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Guidance

NHS Protect has produced guidance on a range of issues relating to NHS anti-crime work.

Our guidance documents provide a framework for NHS organisations to deal with crime at a local level. The documents may be used to develop or adapt local policies, procedures and systems. Additional guidance is available on NHS Protect's Extranet.

Fraud, bribery and corruption

Employment agency fraud: Guidance on reducing risks

The guidance in this document is intended as a framework for NHS organisations to develop or adapt their own policies, procedures and systems for dealing with employment agency fraud. The document focuses specifically on two areas of agency fraud risk, pre-employment checks and agency invoicing, and it provides a number of recommendations to help NHS organisations deal with these risks.

Employment agency fraud: Guidance on reducing risks

Payroll fraud: Guidance on prevention, detection and investigation

This guidance document has been developed to provide an understanding of the payroll fraud threat facing the NHS as well as advice and guidance on how to respond to it effectively.

Payroll fraud: Guidance on prevention, detection and investigation

The document covers the following areas:

  • Fake qualifications
  • Timesheet fraud
  • Working while off sick
  • Expenses claims fraud

A series of factsheets focusing on these four types of payroll fraud is available on the Crime awareness toolkit page.

Applying appropriate sanctions consistently – Policy statement

This document was developed in consultation with the Department of Health Legal Services and the Crown Prosecution Service and describes NHS Protect's approach to pursuing sanctions. It outlines the range of available sanctions – criminal, civil, disciplinary and regulatory – which should be considered at the earliest opportunity in cases of suspected fraud, bribery or corruption affecting the NHS. The policy states that any or all of these types of sanctions may be pursued where and when appropriate. The appendix presents an example of a case where criminal, civil and regulatory sanctions were applied successfully.

Applying appropriate sanctions consistently – Policy statement

Fraud-proofing local policies: A guide for Local Counter Fraud Specialists

This document provides information and guidance to assist Local Counter Fraud Specialists in making recommendations for fraud-proofing of local policies at their NHS bodies. It has been designed to act as a guide to the measures that can be applied when fraud-proofing. Local Counter Fraud Specialists should adapt the recommended procedures to reflect their specific organisational needs.

Fraud-proofing local policies: A guide for Local Counter Fraud Specialists

Medicines governance

Medicine security self-assessment tool

Designed for use by providers of hospital based pharmacy services in the acute, mental health and community settings, the Medicine security self-assessment tool focuses on the security and governance arrangements of all medicines within the organisation.

The tool has been developed by NHS Protect with the support of the Chief Pharmaceutical Officer at the Department of Health and in consultation with the Care Quality Commission, Royal Pharmaceutical Society, pharmacy leads and local specialists at NHS organisations.

This self-assessment tool provides a very helpful framework to engage the key individuals (particularly pharmacy and nursing leads) in a methodical consideration of medicines governance, and in translating the outcomes into an agreed action plan. The process is not onerous and the service will benefit from medicines governance improvements.
Steve Brown, Director of Pharmacy, University Hospitals Bristol NHS Foundation Trust (former Associate Director, Medicines Management, NHS South West).

The self-assessment tool is a useful tool that trusts can utilise to both assist with and demonstrate their evaluation of their policies and procedures for the secure storage of medicines.
Care Quality Commission (Sarah Dennison, Controlled Drugs National Manager and Brian Brown, National Pharmacy Manager)

I'm pleased this important tool is now available to help chief pharmacists demonstrate safe systems are in place. It should be used alongside the Royal Pharmaceutical Society's hospital standards to ensure robust policies and procedures exist throughout hospitals for the secure management of medicines.
Catherine Duggan, Director of Professional Development, Royal Pharmaceutical Society

The tool has been designed to support chief pharmacists in their evaluation of organisational policies and procedures against guidance and legislative requirements for the secure management and storage of medicines.

The self-assessment tool can also be used to demonstrate on-going progress against identified actions. Instructions for completion are in the main document.

Checklists

Two checklists are provided to support the process. One focuses on pharmacy, including main and associated pharmacy departments. The other focuses on wards and/or departments. These can be used to randomly sample security and governance arrangements or to target specific pharmacy areas, wards or departments.

Medicine security pharmacy checklist

Medicine security ward/department checklist

Action plan template

An action plan template is provided to support the process. This should be used to develop a plan of action on how areas identified as lacking or needing improvement will be addressed, as well as on the timescales and those responsible.

