Building Partnerships, Staying Safe The health sector contribution to HM Government’s Prevent strategy: guidance for healthcare organisations
DH InformatIon reaDer BoX
Policy HR/Workforce Management Planning Clinical
Estates Commissioning IM&T Finance Social Care/Partnership Working
Document purpose BestPracticeGuidance
Gateway reference 16555
title BuildingPartnerships,StayingSafe–Thehealthsector contributiontoHMGovernment’sPreventstrategy: guidanceforhealthcareorganisations
author DH–CentralPreventTeam,NHSFinance,Performance andOperations
Publication date November2011
target audience PCTCEs,NHSTrustCEs,SHACEs,CareTrustCEs, FoundationTrustCEs,MedicalDirectors,Directors ofPH,DirectorsofNursing,DirectorsofAdult SSs,DirectorsofHR,GPs,CommunicationsLeads, EmergencyCareLeads,DirectorsofChildren’sSSs, RegionalPreventLeads,RegionalPreventCo-ordinators
Circulation list MedicalDirectors,DirectorsofPH,DirectorsofNursing
Description Guidanceandtoolkitforleadersandmanagersin healthcareorganisationstosupportimplementation ofthePreventawareness-raisingprogramme.The healthserviceisacriticalpartnerinPrevent.Supporting vulnerableindividualsandreducingthethreatfrom radicalisersisapriorityforthehealthserviceandits partners
Cross reference �N/A
Superseded documents BuildingPartnerships,StayingSafe–Theprevention ofviolentextremism–pilotprogramme:guidancefor healthcareorganisations
action required SupporttheimplementationofPreventacrossthe healthsector
timing N/A
Contact details CentralPreventTeam NHSFinance,PerformanceandOperations DepartmentofHealth [email protected]
for recipient use
Prepared by the Department of Health Central Prevent team
nHS finance, Performance and operations
©Crowncopyright2011
ProducedbyCOIfortheDepartmentofHealth
Thetextofthisdocumentmaybereproducedwithoutformalpermissionorcharge forpersonalorin-houseuse.
Building Partnerships, Staying Safe Thehealthsectorcontributionto HMGovernment’sPreventstrategy: guidanceforhealthcareorganisations
november 2011
Contents
foreword 3
executive summary 4
Part 1: the Prevent strategy 5
ThehealthsectorcontributiontoPrevent 6
BackgroundtoPrevent 8
Preventobjectives 5
HowtheobjectivesofPreventarerelevanttothehealthsector 6
Processofexploitation 9
Summaryofexploitation 11
Nationalthreats 12
Thelocalpicture 12
Healthandotherpublicsectorpartners 12
Partnershipsinaction 13
Informationsharing 14
Part 2: toolkit 15
Aimsofthetoolkit 15
Whoisthistoolkitfor? 15
Statusandstructureofthetoolkit 16
Practicalstepsforhealthcareorganisations 16
Staffcontribution 17
Organisationalmanagementandgovernance 17
Localpartnershipworking 18
Raisingconcerns 19
Accessingtargetedandspecialistsupportforvulnerableindividuals 22
Managingrisk 22
Harmfulinfluencesonvulnerableindividuals 22
Respondingtoevents 23
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BuildingPartnerships,StayingSafe
Internetuse 24
Informationsharing 24
Part 3: Prevent self-assessment tool 25
Introduction 25
Self-assessmenttoolforinternaluse 26
Actionplan 31
Policiesandprocedureschecklist 32
annex 1: Legislation and guidance 33
annex 2: Partners for health organisations at national, regional and local levels 35
annex 3: Prevent escalation process – raising concerns relating to a colleague 36
references 37
2
foreword
TheHomeSecretaryannouncedtherevisedPrevent strategyon7June2011.
ThenewPreventstrategyfocusesonstoppingpeople becomingterroristsorsupportingterrorism.Toachieve this,therevisedstrategyalsocontainsanumberof initiativesthatcanproactivelycontributetotheprotection andsafeguardingofvulnerableindividuals.Therearemany opportunitiesforhealthcarestafftohelptoprotectpeople fromradicalisation–thekeychallengeistoensurethat healthcareworkersareconfidentandknowledgeablein
addressingsituationsthatcauseconcern.
Wherehealthcareworkersencountersomeonewhomaybeintheprocessof beingradicalisedtowardsterrorism,itisvitalthattheindividualisappropriately supported.Itisthereforeimportantthatthecrucialrelationshipoftrustand confidencebetweenpatientandclinicianisbalancedwiththeclinician’s professionaldutyofcareandtheirresponsibilitytoprotectwiderpublicsafety.
ThenewPreventstrategyprovidesanopportunityforhealthcareorganisationsto assesstheirpoliciesandproceduresandensurethattheircorporategovernance supportsthepatientandtheworkforceintermsofsafeguardingindividualswho mayhavebeenexploitedbyradicalisers.
Terrorist-relatedactivityisnotasubjectnormallyassociatedwiththehealth service,butourexperienceofmanagingvulnerabilitiesthroughstructureswithin safeguardingplacesthehealthsectorinakeypositiontosupportindividuals,while providingadviceandsupporttoourpublicsectorpartners.
Ihopethatyouwillfindtheinformationinthisbookletusefulinassistingyour organisationtocontinuallyimprovethequalityofcareweofferourpatientsboth directlyandinthewidercommunity.
RtHonSimonBurnsMP MinisterofStateforHealth
3
executive summary
Prevent�ispartoftheGovernment’scounter-terrorismstrategyCONTEST,which isledbytheHomeOffice.Thehealthsectorhasanon-enforcementapproach toPreventandfocusesonsupportforvulnerableindividualsandhealthcare organisations.TheDepartmentofHealthandthehealthsectorarekeypartnersin workingtoprevent vulnerable individualsfrombeingdrawnintoterrorist-related activities.
Followingthepilotphase,mosthealthcareorganisationsatlocallevelconcluded thatsincePrevent�isaboutrecognisingwhenvulnerableindividualsarebeing exploitedforterrorist-relatedactivities,itfollowsthatitismostappropriately managedwithinexistingsafeguardingstructures,workingcloselywithemergency planning.SituatingPreventwithinsafeguardingenablestheprogrammeto continueregardlessoffuturechangestotheNHSorganisationalstructure.Itisalso inlinewithwiderattemptstomainstreamPreventinothergovernmentsectors.
