Procedure for security of patients’ cash and valuables on ... · The cash and valuables should be...

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Do not retain a paper version of this document, always view from the website www.cwp.nhs.uk to ensure it is the correct version

Document level: Trustwide (TW)

Code: CP62 Issue number: 2

Procedure for security of patients’ cash and valuables on wards

Lead executive Director of Finance Author and contact number Deputy Director of Finance – 0151 604 7284

Type of document Policy Target audience All inpatient staff

Document purpose This document outlines the procedure for security of patients’ cash and valuables on wards details ward staffs responsibilities.

Document consultation Modern matrons, Finance department, governance support team Approving meeting Board of Directors 16-Oct-12 Ratification Document Quality Group (DQG) 16-Oct-12 Original issue date Jul-04 Implementation date Oct-12

CWP documents to be read in conjunction with

HR6

Trust-wide learning and development requirements including the training needs analysis (TNA)

Training requirements There are no specific training requirements for this document.

Financial resource implications No

Equality Impact Assessment (EIA) Initial assessment Yes/No Comments Does this document affect one group less or more favourably than another on the basis of: • Race No • Ethnic origins (including gypsies and travellers) No • Nationality No • Gender No • Culture No • Religion or belief No • Sexual orientation including lesbian, gay and bisexual people No • Age No • Disability - learning disabilities, physical disability, sensory

impairment and mental health problems No Is there any evidence that some groups are affected differently? No If you have identified potential discrimination, are there any exceptions valid, legal and/or justifiable? N/A Is the impact of the document likely to be negative? No • If so can the impact be avoided? N/A • What alternatives are there to achieving the document without

the impact? N/A

• Can we reduce the impact by taking different action? N/A

http://www.cwp.nhs.uk/

http://www.cwp.nhs.uk/GuidancePolicies/CWPPolicies/Humanresources/Pages/HR6.aspx

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Where an adverse or negative impact on equality group(s) has been identified during the initial screening process a full EIA assessment should be conducted.

If you have identified a potential discriminatory impact of this procedural document, please refer it to the human resource department together with any suggestions as to the action required to avoid / reduce this impact. For advice in respect of answering the above questions, please contact the human resource department. Was a full impact assessment required? No What is the level of impact? Low

Document change history Changes made with rationale and impact on practice 1. Full document review

External references References 1.

Monitoring compliance with the processes outlined within this document Please state how this document will be monitored. If the document is linked to the NHSLA accreditation process, please complete the monitoring section below.


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Content 1. Introduction ................................................................................................................................. 4 2. Admissions ................................................................................................................................. 4 3. Requests from in-patients for cash and / or valuables ................................................................. 5 4. Requests from in-patients for cheques ........................................................................................ 6 5. Income received on behalf of in-patients ..................................................................................... 6 6. Discharge of a patient ................................................................................................................. 7 7. Death of a patient ........................................................................................................................ 7 8. Transferred patients .................................................................................................................... 7 9. Duties and responsibilities .......................................................................................................... 7 9.1 Chief Executive ........................................................................................................................... 7 9.2 Director of Finance ...................................................................................................................... 8 9.3 Deputy Director of Finance ......................................................................................................... 8 9.4 Ward Managers .......................................................................................................................... 8 9.5 Cash Office Managers ................................................................................................................ 8 9.6 All CWP staff ............................................................................................................................... 8 Appendix 1 – Patients cash, valuables and clothing sheet .................................................................... 9 Appendix 2 – Record of patient cash / valuables deposited in or withdrawn from ward safe ............... 10 Appendix 3 – Request for return of patient’s cash and or valuables .................................................... 11 Appendix 4 – Patient Monies – Request for cheque ........................................................................... 12 Appendix 5 – Transfer of patients property ......................................................................................... 13 Appendix 6 – Cash and valuables for safe custody – East Cheshire ................................................... 14


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1. Introduction This procedure outlines the responsibilities of ward staff and covers:

• Admissions (including 48 hour deposits); • Income received on behalf of patients; • Requests (from inpatients) for: cash / return of valuables; • Requests (from inpatients) for: cheques; • Discharge of a patient; • Death of a patient; • Transferred patients.

