Patients, staff & other assets – how do we keep them safe?

It is incumbent upon the senior officer, normally the CEO, of any NHS organisation to know the assets of the organisation and have adequate processes in place to protect the public investment in them. Whilst the CEO will obviously not carry out basic Asset Management on behalf of the organisation in person the responsibility lies at their door.
    
It has been interesting in analysing the White Paper to note that just about everything it says revolves around clinical delivery, and quite rightly so for, after all, the NHS is here to provide for and protect our health. However, with around a third of healthcare spend being on the facilities that are used to house the delivery of this service it is clear that clinical delivery can only continue while facilities exist to support that delivery. So I find it staggering that so little care seems to be taken of the assets that the NHS employs day after day to support and enable the core function of maintaining the health of the nation.

Smaller assets
I can hear some of you already huffing and puffing and saying: “What is he on about? We do look after our assets as best we can within the financial constraints we have always had to work under.” Whilst this is generally (but by no means always) true of the buildings and other large assets we do seem to have a very poor track record of keeping tabs on some of the smaller of our assets. For example, how many laptops are being lost in the NHS every week? I don’t actually know but it must be fairly regularly as when we monitor the media for our ‘NHS in the News’ summaries we see laptop thefts reported and, more importantly, the sad cases of patient information or research data being lost with them. Alongside this, anecdotally, we hear that BlackBerrys are being lost by NHS staff at an alarming rate.
    
There are many solutions to help protect the valuable assets of IT, communications equipment and data but few are linked in such a way as to automatically protect the data when phone and laptop are separated. We can provide secure housings for IT equipment, but when left in a car or on a table at home laptops are very vulnerable, as proven by recent media reports. We can provide secure access gateways but when someone downloads a file to work on locally it is at risk. We have moved from the era where mobile communication devices were positively banned on hospital premises to where they are the routine communications pathway for staff. All this conspires to provide high value, easily portable kit in a relatively high stress and certainly not interruption free environment where kit can be left logged in or on a table and in public access areas where we have no real control over who is in the building.
    
Recently we have seen a simple solution that works by checking that the phone and laptop are in close proximity; if not then the laptop is electronically locked making it useless to the thief. As an option the hard drive can be automatically wiped if an illegal startup is tried. “Simples” as the Meerkat would say. Add into this the ability to have a remote backup at a secure NHS Net compliant facility and, if triggered accidentally, the process can be reversed providing the laptop returns in full working order.
    
One of the older technologies that can easily and cheaply be used to protect such relatively high value and easily portable assets is security marking or tagging. The use of smart water in its various forms is well known but seems to have been little implemented in the NHS as a whole. Passive chips can be implanted into now very small equipment and these will be shown as present by the use of a hand held reader. As all UK Police forces use this technology any stolen and recovered equipment can be checked and returned to its rightful owner. Alongside this the labelling of such assets to warn of the use of such technologies provides a real and effective disincentive to the casual opportunistic thief. Through membership discounts organisations like the Healthcare Facilities Consortium make for easier and cheaper access to these technologies.

Looking after staff
One of our biggest assets is our staff and yet taking care of them often seems to be a relatively low priority. In recent years we have seen workplace massage and laughter sessions demonstrated at conferences to good effect and yet take up by the NHS has been very low. We set up internal award schemes to motivate yet we tend to ignore things like preventing avoidable back injury by installing bed hoists in new builds. The Fable Hospital project showed the cost savings that could be achieved by this simple expedient but I have yet to see a new build with this implemented.     
    
Recently we have heard of an increase in trips and slips resulting in staff being off work with injuries but as yet have not seen any statistics to back this up. Slips and trips incidents are recorded through normal accident reporting but the outputs nationally from such reports can take some time and often will not include the potential cause of the incident. To help us see if a change in cleaning processes, for example, has exacerbated this issue we are asking for direct feedback. If you are aware of what may appear to you to be isolated incidents do please let us know and we will coordinate the reports.1
    
We are constantly being told that we have to make savings, to be more efficient but some of the simpler tasks to keep assets more secure and avoid the consequential costs of loss or theft are not being enacted; improved staff safety and security can reduce costs by not having staff away from work after injury and replacing them with bank or contracted in staff. Savings made this way cost little or nothing but can significantly reduce our outgoings.

Managing car parks
We all know that car parking is a pain. It is a problem to manage an often limited resource and have plans in place that cope with the high points of visits to main Out Patient clinics. It causes stress to patients and visitors but also to staff who have to commute between premises or be off site for part of their role and then return to base. Car parking on hospital premises is a real problem as it costs the NHS in broken and delayed appointments.
    
Recently I had to drop a patient who requires positive assistance off at a doorway and then drive almost all the way round a large hospital site in order to park the car, then walk back the full length of the hospital main corridor in order to collect the patient where I had left them and escort them to their appointment. At least one other person saw the same problem and after making the obvious comments simply drove their aged relative straight out of the hospital.
    
When visiting non NHS premises around the country I often benefit from technology that allows me to be pre-allocated a car parking space. These spaces are then managed for use through the day increasing the overall occupancy rate. It should not be beyond the capabilities of our car parking contractors to implement this in hospital car parks to patients who need this type of support. A pre-booked car parking ticket is a relatively easy solution but may require some infrastructure changes so that the users of such a system do not get caught in the routine visiting hours queues into the main car parks. The same technology would be of real use to independent but vehicle reliant patients. How much do we value the patients and their carers who visit our premises? Not as much as we should it appears.
    
Automatic Number Plate Recognition (ANPR) is slated by those who wish to break the laws relating to maximum speeds on the roads and perhaps drive without Road Tax or insurance but it can be employed in a wide range of ways to help our patients and visitors as they access our premises. Perhaps it might be good use of a manager’s time to have a quiet chat with their car parking contractor or the British Parking Association (BPA) and see what could be done instead of simply saying the car park needs to be patrolled and the existing barriers kept working. It would certainly make a good story for the first NHS body to issue a press release showing how they have used income from car parking to benefit their patients.

Benefiting patients
For many of the problems we face in managing healthcare facilities for the benefit of our patients and visitors there are a range of solutions. Some are relatively high tech and may have a significant cost or require infrastructure changes. For these a full and proper cost benefit analysis needs to be carried out to ensure that any money we do spend is used wisely and to good effect, and in today’s climate will pay their own way.
    
Other solutions are just plain common sense or use of relatively simple technologies, like marker pens or engraving on high value portable assets, or keeping the office door shut and not allowing people to tailgate through. These simpler and more routine solutions are often overlooked as we assume that they are already in place or we are too busy dealing with the fire fighting situations to step back and carry out a base level review. However, there are real benefits to be achieved and savings to be realised by making sure that our assets, of all sizes, are properly protected.

Note
1. Slips and Trips: Please consider informing the HFC Help Desk of such incidents on 08540 349645 or e-mail info@hfc.org.uk with Slips and Trips in the subject line.

MORE INFORMATION
Web: www.hfc.org.uk