Thisguideisforseniorleadersofhealthcareorganisationsinthepublic,private andvoluntarysectors.Aguidancedocumentisalsoavailableforhealthcare workerswhohaveattendedaPreventawareness-raisingsession.
Thisdocumentcomprisesthreeparts.Part1introducesPreventandexplains howitfitswithCONTEST.Italsoexplainswhythehealthsectorisakeystrategic partnerinPreventandhow,byworkingwithotherpublicsectorbodies,the healthsectorcanhelptoprotectvulnerableindividualsandthosearoundthem fromexploitationorharm.ThetoolkitinPart2isdesignedtohelphealthcare organisationstoassesswhethertheyhaveappropriategovernanceandsupport mechanismsinplacetodealwithanyconcernsthatareraised.Part3isthe self-assessmenttool.
Itisimportanttostatethattheroleofhealthcareorganisationsremains unchanged.Thereisnointentionthathealthcareworkerstakeonsurveillance orenforcementrolesasaresultofPrevent.Rather,thePrevent agendarequires healthcareorganisationstoworkwithpartnerorganisationstocontributetothe preventionofterrorismbysafeguardingandprotectingvulnerableindividualsand makingsafetyasharedendeavour.
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Part 1: the Prevent strategy
1.1 TheOfficeforSecurityandCounterTerrorism(OSCT)intheHomeOfficeis responsibleforprovidingstrategicdirectionandgovernanceonCONTEST.As partofCONTEST,theaimofPreventistostoppeoplebecomingterroristsor supportingterrorism.
1.2 CONTESTisprimarilyorganisedaroundfourkeyprinciples.Workstreams contributetofourprogrammes,eachwithaspecificobjective:
• Pursue:�tostopterroristattacks
• Prevent:�tostoppeoplebecomingterroristsorsupportingterrorism
• Protect:�tostrengthenourprotectionagainstaterroristattack
• Prepare: tomitigatetheimpactofaterroristattack.
1.3 TheDepartmentofHealthisalong-establishedpartnerinCONTESTthrough Prevent,ProtectandPrepare.ResponsibilityforPursuelieswiththe enforcementagencies.
Prevent objectives
1.4 ThreenationalobjectiveshavebeenidentifiedforthePreventstrategy:
• objective 1: respond to the ideological challenge of terrorism and the threat we face from those who promote it
• objective 2: prevent people from being drawn into terrorism and ensure that they are given appropriate advice and support
• objective 3: work with sectors and institutions where there are risks of radicalisation which we need to address.
1.5 Inordertodelivertheseobjectives,anumberofactivitiesaretakingplace atnational,regionalandlocallevels.Manyactivitiesfocusonworkingwith thosewhomaybevulnerable,reducingexploitationandsusceptibilityto radicalisationintoterrorism.
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BuildingPartnerships,StayingSafe
the health sector contribution to Prevent
1.6 Healthcareprofessionalsmaymeetandtreatpeoplewhoarevulnerableto radicalisation.Peoplewithmentalhealthissuesorlearningdifficultiesmay bemoreeasilydrawnintoterrorism.Wealsoknowthatpeopleconnected tothehealthsectorhavetakenpartinterroristacts.
1.7 Thekeychallengeforthehealthsectoristoensurethat,wherethereare signsthatsomeonehasbeenorisbeingdrawnintoterrorism,healthcare workerscaninterpretthosesignscorrectly,areawareofthesupportthat isavailableandareconfidentinreferringthepersonforfurthersupport. Preventingsomeonefrombecomingaterroristorfromsupportingterrorism isnodifferentfromsafeguardingvulnerableindividualsfromotherforms ofexploitation.
1.8 ThemethodofdeliveringthehealthcarecontributiontoPreventintroduces anescalationprocessthatwillenableanyworkerwithconcerns,especially front-lineworkers,toraisethemconfidentlyandwithinappropriate governancestructures.However,thisisnotintendedtoreplaceexisting escalationprocessesthathaveproveneffective.DeliveryofPreventrequires anincreaseinpartnershipworkingandtheappropriatesharingof informationwithotherpublicsectoragencies.
1.9 ThehealthsectorhasbeeninvolvedintheGovernment’sPreventagenda sinceOctober2008.ApilotphasecommencedacrossStrategicHealth AuthoritiesinEnglandinJanuary2010inareasincludingmentalhealth, primarycare,drugandalcoholprogrammes,prisonhealthandschool nursing.ThescopeofPreventactivityinthehealthsectorhasnow expandedtoincludeworkwithcharities,medicaldeaneriesandthe privatehealthsector.
1.10 WorkingcloselywiththeHomeOffice,Preventawareness-raisingproducts (HealthWRAPandShortHealthWRAP)havebeenspecificallydevelopedfor thehealthsectorandhaverecentlybeenupdatedtoreflectthenewstrategy andtoimprovedeliveryofthePreventagendainthehealthsector.
How the objectives of Prevent are relevant to the health sector
objective 2
1.11 Objective2aimstopreventpeoplefrombeingdrawnintoterrorismand toensurethattheyaregivenappropriateadviceandsupport.
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Part1:ThePreventstrategy
1.12 Radicalisationisaprocessnotanevent,andthereisnosingleroute orpathwaytoradicalisation.Evidenceindicatesthatthosetargetedby radicalisersmayhavedoubtsaboutwhattheyaredoing.Itisbecauseofthis doubtthathealthcareorganisationsandfront-lineworkersneedtohavethe mechanismsandinterventionsinplacetosupportanindividualbeing exploitedandtohelpthemtomoveawayfromterrorist-relatedactivity.
1.13AkeycomponentofthehealthsectorcontributiontoObjective2isensuring thathealthcareorganisationshaveeffectivepoliciesandproceduresinplace tosupportstaffwhoraiseconcernsaboutapatientoracolleague.Itis importantthattheyareequippedwiththeknowledgeofhowtoraisethe concern,andareconfidentthattheirorganisationwillhandletheconcern intheappropriatemanner.
