VIOLENCE IN HEALTH AND SOCIAL CARE WEBINAR Andrew Hynes Solicitor - - PowerPoint PPT Presentation

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VIOLENCE IN HEALTH AND SOCIAL CARE WEBINAR

Andrew Hynes Solicitor Legal and Risk Services Companies House, Cardiff 22 February 2019

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• The combination of an ageing population and

increased longevity means that the size of the hospital and care population is increasing as is the average age of the patients.

• Older patients will tend to present more

frequently with cognitive impairment in addition to their medical issues.

• This demographic will lead to increasing

incidents of violence and aggression against staff in general medical wards as well as in mental health settings.

• The management of the impact of this

developing reality is a key challenge for all Health Organisations.

THE ELEPHANT IN THE ROOM

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VIOLENCE AND AGGRESSION CIVIL CLAIMS – TREND ANALYSIS

78 105 125 134 136 140 153 150 140 154 152 145 145 11 15 21 21 22 21 22 22 17 19 16 12 13

Apr 12 to Sep 12 Oct 12 to Mar 13 Apr 13 to Sep 13 Oct 13 to Mar 14 Apr 14 to Sep 14 Oct 14 to Mar 15 Apr 15 to Sep 15 Oct 15 to Mar 16 Apr 16 to Sep 16 Oct 16 to Mar 17 Apr 17 to Sep 17 Oct 17 to Mar 18 Apr 18 to Sep 18

All Wales Sample Health Board

• The writer has defended the NHS since 1998.
• V&A Claims have doubled since 2012
• They are now more prevalent than patient manual handling claims (36)
• Claims are the tip of the iceberg
• Estimate that less than 50% of patient or staff assaults are reported
• Estimate 5% of incidents end up in criminal or civil courts

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• The Incident Report Form takes the position of a

conductor within a symphony. The Incident Report Form is the trigger for all other matters.

• All objectives very much depend upon whether or not

the Incident Report Form is filled in. (See Diagram)

• They are certainly achieved more easily when one is

done. The Central Importance of the Incident Report Form

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CAPTURE

INCIDENT FORM

Human Resources & Payroll Corroborates incident for benefits purposes – Sick Pay Emotional Air Employee has communicated and been listened to Prevention Goes to Health & Safety Dept. Statistical analysis identifies trends for effective Risk Management Departmental Manager can assist to identify

• trends. Make a case for

extra resources Estates Department Environment repairs Procurement Department Defective equipment Occupational Health Goes to OH. Correlation between system of work and injury? Medical Support Prompts referral to A & E

• r other medical treatment

rehab Proper Investigations Key prompts What happened? Proper Investigation prompted witnesses RIDDOR report to HSE Litigation Dept provides vital evidence

Central Importance of Incident Form

CAPTURE

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CASE STUDY

Actual case study of Appeal in Violence and Aggression Case Before His Honour Judge Bidder QC “JUDGEMENT”

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RISK INTEGRATION

In relation to prosecution and civil cases

The issues are equivalent or overlap Investigation Topic – Key Investigation subject areas uncover the root

• f the problem

Civil case Employer v Employee Negligence/ Breach of Statutory Duty

Facts Corroborated Generic Risk Assessment Unescorted leave – decision reached by MDT Specific Risk Assessment Final decision on unescorted leave Environmental Risk Assessment Imports control measures met as CCTV at entrance Placement of Patient Voluntary patient with ongoing requirement for treatment Training of all staff Not pleaded as a breach of duty - Staff male /female ratio considered Contributory Negligence Claimant’s conduct not criticised – needs to be more than inadvertence Equipment Provided Breathalyser not relevant to violent reaction Vicarious Liability Not a factual finding that staff assisting didn't follow training

PREVENTION is more likely if duty of care is met DEFENCE is more likely if duty of care is met

Hidden organisation costs are huge

• Management Time
• Divisive nature of proceedings
• Loss of new staff
• Disintegration of teams
• Morale
• Falling standards of care

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RISK INTEGRATION

In relation to prosecution and civil cases

The issues are equivalent or overlap Criminal Case against Perpetrator/Patient for assault

Investigation Topic – Key Investigation subject areas uncover the root of the problem

Criminal Case against Health Organisation Corporate Manslaughter Fines under H&S Offences Act

Facts Generic Risk Assessment Specific Risk Assessment Environmental Risk Assessment Placement of Patient Training of all staff Contributory Negligence Equipment Provided Vicarious Liability

PREVENTION is more likely if duty of care is met DEFENCE is more likely if duty of care is met

Hidden organisation costs are huge

• Management Time
• Divisive nature of proceedings
• Loss of new staff
• Disintegration of teams
• Morale
• Falling standards of care

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How to Manage Unintentional Violence in Healthcare

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Scan QR code using mobile device to take you to the webpage

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Full agreement is available at

http://www.nwssp.wales.nhs.uk/nhs-wales-anti-violence-collaborative

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