2. Admissions On admission to a ward, a patient possessing cash and / or valuables (patient’s property) should be encouraged to hand over the property to the nurse in charge for safekeeping. Admitting staff must bring to the attention of the patient, their relative or representative, that the Trust will not accept responsibility or liability for patients’ monies and personal property retained by the patient. Where the patient refuses to hand over cash / valuables, the nurse in charge should record on the admission sheet notes to this effect stating also that the patient their relative or representative was notified that the Trust will accept no responsibility or liability in the effect of a loss or theft. The appropriate section of the property book should then be completed, signed by the patient, senior nurse and a witness. Where a patient is unable to sign the relative / representative should be requested to do so, indicating in what capacity (husband, daughter, next door neighbour). Exceptionally, if no relative / representative is available a witness should be obtained from ward staff. The patient’s cash, valuables and clothing sheet have now been combined. There are sections for items handed over for safekeeping and items retained by the patient along with the appropriate disclaimer (Wirral and West appendix 1), (East appendix 6). The form should be completed by the nurse in charge and witnessed by a second member of staff and signed by the patient. The property should not be accepted by ward staff until the form is signed by all parties. Only one book may be held in each ward at any time. A completed book should be handed to the general / cash office in order to obtain a new one. These books must be kept secure at all times. The Property Books contain 4 part NCR (No Carbon Required) forms, each part is to be treated thus:

• Part 1 Retained by General / Cash Office on receipt of the property from the ward staff. • Part 2 Ward copy; • Part 3 Patients / representatives copy; • Part 4 Retained in the book.

It is important that items such as gold and diamond are not used when describing the property, expressions such as yellow metal and white stone must be adopted. Full details of pension / bank / cheque books, insurance policies savings certificates etc must be entered in the property books. The property must be placed in a patient’s property envelope and sealed. Both nurses must sign across the seal.


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The cash and valuables should be taken immediately with the completed patients property book to the general / cash office for deposit and safekeeping. General / cash office staff must receipt the cash and valuables in the appropriate box at the bottom of the patient’s cash, valuables and clothing sheet. Where patients’ property is accepted out of office hours, it must be lodged in the designated site night safe and forwarded to general / cash office at the start of business on the next working day. 48 hour deposits Where patients wish to deposit valuables for safekeeping for a short period, valuables may be retained on the ward within a designated locked safe for a maximum of forty-eight hours. This system should only be used where absolutely necessary and all cash and valuables should be taken to the general office for deposit or placed in the night safe outside office hours. This procedure should not be used as a weekend holding facility. The property must be placed in an envelope as described above and where possible the patient must sign for their deposits. The details must be entered in the 48 hours book (appendix 2) along with the receiving nurse’s signature and a witness signature from a colleague against each entry made. A witness signature must always be obtained where the patient is unable to sign for deposits or withdrawals from the ward safe. A maximum of £500 cash may be held in the 48 hour safe on the ward for any one patient. Should the patient be insistent that cash exceeding this limit be held within the 48 hours facility, the senior nurse should contact the finance department at the earliest possible opportunity? The Director of Finance or the Director of Operations will then be advised and may wish to over rule the patient’s wishes and deposit the cash and valuables at the general office in the interest of security. On communication of this the senior nurse should take the cash and valuables to the nearest general office or night safe immediately. Within 48 hours such valuables must either be handed back to the patient for which the patient must sign where possible, or entered in the property book and handed into the general / cash office. A note to this effect should be made in the 48 hours book and the entry signed by the issuing nurse and witnessed by a colleague. The safe key must be held by the senior nurse in charge at all times and the safe must be located in a secure place and bolted to the floor in line with the manufacturers’ guidelines. A hand over procedure must take place on change of shift between the senior nurses for cash and valuable items still held in the safe on the ward. The contents of the safe should be checked to the entries in the 48 hours book and the period of time between deposit and hand over to ensure they do not exceed the 48 hours limit. Both nurses should sign the shift change box on the 48 hours sheet for each entry carried over. 3. Requests from in-patients for cash and / or valuables Each ward will be supplied with a two part NCR, Request for return of patient’s cash and or valuables (appendix 3) to be used on each occasion a request for cash or return of valuables is made. On receiving from a patient, a request for cash or for the return of valuables in part or in full, the senior nurse on duty should complete and sign a “request for cash and / or valuables” form in the presence of the patient and a second member of staff. The patient and the second member of staff, as a witness, should both sign to authorise the transaction. Where a patient is unable to sign the request form, the signature of the ward manager must be obtained. He / she should record in writing on the form that they have been authorised verbally by the patient to request monies / valuables, giving a time, the date and the precise reason why the patient is unable to sign. For reasons of security the maximum cash reimbursement shall normally be £100, unless the patient specifically requests more than this amount when the Director of Finance or Deputy Director of Finance must approve the transaction prior to releasing the cash.