1.14 Theresolutionoftheseincidentswillrarely,ifever,bethesoleresponsibility ofanysinglehealthcareprofessionalorprovider.Itisthereforeimportant thathealthcareorganisationsdevelopstrongcommunicationlinkswithother publicsectorpartners.Theseinclude,butarenotlimitedto,localauthorities, education,socialservices,probationservices,youthjusticeboardsand thepolice.
1.15 Healthcareorganisationsshouldseektodevelopworkingrelationshipswith localmulti-agencypartnershipsinvolvedinthisagenda.Theseareoften calledChannelGroups1and,whereappropriate,RegionalPrevent Co-ordinators2withineachStrategicHealthAuthorityneedtoensurethatthe healthsectorisrepresentedappropriately.WhereChannelGroupsarenot active,participationinmulti-agencysafeguardinggroupswillbeessential.
objective 3
1.16 Objective3focusesonworkwithsectorsandinstitutionswherethereare risksofradicalisationwhichweneedtoaddress.Some1.3millionNHS workershavecontactwithover315,000patientsdailyand700,000workers inprivateandvoluntaryorganisationsdeliveringhealthcareservicesseemany thousandsmore.
1 ChannelGroupsprovideamechanismforsupportingindividualswhomaybevulnerableto terrorist-relatedactivitybyassessingthenatureandtheextentofthepotentialrisk,agreeingand providinganappropriatesupportpackagetailoredtoanindividual’sneeds.Channelisamulti-agencypanel(includingthehealthsector)andthelocalChannelleadisnormallylocatedwithin thepoliceorlocalauthority.
2 RegionalPreventCo-ordinators(RPCs)areresponsiblefortheoperationalco-ordinationof PreventwithineachStrategicHealthAuthority.
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1.17 Withsuchvastnumbersofpeopleworkingwithinthesectorandaccessing healthcareservices,itisimportantthatorganisationsaresatisfiedthatthey havepoliciesandproceduresinplacethatarefitforpurpose,ensuringthat anorganisationisabletohandleanyPrevent-relatedconcernsthatmay arise.Bestpracticeincludesadequaterecordkeepingandrobustaudittrails.
1.18 Partofthisinvolvesunderstandingtheactivitiestakingplaceinanyfacility providingservicestoNHSpatients;forexample,ensuringthatmeetingroom facilitiesarenotmisusedandservicessuchasinternetaccessaremanaged.
1.19 HealthcareprovidersalsoneedtounderstandtheissuesrelatedtoPrevent thatimpactonthelocalcommunity.
Background to Prevent
1.20 Supportforterrorist-relatedactivitycantakemanyformssuchasrecruiting othersandprovidingfundingand/orfundraising.Forexample,training recruitscaninvolveOutwardBound-typecoursestoencouragebondingwith radicalisersbothintheUKandabroad.Asthereisnotypicalprofilefora UK-basedterrorist,allpublicsectoragencieswillneedtoworktogether throughthiscomplexareainordertoprotectthesafetyoftheUKpopulation asawhole.
1.21 Ongoingresearchiscontributingtothebodyofknowledgeabouthowand whyindividualsbecomeinvolvedwithterrorist-relatedactivity.Evidence takendirectlyfromresearchandcasereviewssuggeststhatthepath,or radicalisationprocess,toterrorist-relatedactivityisnotlinearorpredictable andthelengthoftimeinvolvedcandiffergreatly–fromafewweeksto anumberofyears.Itshouldbenotedthatevenifanindividualfollows aradicalisationpaththisdoesnotnecessarilymeanthatitwillresultin terroristacts.
1.22Tobeeffective,healthcareorganisationsneedto:
• understandthenatureofthethreat(atanationalandlocallevel)
• beawareoftheactivitieshappeningnationallyandlocallytoprevent terrorist-relatedactivityorterrorism
• ensurethatpoliciesandproceduresareinplaceandthattheworkforceis awareandabletorecognisethosewhoaresusceptibletoexploitation
• undertaketimelyinterventionstopreventradicalisationofvulnerable individualsthatmayleadtoterrorism.
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Part1:ThePreventstrategy
Process of exploitation
1.23 Itissuggestedthatthereisnosingleprofileorindicationofapersonwho islikelytobecomeinvolvedinterrorist-relatedactivity.Todatethereisno universallyacceptedviewofwhyvulnerableindividualsbecomeinvolved.
1.24 Thefactorssurroundingexploitationaremanyandtheyareuniqueforeach person.Theincreasingbodyofinformationindicatesthatfactorsthoughtto relatetopersonalexperiencesofvulnerableindividualsaffectthewayin whichtheyrelatetotheirexternalenvironment.
1.25 Inthissense,vulnerableindividualsmaybeexploitedinmanywaysby radicaliserswhotargetthevagariesoftheirvulnerability.Contactwith radicalisersisalsovariableandcantakeadirectform,i.e.facetoface,orcan happenindirectlythroughtheinternet,socialnetworkingorothermedia. Morecommonlythiswilloccurthroughacombinationoftheabove.
Contact with radicalisers
1.26 Itisgenerallymorecommonforvulnerableindividualstobecomeinvolvedin terrorist-relatedactivitythroughtheinfluenceofothers.Initialcontactmay beviapeers,siblings,otherfamilymembersoracquaintances,withthe processofradicalisationoftenbeingasocialone.Suchsocialinteractiontakes placeinarangeofunsupervisedenvironmentssuchasgymsorcafés,in privatehomesandviatheinternet.
1.27 Accesstoextremistmaterialisoftenthroughleafletsandlocalcontacts. However,theinternetplaysanimportantroleinthecommunicationof extremistviews.Itprovidesaplatformforextremiststopromotetheircause andencouragedebatethroughwebsites,internetforumsandsocial networking,andisaswiftandeffectivemechanismfordisseminating propagandamaterial.Healthcareorganisationsshouldbeawareofanyone makingfrequentvisitstowebsitesshowingimagessuchasarmedconflict aroundtheworldandprovidingspeechesandaccesstomaterialfromthose involvedintheradicalisingprocess.