Medicine security action plan template

Violence against NHS staff

Mental health protocol

Where an alleged crime occurs in mental health settings, it is likely that no prosecution will result, due to difficulties particularly around the provision of sufficient evidence of an individual’s capacity and criminal intent. This may either mean that a case is not reported to the police, an investigation does not proceed, or based on available evidence a prosecution is considered not in the public interest.

This national protocol between the NHS and police reflects that mental ill health is not necessarily a barrier to an investigation, and that taking action may lead to individuals getting appropriate and safe levels of treatment and care. It details how the NHS can support the police in responding to incidents of crime, investigate and take appropriate cases forward for prosecution. This agreement should form the basis for local discussion between NHS organisations and police forces to develop new or update existing local agreements to manage crime.

National partnership protocol for managing risk and investigating crime in mental health settings

Working in partnership with your local Pubwatch scheme

This document aims to assist those ambulance trusts who wish to liaise with their local Pubwatch scheme to address the issue of alcohol-related violence against their staff.

Working in partnership with your local Pubwatch scheme

A guide for the better protection of lone workers in the NHS

This guidance document (revised March 2017) is designed to help NHS organisations develop local policies and procedures to assess and minimise the risks faced by those who work alone, and meet their health and safety responsibilities in relation to lone working.

A guide for the better protection of lone workers in the NHS

Misuse of social media to harass, intimidate or threaten NHS staff

This short guidance document aims to help Local Security Management Specialists (LSMSs) support and advise NHS staff in cases where social media has been misused to harass, intimidate or threaten them.

Misuse of social media to harass, intimidate or threaten NHS staff

Patients recording NHS staff in health and social care settings

This short guidance document aims to help Local Security Management Specialists (LSMSs) support and advise NHS staff in cases where patients are recording their treatment and care.

Patients recording NHS staff in health and social care settings

Community Safety Accreditation Scheme: Guidance for the NHS

Under the Community Safety Accreditation Scheme (CSAS), police chief officers can delegate limited powers to accredited persons within NHS organisations to help tackle anti-social behaviour in partnership with the police. This new guidance provides information for NHS organisations on the general requirements, the accreditation process and the benefits of participation in CSAS. It was developed by NHS Protect in collaboration with the Home Office and the police.

Community Safety Accreditation Scheme: Guidance for the NHS

The CSAS application form for NHS organisations (Appendix 3 of the guidance) is also available in an editable format (.docx)

An FAQ document about the guidance is also available.

Anti-social behaviour injunctions: Powers and tools guide

The Anti-social Behaviour, Crime and Policing Act 2014 provides new powers for obtaining anti-social behaviour injunctions (ASBIs) against individuals causing harassment, alarm or distress to another. NHS Protect has been granted the statutory power to seek ASBIs in civil courts.

The guidance document outlines the procedure for an ASBI application, how to build a case file and definitions of key legal terms and concepts such as burden/standard of proof. It also describes the support available from NHS Protect’s Legal Protection Unit, which can commence court proceedings to seek an ASBI.

Anti-social behaviour injunctions: Powers and tools guide

Annex A - Witness statement

Conflict resolution training: Implementing the learning aims and outcomes

This document provides new guidance for NHS organisations and providers of NHS services on conflict resolution training (CRT). The guidance covers who should receive CRT, recommended minimum standards of content and delivery, means of delivery, quality assurance as well as the relevant legal and regulatory framework.

Conflict resolution training: Implementing the learning aims and outcomes

Unacceptable behaviour - Guidance on warning letters and other written communications

This guidance has been produced to assist those in the NHS who have responsibility for dealing with unacceptable behaviour from patients, relatives, visitors or members of the public. It provides help with drafting letters and behaviour agreements, sharing information and ensuring that proper records of decision making are kept.

Due to the wide range of unacceptable behaviour encountered, the numerous types of locations involved, and the fact that each incident will have its own aggravating and mitigating factors, this guidance does not recommend what action should be taken in response to particular types of behaviour.

Support and advice on unacceptable behaviour and the responses outlined in this document can be obtained from the Area Security Management Specialists (ASMSs) or Legal Protection Unit (LPU) at NHS Protect.