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The book should be taken to the general / cash office who will sign and retain the top copy of the form. The disbursement of the cash/valuables will be made directly to the patient or named member of staff, by the general / cash office. A receipt must be issued to and signed by the patient and witnessed by a member of the nursing staff, to acknowledge receipt of the cash and / or valuables. If the patient is unable to sign they should be asked to make their mark and this should be witnessed by two senior ward staff. If the patient is capable of attending the general / cash office to collect their own property, they should be given the completed “request for return of cash and / or valuables” form to present. However, the patient must have some proof of identity or be escorted by a nurse. Where cash requested is subsequently not spent in full, the in-patient should be encouraged to re-deposit the cash for safekeeping. Wirral and west appendix 1 or east appendix 6 must be completed as outlined in Section 1. As a general rule, relatives and representatives of the patient cannot sign on behalf of the patient for receipt of cash / valuables. Staff must not hand cash or valuables to anyone other than the patient. Without the signature of the patient, there is no proper legal discharge of the property and the Trust would be open to litigation in respect of transfer to a third party. Where patients are likely to be discharged after office hours and they have cash / valuables deposited, ward staff must ensure that the property is collected / returned to the patient during office hours. If there is any delay in handing the property to patient, the ward staff should ensure that the items are adequately safeguarded. Please refer to NHS Protect guidance for Managing patients’ property flowchart 4. Requests from in-patients for cheques Each general / cash office will be supplied with a two part NCR Patient Monies – Request for cheque book (appendix 4). When it becomes necessary to pay a household bill or other disbursement on behalf of a patient, details with full supporting documentation should be presented to the general / cash office, who will complete a “Request for Cheque” form. The form will be taken to the patient to sign authorising the transaction. The form must then be signed by the senior nurse and witnessed by another member of the ward staff. The general / cash office will submit the top copy to the Director of Finance / Financial Services Department for production of the cheque. At this stage the general / cash office must ensure there are sufficient funds in the account to meet the request, as detailed on appendix 4. If funds are insufficient the request will not be discharged. Where a patient is unable to sign the request form, the signature of the ward manager must be obtained. He / she should record in writing on the form that they have been authorised verbally by the patient to request a cheque, giving the amount, time and date of the request. In-patients should be informed that all cheques, requested by them, to third parties will be mailed direct to the third party by Financial Services Department unless the patient requests otherwise. 5. Income received on behalf of in-patients Income (pensions, disability allowance etc) will be received, receipted and recorded by the general / cash office. However, when cash is received on the ward Section 1 above should apply.


http://www.nhsbsa.nhs.uk/Documents/SecurityManagement/Managing_patients_property_flowchart.pdf

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6. Discharge of a patient For reasons of security reimbursement of patients monies on discharge will usually be by cheque. The maximum cash reimbursement shall normally be £100.00, unless the patient specifically requests more than this amount and the Director of Finance or Deputy Director of Finance has had confirmation that there are sufficient funds in the account. For reasons of security reimbursements in excess of £100.00 should be discouraged, such occurrences would normally arise if the patient does not hold their own bank account. Any cheque requested on discharge of a patient to a domestic or nursing home environment will be made payable to the patient by name. Completion of the requisite forms (appendix 3 and appendix 4) on discharge of patient is explained in detail in Sections 2 and section 3. On the return of valuables to a patient on discharge, general / cash office will ensure that patient and a nurse witness signatures are obtained. 7. Death of a patient Notification of the death of a patient will be made to the general / cash office as soon as is practicable on a notification of death form. Following a death all property must be recorded in patient’s cash, valuables and clothing sheet (Wirral and West appendix 1, East appendix 6) and taken to the general / cash office. Valuables and cash are not to be handed over to the lawful next of kin by the nursing staff. This function is performed by general / cash office when their identity has been verified and a form of indemnity has been signed. When the balance held is £5000 or less the general / cash office must always seek absolute proof e.g. a solicitors’ letter, confirming that the person making the request is the only beneficiary or next of kin of the deceased patient. Where the Balance is in excess of £5000 letter of administration or probate must be produced. 8. Transferred patients When a patient is transferred within a hospital and cash and/or valuables have been deposited with the general / cash office the transferring ward should ensure that the office is advised of the new location of the patient and also that the receiving ward is advised that property has been deposited for safekeeping. When a patient is transferred to another hospital and cash and / or valuables have been deposited for safekeeping the general / cash office must be advised. The general / cash office will then arrange for the property to be transferred. Small value items and clothing which are retained by the patient and are therefore transferred with the patient must be recorded in the transfer of patient’s property book (appendix 5) and forwarded to the receiving ward in order that they can acknowledge receipt of the property. When a transfer is to take place ward staff must advise general / cash office in order that they can arrange the transfer of any cash and or valuables which have been deposited for safe keeping. 9. Duties and responsibilities 9.1 Chief Executive As accountable officer, the Chief Executive must ensure that responsibility regarding management of the security of patient’s cash and valuables is delegated to an appropriate executive lead.