Use of extremist rationale (often referred to as ‘narrative’)
1.28 Radicalisersusuallyattractpeopletotheircausethroughapersuasive rationalecontainedwithinastorylineornarrativethathasthepotentialto influenceviews.Inspiringnewrecruits,embeddingthebeliefsofthosewith establishedextremeviewsand/orpersuadingothersofthelegitimacyoftheir
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BuildingPartnerships,StayingSafe
causeistheprimaryobjectiveofthosewhoseektoradicalisevulnerable individuals.
Vulnerability
1.29 Intermsofpersonalvulnerability,thefollowingfactorsmaymakeindividuals susceptibletoexploitation.Noneoftheseareconclusiveinthemselvesand thereforeshouldnotbeconsideredinisolationbutinconjunctionwiththe particularcircumstancesandanyothersignsofradicalisation.
Identity crisis
Adolescents/vulnerableadultswhoareexploringissuesofidentitycanfeel bothdistantfromtheirparents/familyandculturalandreligiousheritage,and uncomfortablewiththeirplaceinsocietyaroundthem.Radicaliserscanexploit thisbyprovidingasenseofpurposeorfeelingsofbelonging.Wherethis occurs,itcanoftenmanifestitselfinachangeinaperson’sbehaviour,their circleoffriends,andthewayinwhichtheyinteractwithothersandspend theirtime.
Personal crisis
Thismay,forexample,includesignificanttensionswithinthefamilythat produceasenseofisolationofthevulnerableindividualfromthetraditional certaintiesoffamilylife.
Personal circumstances
Theexperienceofmigration,localtensionsoreventsaffectingfamiliesin countriesoforiginmaycontributetoalienationfromUKvaluesandadecision tocauseharmtosymbolsofthecommunityorstate.
Unemployment or under-employment
Individualsmayperceivetheiraspirationsforcareerandlifestyletobe underminedbylimitedachievementsoremploymentprospects.Thiscan translatetoageneralisedrejectionofciviclifeandadoptionofviolenceas asymbolicact.
Criminality
Insomecasesavulnerableindividualmayhavebeeninvolvedinagroupthat engagesincriminalactivityor,onoccasion,agroupthathaslinkstoorganised crimeandbefurtherdrawntoengagementinterrorist-relatedactivity.
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Part1:ThePreventstrategy
1.30 Similarlytotheabove,thefollowinghavealsobeenfoundtocontributeto vulnerablepeoplejoiningcertaingroupssupportingterrorist-relatedactivity:
• ideologyandpolitics
• provocationandanger(grievance)
• needforprotection
• seekingexcitementandaction
• fascinationwithviolence,weaponsanduniforms
• youthrebellion
• seekingfamilyandfathersubstitutes
• seekingfriendsandcommunity
• seekingstatusandidentity.
Grievances
1.31 Thefollowingareexamplesofgrievanceswhichmayplayanimportantpart intheearlyindoctrinationofvulnerableindividualsintotheacceptanceofa radicalviewandextremistideology:
• amisconceptionand/orrejectionofUKforeignpolicy
• adistrustofwesternmediareporting
• perceptionsthatUKgovernmentpolicyisdiscriminatory (e.g.counter-terroristlegislation).
Summary of exploitation
1.32 Evidencesuggeststhat:
• thereisnoobviousprofileofapersonlikelytobecomeinvolvedin terrorist-relatedactivity,orsingleindicatorofwhenapersonmightmove tosupportextremism
• vulnerableindividualswhomaybesusceptibletoradicalisationcanbe patientsand/orstaff
• radicalisersoftenuseapersuasiverationaleornarrativeandareusually charismaticindividualswhoareabletoattractpeopletotheircause whichisbasedonaparticularinterpretationordistortionofhistory, politicsorreligion
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BuildingPartnerships,StayingSafe
• factorssuchasachangeinaperson’sbehaviourmaybeanexampleof increasedvulnerability
• theparticularriskstovulnerableindividualswithincommunitieswillvary acrossthecountry.
national threats
1.33 TheGovernmentassessesthattheUKisahighprioritytargetforterrorism. ThereisalsoathreatfromBritishnationalandUK-basedradicalisersaswell asfromterroristorganisationsbasedoverseas.
1.34 TheJointTerrorismAnalysisCentre(JTAC)independentlysetsthethreatlevel fortheUK.Moreinformationcanbefoundatwww.mi5.gov.uk/output/ threat-levels.html
1.35 InadditiontothethreatposedbyAlQa’ida-influencedgroups,thereremains aseriousandpersistentthreatfromarangeofterroristgroupsand organisationsincludingthoselinkedtoNorthernIreland-relatedterrorism orextremeright-wingterrorism.Thesegroupsoftenaspiretocampaignsof violenceagainstindividuals,familiesandparticularcommunitiesand,ifleft unchecked,mayprovideacatalystforalienationanddisaffectionwithin somecommunities.
1.36Alistofthegroupsormovementsthatespousetheuseofviolenceandmeet theconditionsforbeingbannedorproscribedundercounter-terrorism legislationisatwww.homeoffice.gov.uk
the local picture
1.37 Thechallengefromradicalisersandactivitiesofdifferentgroupswillvary acrosscommunities.Localauthoritiesandpolicewillbeabletoprovide informationandassistancetohelphealthcareorganisationstogainan overviewofcurrentlocalissues.
Health and other public sector partners
1.38 Inthecourseofdailywork,healthcareworkersmayfacesituationsthatgive themcauseforconcernaboutthepotentialsafetyofapatient,theirfamily, stafforothersaroundthem.Earlyinterventioncanre-directavulnerable individualawayfromcarryingoutanactofterrorism.Byworkingclosely withpartnerssuchaslocalauthorities,socialservices,thepoliceandothers, healthcareorganisationscanimprovetheireffectivenessinhowtheyprotect
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Part1:ThePreventstrategy
vulnerableindividualsfromharmorfromcausingharmtothemselvesor thewidercommunity.Thehealthsectorwillneedtoensurethatthecrucial relationshipoftrustandconfidencebetweenpatientandclinicianisbalanced withtheclinician’sprofessionaldutyofcareandtheirresponsibilitytoprotect widerpublicsafety.
