplined situations such as medication queues
Whilst we are aware of the use of body worn cameras in some NHS and secure environments (for the purpose of staff safety), we have considerable concerns about the potential impact on the essential rapport building required between clinicians and patients if our clinicians start wearing body worn cameras. It can be challenging to gain trust with our patients in prison for a variety of reasons. Our concern is that simply wearing body worn cameras – even if not always turned on –could impact on the confidence patients have in the confidentiality of their consultation. Thus cameras could have an adverse impact on a prisoner’s engagement with health services and possibly lead to poorer health outcomes rather than result in any improvements in the quality of their clinical care.
Thus, following due consideration and debate, Care UK’s position remains that we neither support the filming of resuscitations by officers nor the wearing of body worn cameras by nursing staff. We have communicated this to NHSE and HMPPS
We trust that the above response provides the information that you require but please do not hesitate to contact us if Care UK can provide any further information to address your concerns.