Unacceptable behaviour - Guidance on warning letters and other written communications

 

Security of NHS property

Guidance on the security and management of NHS assets

This document provides the necessary tools to enable NHS health bodies to risk assess their assets and identify appropriate ways to help protect and secure them. This guidance document should be used as a template to help develop and implement local procedures and systems to promote the security and better management of NHS assets. Implementation of the guidance should take account of local environments and work activities in the way assets are used and managed.

Guidance on the security and management of NHS assets

The guidance includes a checklist to help NHS health bodies conduct risk assessment on individual assets or groups of assets. This is also available in editable format (MS Word) below.

Appendix 1 - Checklist for assessing risks to NHS assets

Guidance for NHS organisations on the secure management of patients' property

This is an updated version of NHS Protect's guidance on the secure management of patients' property, incorporating a small number of changes to the original guidance published in July 2012. The document provides the necessary tools to enable NHS organisations to identify appropriate ways to help protect and secure the property of patients in their care. NHS organisations should use the guidance as a basis to develop and implement local procedures and systems to secure and manage patients’ property.

Guidance for NHS organisations on the secure management of patients' property - Updated September 2013

We have also produced a flowchart which highlights key actions staff should undertake in the management of patients' property during their admission, stay, transfer and discharge from NHS premises. This should be read in conjunction with the guidance.

Managing patients' property flowchart

Medicine security

Guidance on the security and storage of medical gas cylinders

This guidance provides security advice to those responsible for the management and use of medical gas cylinders in healthcare organisations across England. It provides a framework for NHS organisations to develop or adapt local policies, procedures and systems to ensure the security of medical gas cylinders against theft. This guidance is primarily intended for NHS organisations and NHS staff, however its provisions may equally benefit non-NHS healthcare providers holding medical gas stocks.

Guidance on the security and storage of medical gas cylinders

In addition to the guidance, two checklists are provided to support the process. Part 1 focuses on the policies, standard operating procedures, security management arrangements, and reporting and audit processes relating to the life cycle of medical gas cylinders. Part 2 focuses on the physical security and storage arrangements in place.

Security of medical gas cylinders - General checklistSecurity of medical gas cylinders - Physical security and storage checklist

Security of prescription forms guidance (updated August 2015)

This document aims to assist those responsible for the security of prescription forms to develop and implement local procedures and systems in this area. The guidance applies to both NHS and non-NHS settings.

Security of prescriptions forms guidance - Updated August 2015

Security of prescription forms aide-mémoires

These aide-mémoires have been developed for three specific audiences (NHS England area teams, prescribers and practice managers). They highlight and summarise the key points to bear in mind when managing the security of prescription forms.

Aide-mémoire - Area teams

Aide-mémoire - Prescribers

Aide-mémoire - Practice managers

Security standards and guidance for the management and control of controlled drugs in the ambulance sector

This document sets out security standards to improve the safe and secure management of controlled drugs in ambulance trusts in England. The guidance establishes minimum security standards for ambulance trusts and their contracted providers and makes recommendations for best practice. First published in June 2012, the document has been revised to take account of recent changes and new secondary legislation, particularly The Controlled Drugs (Supervision of Management and Use) Regulations 2013. Ambulance trusts should use it as a starting point to review and improve security standards for the management and control of controlled drugs in their trusts.

Security standards and guidance for the management and control of controlled drugs in the ambulance sector

To complement the standards and guidance we have produced a Frequently Asked Questions document (PDF) and a Template security audit checklist (Word) which will assist ambulance trusts in completing risk assessments based on the standards and recommendations in the guidance.

Other security-related guidance

Meeting needs and reducing distress: Guidance on the prevention and management of clinically related challenging behaviour in NHS settings

This guidance provides chief executives, senior managers, clinical and non clinical staff, trainers and security professionals with practical strategies to prevent and manage challenging behaviour related to a patient’s clinical condition. Developed in conjunction with a clinically led expert group, the guidance emphasises reducing a person’s distress, meeting their needs and delivering the highest-quality individualised care within a safe environment.

The guidance is available, along with a range of related resources, at www.nhsprotect.nhs.uk/reducingdistress

Public places, private places and dwellings: Guidance on the nature of the location in some criminal offences

This guidance document provides an overview of issues relating to the location of incidents in the more common criminal offences encountered by NHS staff.

Public places, private places and dwellings: Guidance on the nature of the location in some criminal offences

 

Tackling nuisance and disturbance behaviour

Training resources on powers to remove and prosecute people causing a nuisance or disturbance on NHS premises.