1.39 Therefore,inordertocontributetothePreventagenda,healthcare organisationsneedto:
• workinpartnershipwithlocalagenciesinvolvedinPreventto protect vulnerableindividualsintheircarefrombecomingradicalisedinto terrorist-relatedactivity
• ensurethatappropriategovernancerequirementsareinplace,including thesharingofappropriateinformation,professionalaccountability, confidentialityandCaldicottprinciples
• establisheffectiveworkingrelationshipsbetweenhealthcareorganisations andotherpublicsectororganisationswithinthecommunity.
Partnerships in action
1.40 Itisimportantthathealthcareorganisationsunderstandlocalchallengesand remainuptodatewiththespecificissuesaffectingtheircommunities.Local authorities,Preventpartnersandthepolicewillbeabletohelphealthcare organisationstogainanoverviewoflocalissuesandcangivevaluable supportandadviceonissuesconcerningterrorist-relatedactivity.
1.41 Jointagencyworkingwillinvolvearangeofpartnersworkingtogether, includingthepoliceandotherstatutoryandvoluntaryagencies.Therangeof activitiesbeingundertakenwillvarydependingonthescaleofthechallenges inthelocalarea.Healthcareorganisationsneedtobuilduponexisting partnershiparrangements,forexamplebyusingexistingsafeguarding frameworkswheretheycan.Wheretheappropriatepartnershipsarenot inplace,theywillneedtobedeveloped.
1.42 Jointagencyworkingwithpartnerswillalsohelphealthcareorganisations tofurtherunderstandanytensionswithinthelocalcommunitythatmight impactlocalpeople.Inthecourseofhealthcaredelivery,staffhaveaccess topatientsthroughhospitals,clinicsandGPsurgeriesandintheirown homes.Additionally,inthecourseoftheircontactwithpatientsstaffmay facesituationsthatgivethemcauseforconcernaboutthepotentialsafety ofapatient,theirfamilyorothersaroundthem.Itisthereforeimportant
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BuildingPartnerships,StayingSafe
thatagreedprotocolsandproceduresareinplacetoenabletheseconcerns toberaisedsafelyandconfidently,andsharedappropriately.
1.43 Healthcareorganisationsneedtohaveinplaceappropriatemechanisms andforumsforsharinginformationwithpartnerswhenconcernsareraised. Theyalsoneedtoengageinlocalpartnershipworkingonthepreventionof terrorist-relatedactivitytoensurethattheycarryouttheirresponsibilitiesin deliveringequitableaccess,protectingvulnerableindividualsandmaintaining thesafetyofstaffandserviceusers.
1.44 Muchoftheworkthathealthcareorganisationsarealreadydoingwillhelpto contributetothegoalofstoppingvulnerableindividualsbeingdrawninto terrorist-relatedactivity.Forexample,healthcareorganisationscanbuildon worktheyalreadydoinsafeguardingadultsandchildrenthrough:
• meetingtheircorporategovernanceresponsibilities
• deliveringNo�Secrets�(DepartmentofHealth,2000),Working�Together� to�Safeguard�Children(DepartmentforEducation,2010)and Safeguarding�Adults:�The�role�of�health�services(DepartmentofHealth, 2011)
• workingwithpartnerstopreventvulnerableindividualsbecomingthe victimsorcausesofharm
• workingwithpartnersandotheragenciestobuildcommunitynetworks thatcanprovideadviceandguidancetohealthcareorganisations.
Information sharing
1.45 Itisvitalthathealthcareorganisationshaveinplaceeffectiveinformation sharingandcommunication.Healthcareorganisationsneedtoensurethat theyarefamiliarwithandincludewithintheirorganisationalpoliciesand procedurestheguidanceoninformationsharingcontainedinInformation� Sharing:�Guidance�for�practitioners�and�managers(HMGovernment,2009); TheCaldicottCommittee’sReport�on�the�Review�of�Patient-Identifiable� Information(DepartmentofHealth,1997);Confidentiality:�NHS�Code�of� Practice(DepartmentofHealth,2003);andtheDataProtectionAct1998.
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Part 2: toolkit
aims of the toolkit
2.1 Thetoolkitprovidesadviceonhowhealthcareorganisationscanreview currentpracticetobuildandstrengthentheirexistingsafeguardingwork. Italsoprovidespracticalstepsonhowtotakeforwardtheirresponsibilities incontributingtoPrevent.
2.2 Itwill:
• raiseawarenessamonghealthcareorganisationsandtheirstaffofthe threatfromterroristgroups
• highlighttherisktovulnerable individualswhocouldbeknowntoor mayatsomepointaccesshealthcareservices
• helphealthcareorganisationsandstafftounderstandtheirroleinmaking apositivecontributiontopreventingterrorism
• helpstafftocarryouttheirresponsibilitiesthroughcontributingtothe protection and well-beingofparticularpatientsorgroupswhomaybe vulnerabletoexploitation
• provideadviceonmanaging risks atorganisational,staffandclinical practitionerlevel.
2.3 Thepurposethroughoutthistoolkitistosupporttheconfidenceand capabilityofhealthcareorganisationsandtheirstaff,andtoencouragelocal partnership/inter-agencyworking.
Who is this toolkit for?
2.4 ThistoolkitisforallorganisationsinEnglandprovidinghealthcareservicesto NHSpatients,includingtheindependentandvoluntarysectors.Itisintended forusebyleaders(e.g.executivesandseniormanagement)ofhealthcare organisationsinreviewingtheirorganisationalpracticesandinbriefingstaff. Itincludesaself-assessmenttoolthatcanbeusedasabasisforchecking thatorganisationalsystemsandprocessessupportthereductionof exploitationbyradicalisers.
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Status and structure of the toolkit
2.5 Thetoolkitandself-assessmentareprovidedasguidanceanddonotimpose anynewrequirementsonhealthcareorganisations.Thetoolkitincludes informationonhoworganisationspreparethemselvestomanageany concernrelatingtotheriskofavulnerableindividualbeingexploited. Itprovidespracticalstepsforreviewingorganisationalpractices,systemsand processesandemphasisestheimportanceofdevelopingpartnershipworking.
