Chamber and committees

Scottish Ambulance Service submission of 22 October 2021

PE1877/C: Provide body cameras for all frontline NHS staff

The number of incident reports completed by Scottish Ambulance Service staff reporting either physical or verbal abuse in 2020 was 260, down from 315 in 2019. The reduction in reported assaults may be associated with a reduction in overall activity during the pandemic lockdown periods of 2020. In 2021 so far (up to Oct 21), there have been 208 reported assaults, comprising of 91 verbal assaults and 117 physical assaults against SAS staff.

Evidence from across the UK suggests that violence against Ambulance staff is an increasing trend. The types of violent act are many and varied. These include weapons with knives and guns becoming more prevalent as well as verbal and sexual assault. Spitting and punching remains a regular occurrence. No form of assault on our staff is acceptable.

Currently all frontline Scottish Ambulance Service ambulances, are fitted with CCTV which record vehicular traffic around the vehicle, as well as a facility, if activated by a crew member, to initiate recording within the ambulance patient care area. A further safety measure available to staff is the ability to activate an ambient listening function on staff issued Airwave radios. This function, whilst not without its limitations, is useful in situations where staff feel threatened when away from the ambulance such as in a building or residential setting.

The Scottish Ambulance Service has a legal responsibility under the Health and Safety at Work Act 1974 to ensure the safety of its staff. As part of Service’ work towards supporting Health, Safety and Wellbeing, the group responsible for the oversight of Health & Safety recently considered and approved a limited trial of body worn video recording devices in the Service. The group acknowledged the perceived benefits of body worn cameras over other recording mediums to include deterrence; that a potential aggressor may be less likely to perpetrate an assault if known that the act will be filmed for later prosecution.

In June 2021, NHS England announced that after a successful trial in the London Ambulance Service and North-East Ambulance Service, body worn cameras were being rolled out for trial across all 10 ambulance trusts in England. The London Ambulance Service reports that in addition to contributing towards the protection of crews, video footage has been requested on multiple occasions by the Metropolitan Police to support prosecutions. From an evidential perspective, high-definition video footage will likely support prosecution better than audio only recording, particularly in the context of an offence under the Emergency Workers (Scotland) Act 2005. 

The use of surveillance equipment such as CCTV and body worn cameras can be an emotive subject and patient confidentiality within the context of data protection legislation is of paramount importance. Scottish Ambulance Service has in place strict policies and procedures for the control of data collected during the operation of CCTV on its vehicles. A fundamental aspect of operating body worn cameras is the governance that balances the rights of an individual to privacy with the safety of staff. Any implementation of this equipment must adequately take cognisance of this principle.

There is also a potential role for the use of body worn cameras to live stream patient information to decision support clinicians in the Ambulance Control Centre, and as data collection for clinical research, but this would need careful consideration, evaluation, and agreed through patient and public engagement groups. To ensure any reservations that clinical staff may have with regards to preserving the patient - clinician relationship in the presence of cameras, development work must include close engagement with patient and staff representatives, this work has previously been successfully carried out in the award winning 3RU programme in Edinburgh.

In order to comply with data protection legislation, it is important that the equipment selected is of a sufficient standard, therefore the full implementation of this equipment for the Scottish Ambulance Service, could easily run to a capital investment cost in the region of a million pounds. Recurring costs are estimated to be in the region of £350k per annum, with costs associated with asset and data management equipment, staffing costs and digital cloud storage costs. A cost benefit may be realised in a potential reduction in assault related staff absence and improvement in staff wellbeing. This improvement in staff wellbeing will likely also be associated with an increased sense of safety amongst staff which will undoubtedly have a beneficial impact on the care patients receive.