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9.2 Director of Finance The Director of Finance has delegated responsibility to ensure the security of patient cash and valuables regarding:

• Admissions; • Income received on behalf of patients; • Requests (from inpatients) cash/ cheque / return of valuables; • Discharge of a patient; • Transfer of a patient.

9.3 Deputy Director of Finance

• Responsible for ensuring regular patient reconciliations to financial statements and Trust stationary;

• To ensure adherence to governance systems; • To provide an audit trail.

9.4 Ward Managers

• To make patients aware of CWP cash and valuables policy at the earliest possible opportunity;

• To record all transactions and obtain authorised signatories in accordance with the policy; • To ensure cash and valuables are taken immediately with completed paperwork to the

cash office for deposit and safe keeping. 9.5 Cash Office Managers

• Responsibility for recording all transactions an issuing receipts; • Banking patient money in accordance with the policy; • Issuing cash / cheque to patients on request, in accordance with the policy; • Providing bank and safe reconciliations.

9.6 All CWP staff The policy is applicable to all CWP staff involved in the treatment and care of patients and / or patient’s monies. Staff should ensure they use appendix 1 for Wirral and West Cheshire and appendix 6 for East Cheshire processes.


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Appendix 1 – Patients cash, valuables and clothing sheet


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Appendix 2 – Record of patient cash / valuables deposited in or withdrawn from ward safe Held for a maximum of 48hrs

Patient named

Date Deposit of withdrawal

Details of cash

Details of valuables

Signature of patient

Signature of nurse

Signature of witness

Balance of cash


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Appendix 3 – Request for return of patient’s cash and or valuables

Unit Ward / department

Patients surname Forenames

Patients signature

CASH

The above names patient has requested a cash withdrawal for the sun of: (IN WORDS Pounds Pence

IN FIGURES From the patient’s monies deposited with the Trust

Purpose of withdrawal

VALUABLES

The above named patient has requested the return of (delete as appropriate):

- ALL the patient’s valuables deposited with the Trust - PART of the patient’s valuables deposited with the Trust as listed

Person named Grade

Signature of senior nurse Date

Witness Date

Staff must not hand cash and / or valuables to anyone other than the patient, relatives cannot sign on behalf of the patient for receipt of property

GENERAL OFFICE USE ONLY

Posted to account / Register: Ref Initials Date


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Appendix 4 – Patient Monies – Request for cheque

Unit Ward

Patients surname Forenames

Patients signature

Section 1 (to be completed BY General Office Manager

Please pay the sum of £ Pounds Pence

From monies held in my / the patient’s personal account:

To at In respect of

Signature of senior nurse

Signature of Witness

Posted to account / Register: Ref Initials Date

To: Director of Finance I certify that the balance held in the patient’s personal account is sufficient to meet the payment Date Signed General Office Manager Balance £

E DIR COST CENTRE SUBJ SPEC OTHER

Z C A Z 0 1 C A 4 7 0 0 0 0 0 0 0

Section 2 (to be completed at Finance Department – this section to be returned to unit) To: Patient Monies Officer (Unit) Cheque payment has been made this day and forwarded accordingly or enclosed herewith

Date Cheque No Amount

Signed For Director of Finance


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Appendix 5 – Transfer of patients property

Patient’s name Ward

Transfer from Hospital to Hospital

Date

TO BE COMPELTED BY SENIOR NURSE and forwarded to general / cash office

Property retained by the patient

We certify that the above items of property were placed into the property container which accompanied the patient upon transfer on _______________________ date.

Signed Senior Nurse

Witness Designation

TO BE COMPELTED BY GENERAL / CASH OFFICE

Property enclosed:

Transfer of monies between hospitals within Cheshire and Wirral Partnership NHS Foundation Trust Balance of monies transferred £ Amount in words Pounds Pence Please add above amount to any balance of monies currently held at your hospital.

Signed Rank / Designation

TO BE COMPELTED BY RECEIVING HOSPITAL I certify that the property and /or monies listed above have been received and entered into the property / cash record at this hospital.

Signed Rank / Designation

Hospital Date


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Appendix 6 – Cash and valuables for safe custody – East Cheshire


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