2.6 Toaccompanythistoolkit,RegionalPreventCo-ordinatorscanprovide healthcareorganisationswithcustomisedinformationandcontactdetails relevanttotheirlocalarea.
2.7 Thefollowingsectionsetsoutpracticalstepsfororganisationstofollowand includesaself-assessmenttooltohelpanorganisationtodeterminewhat stepsarenecessarytoensurethatithastheframeworksinplacewhich enablestafftoraiseconcernsconfidently.Alistisalsoincludedofthepolicies thatshouldbereviewedtoensurethattheyincludeissuesrelatingto Prevent.
Practical steps for healthcare organisations
2.8 HealthcareorganisationscanintegratetherelevantPreventobjectivesinto theirgovernancestructuresby:
• deliveringtrainingandawarenessprogrammesforstaff
• developingorganisationalprotocols,policiesandproceduresthatenable staffandpatientstoraiseconcerns
• workingwithpartnerstodevelopandstrengthensafeguardingof vulnerableindividualsandobtainspecialistadviceandsupport
• assessingandreinforcingsystemsforvulnerableandharder-to-reach groups
• sustainingsaferhealthcareservices.
2.9 Throughthecourseoftheirwork,healthcareworkersmayencounter changesinthebehaviourofpatientsand/orcolleaguesthataresufficientto causethemconcern.Amemberofstaffwhohascauseforconcernwillneed tobeabletoraisethisconcernintheknowledgethatitwillbehandled appropriatelyandthat,wherenecessary,specialistadviceandguidancecan andwillbeobtained.Page21andAnnex3provideinformationaboutthe
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Part2:Toolkit
Preventescalationprocessforraisingconcerns,intheabsenceofexisting organisationalpoliciesandprocedures.
Staff contribution
2.10 Professionalcodesofpracticeforclinicalstaff,contractualandsafeguarding frameworkssuchasNo�Secrets(DepartmentofHealth,2000),Working� Together�to�Safeguard�Children�(DepartmentforEducation,2010)andEvery� Child�Matters�(HMGovernment,2004)requireallstafftoexerciseadutyof caretoallpatientsand,wherenecessary,totakeactionforsafeguardingand crimepreventionpurposes.Thisincludestakingpreventiveactionand supportingthoseindividualswhoareidentifiedtobeatriskof,orwhoare beingdrawninto,terrorist-relatedactivity.
2.11 Therefore,healthcareorganisationswillneedtoensurethat:
• theyraisestaffawarenesssothattheycanrecogniseexploitationof vulnerableindividualsbeingdrawntowardsterrorist-relatedactivity
• theirstaffareawareoftheescalationprocessesandsupportinplacethat enablethemtodiscusstheirconcerns
• staffreceivetrainingandinformationabouttheorganisationalpolicies, proceduresandprocessesinplacethroughwhichtheycanraiseconcerns anddiscusssensitive/controversialissues
• theirstaffareawareofPreventcontactswithintheirorganisation.
responsibility:boards;non-executivedirectors;humanresourcesdirectors;GP partners;managers;trainingmanagers;allstaff.
organisational management and governance
2.12 Allhealthcareorganisationsarerequiredtoestablishmechanismsthat incorporateanintegratedgovernanceapproachtotheirbusiness.Thiswill include:
• providingpositiveandeffectiveleadership
• ensuringthatregularstafftrainingandupdatestakeplacetobuildstaff understandingofissuesandconfidencetodealwiththem
• promotingcorevaluesofsharedresponsibilityandrespectforpatients’ accesstoandinvolvementintheircare
• usingpatientandstaffsurveys/commentstoimproveservices
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BuildingPartnerships,StayingSafe
• ensuringthatorganisationalpolicies,proceduresandprotocolsarein placetosupportcoreorganisationalvaluesandsupportstaffinraising genuineconcerns
• supportingpatientswhoareatriskwithintheircommunities
• buildingandstrengtheninglocalpartnershipandinter-agencyworking
• monitoringrisksandrespondingappropriatelytoevents–particularlyin theaftermathofaneventorincident
• ensuringthatrecruitmentandinductionarrangementsoperatein accordancewithrelevantregulationsfortheconductandvettingofstaff
• promotingresponsibleandeffectiveuseoftheinternetbyallstaff, volunteersandpatients
• beingawareandregularlyreviewingtheuseofhealthcare premises/facilities.
responsibility:boards;non-executivedirectors;executivedirectors;GP partners;managers;seniorclinicalstaff.
Local partnership working
2.13 Partnershipworkingischallengingforallorganisations,notleastowingto thedifferingdemands,priorities,controlsandfundingarrangementsofeach partner.However,developingstrongpartnershipsandallianceswithother publicsectoragencieswillenablethehealthcaresectortomakeanactive contributionto Prevent.Wherepossible,healthcareorganisationswillneed toensureeffectivepartnershipworkingby:
• developinglocallyagreedjointpolicies,proceduresandprotocols
• utilisingappropriatepartner-agencyexpertisewhendealingwithconcerns
• ensuringthatappropriateinformationsharingtakesplace
• ensuringanappropriatejointresponsetolocalandnationalevents
• ensuringappropriatehealthrepresentationandengagementinlocal Preventgroups.
responsibility: boards;non-executivedirectors;GPpartners;managers;clinicalstaff.
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Part2:Toolkit
raising concerns
2.14 Shouldanystaffmemberhaveaconcernrelatingtoanindividual’sbehaviour whichindicatesthattheymaybebeingdrawnintoterrorist-relatedactivity, theywillneedtotakeintoconsiderationhowreliableorsignificantthese indicatorsare.Indicatorsmayinclude:
• graffitisymbols,writingorartworkpromotingextremistmessages orimages
• patients/staffaccessingterrorist-relatedmaterialonline,includingthrough socialnetworkingsites
• parental/familyreportsofchangesinbehaviour,friendshipsoractions andrequestsforassistance
• partnerhealthcareorganisations’,localauthorityservices’andpolice reportsofissuesaffectingpatientsinotherhealthcareorganisations
• patientsvoicingopinionsdrawnfromterrorist-relatedideologies andnarratives
• useofextremistorhatetermstoexcludeothersorinciteviolence.
2.15 Itmaybethatapatientorstaffmemberisfacingmultiplechallengesintheir life,ofwhichexposuretoterrorist-relatedinfluencesisjustone.Healthcare workerswillneedtousetheirjudgementindeterminingthesignificanceof anychangesinbehaviourwheresufficientconcernsarepresent.These shouldbereportedinaccordancewiththeorganisation’spoliciesand procedures.
2.16 Whenconcernsareraised,staffand/orthehealthcareorganisationmayneed tocontributetoamulti-agencyassessmentofthesituationinlinewiththe locallyagreedprotocols.Itisintheinterestsofallhealthcareorganisationsto identifyaleadwhowillworkcloselywiththeRegionalPreventCo-ordinator andotherexternalagencies/partnerstoexamineareasofconcernina plannedandlogicalwaywhichsafeguardsboththeindividualandthe organisation.
2.17 Everyhealthcareorganisationwillhaveinplaceexistingarrangementsfor reportingconcernswhichcomplywithgoodgovernanceandsafeguarding practices.Staffwillbefamiliarwiththeselocalarrangementsandtheyshould continue.However,healthcareorganisationswillneedtoreviewtheir arrangements,ensuringthattheystrengthenanyexistingprocesses,enabling
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BuildingPartnerships,StayingSafe
stafftoraiseconcernsrelatingtovulnerableindividualsandPrevent confidentlyandsafely.
2.18 Intheabsenceofanyexistingarrangements,thefollowingescalationflow chartisprovidedtoassisthealthcareorganisationsinreviewingtheirexisting systemsandprocesses.Thereisalsoaseparateescalationprocessfor concernsrelatingtostaffatAnnex3.
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Part2:Toolkit
raising Prevent concerns
Healthcare worker obtains specific consent
Patient
Line manager
Organisational safeguarding/
governance lead
Organisational Caldicott Guardian
Interagency partnership
External organisation
Decision
Internal health process
Public
Channel†
KEY
1. Assessment and riskassessment process
2. Decision to review team or provide internal
support
Decision outcome – support for patients
Safeguarding/governance case management team or partnership/interagency review team*
Local police
Prevent lead‡
* To include representatives from other public sector services, such as local authorities, education, social care, etc. † Channel Groups provide a mechanism for supporting individuals who may be vulnerable to terroristrelated activity
by assessing the nature and the extent of the potential risk, agreeing and providing an appropriate support package tailored to an individual’s needs. Channel is a multiagency panel (including the health sector) and the local Channel lead is normally located within the police or local authority.
‡ This is an advisory role and it will be at the discretion of healthcare practitioners and safeguarding leads to contact police Prevent leads for advice and support as necessary. Police Prevent leads can also assist safeguarding leads and Caldicott Guardians with advice on riskassessment procedures.
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BuildingPartnerships,StayingSafe
accessing targeted and specialist support for vulnerable individuals
2.19 Healthcareorganisationsmayidentifyaneedforspecificsupport programmesforindividualsorgroupsofpatientsorstaff,suchas:
• mentoring
• accesstoexpertswhocanproviderelevantguidanceand/orinformation.
2.20 Trustedrelationshipsformedacrossotherpublicsectoragenciesand partnershipworkingwillbevitalinassistingthiswork.
managing risk
2.21 Althoughtherearerelativelyfewinstancesofhealthcareworkers encounteringpatientsexposedtooraccessingmaterialrelatedtoterrorism, itisstillariskthathealthcareorganisationsandstaffneedtobeawareof andpreparefor.
2.22 Riskscouldarisefrom:
• harmfulinfluencesonvulnerableindividuals,forexamplefromstaff, colleagues,volunteers,parents,aspouse,otherfamilymembers,friends, externalgroupsorotherpatients
• inappropriateuseoftheinternetonhealthcarepremises
• externalgroupsusinghealthcarepremisesformeetings,distributing terrorist-relatedmaterialorundertakingterrorist-relatedactivity.
2.23 Thistoolkitwillhelptoguideorganisationsinassessingwhetherornottheir existingarrangementsareoperatinginaccordancewithreducingrisksfrom terrorist-relatedactivity.
Harmful influences on vulnerable individuals
2.24 Healthcareworkers,membersofthepublic,contractorsorpatientsmay expressviews,bringmaterialintotheorganisation,useordirectpatientsto extremistwebsitesoractinotherwaystopromoteterrorism.
2.25 Thisactionmayconstituteabreachoftherelevantprofessionalcodesof conductormayinsomecasesbeillegal.Insuchanevent,healthcareworkers shouldbesubjecttotherelevantdisciplinaryproceduresand,asappropriate,
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Part2:Toolkit
healthcareorganisationsshouldensurethattheymeetalltheirstatutory responsibilities.
responding to events
2.26 Terrorismisunlikelytoaffectmosthealthcareorganisationsdirectly. However,somehealthcareorganisationshavebeenaffectedby:
• nationalincidentssuchastheExeterbombingandtheGlasgowAirport attack,bothofwhichhadaparticularimpactonhealthcareorganisations locally
• internationalpolitics
• domesticpoliticaleventsinothercountriesthatarerelevanttoparticular communitieswithintheUK
• localcounter-terrorismoperationsandrelatedcommunitytensions
• high-profiletrialsofthoseaccusedofterrorist-relatedoffences.
2.27 Healthcareorganisationsneedtodevelopstrongpartnershipsinorderto understandtheissuesthatimpactuponthecommunitiestheyserve,and beawareoftheissuesthataffectlocalpeople.Partnershipworkingaids understandingandappreciationofpartners’rolesandchallenges.
2.28 Thestartingpointforhealthcareorganisationsistoensurethat:
• mechanismsareinplacethatallowanyonewhohasconcernsaboutthe behaviourofanypatient,visitororstaffmembertoseekadvicefrom withintheorganisation
• staffareengagedwithintheorganisationandtheirviewsarelistenedto
• staffknowtheirpatientsandareabletorespondtotheirchangingneeds.
2.29 Healthcareorganisationsneedtohaveeffectivesystemsandprocessesin placetorespondpromptlytoissuesofconcern,informingstaffofthe mechanismsinplaceforraisinganyconcern.Developingstrongpartnership workingistheessenceofPrevent.Healthcareorganisationsshouldensure thatstaffaremadeawareoftheissuesthroughtrainingandawareness programmes,asensuringgoodcommunicationaboutrelevantissuesisvital.
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BuildingPartnerships,StayingSafe
Internet use
2.30 Thegovernmentandthepolicearecommittedtoprotectingthepublicfrom terroristcontentonline,butcannotdothisalone.Adedicatedwebsitewhere peoplecanreportonlinecontenttheythinkmightbeillegal,orwhichthey findoffensive,isavailableatwww.direct.gov.uk/en/CrimeJusticeAndTheLaw/ Counterterrorism/DG_183993
Information sharing
HealthcareorganisationsshouldensurethatanyPreventreferralprocesses putinplaceforfront-linestaffareunderpinnedbytheprinciplesofCaldicott GuardianshipandguidanceinInformation�Sharing:�Guidance�for� practitioners�and�managers(HMGovernment,2009).Employersshould alsoensurethatstaffunderstandConfidentiality:�NHS�Code�of�Practice (DepartmentofHealth,2003)andInformation�Governance:�Guidanceon� legal�and�professional�obligations�(DepartmentofHealth,2007).
24
Part 3: Prevent self-assessment tool
Introduction
3.1 Thisself-assessmenttoolhasbeendevelopedasanaidtohealthcare organisationsinassessingthemechanismstheyhaveinplacetoachievethe objectivesofPrevent.Thetoolisnotintendedtobeprescriptive,norisit intendedtobeusedexternallytomeasureorganisationalperformance.
3.2 Itisrecognisedthatthesearesensitiveissuesforindividualsand organisationstomanagewithconfidenceandconsistency.However, adoptingaprocessofregularself-assessmenthasbeenshowntobeoneof themosteffectivewaystoidentifytheareasandissuesthatneedfurther considerationand/orattention.
25
Self-assessment tool for internal use
organisation_____________________________________________
name___________________________________________________
Date of assessment_______________________________________
name of assessor________________________________________
organisational Care Quality Commission registration regulations (amended 2010)
Comment action required Y/n
Department lead/ nominated lead
Date for completion
1 Policiesandproceduresareinplacewithinthe respectivedepartmentsthataddressPrevent concerns
regulations 12, 24
2 Statutoryandmandatoryinductionandupdating programmescontainPreventawarenesstraining andpolicyupdates
regulations 12, 13, 14
BuildingPartnerships,StayingSafe
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Part3:Preventself-assessmenttool
organisational Care Quality Commission registration regulations (amended 2010)
Comment action required Y/n
Department lead/ nominated lead
Date for completion
3 Thereareorganisationalandjointagencyagreed protocolsandproceduresfor: • obtainingadvice • raisingconcerns • reportingconcerns • consent • informationsharing • escalationprocessesandprocedures • listoflocalandregionalPreventcontacts
regulations 12, 21, 22, 23, 24
4 Organisationalriskassessmentsincluderisk issuesinPreventObjectives2and3
regulations 12, 21, 22, 23, 24
5 Governanceandriskreportingrequirements includePreventincident(s)reportingforboth organisationalandinter-agencyissues
regulations 12, 21, 22, 23, 24
6 Actionplansareputinplacetoaddressissues followinga’nearmiss’incidentoreventand arefedbacktostaffthroughappropriate communicationchannels
regulations 12, 21, 22, 23, 24
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BuildingPartnerships,StayingSafe
organisational Care Quality Commission registration regulations (amended 2010)
Comment action required Y/n
Department lead/ nominated lead
Date for completion
7 Allstaffandvolunteersareawarewherethey canobtaininformationaboutPreventandhow andwheretheycanraiseanyconcerns
regulations 21, 22, 23, 24
8 Allprotocols,policiesandproceduresaddress issuesofpatientinvolvement,participation andengagement;managementofgrievances/ complaints/patientfeedback;equityofaccess; culturaldiversity;inclusion;anddignity andrespect,andareapprovedthroughthe organisation’sgovernanceframework
regulations 21, 22, 23, 24
9 Protocols,policiesandproceduresaddressissues ofinternetaccess
regulations 21, 22, 23, 24
10 Protocols,policiesandproceduresaddressthe managementofbookingmeetingrooms/public areas/seminarrooms,etc.,andthesafetyof theiruse
regulations 16, 17
11 Protocols,policiesandproceduresaddressissues ofinappropriatecanvassing/leafleting
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Part3:Preventself-assessmenttool
organisational Care Quality Commission registration regulations (amended 2010)
Comment action required Y/n
Department lead/ nominated lead
Date for completion
Staff and volunteers
12 Staffapprisethemselveswithandknowwhere toaccessorganisationalprotocols,policiesand procedures
regulations 21, 22, 23, 24
13 StaffandvolunteersattendHealthWRAP awarenessraisingandassociatedupdatesin accordancewithorganisationalrequirements. OrganisationhasapprovedHealthWRAPtrainers
regulations 21, 22, 23, 24
14 Staffandvolunteersareawareofissuesthatcan leadtotheexploitationofvulnerableindividuals, resultinginthembeingdrawnintoterrorist-relatedactivity,andknowhowtosupport patientsatrisk
regulations 21, 22, 23, 24
15 Staffandvolunteersareawareoftheir responsibilitytoraiseconcernsandknowhow andwheretodothis
regulations 21, 22, 23, 24
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BuildingPartnerships,StayingSafe
organisational Care Quality Commission registration regulations (amended 2010)
Comment action required Y/n
Department lead/ nominated lead
Date for completion
Partnership working
16 Locallyagreedprotocols,policiesandprocedures areinplaceforaddressingPreventconcerns thatappropriatelyutilisetheexpertiseofpartner agencieswhendealingwithconcerns
regulations 12, 24
17 Therearelocallyagreedprotocolsand proceduresforsharinginformation,including jointinformation
regulations 12, 24
18 ThereisanominatedPreventrepresentativewho regularlyattendslocalorregionalinter-agency Preventmeetings
regulations 12, 24
19 Thereareappropriateprocessesforco-operation andjointcareplanningwithotherproviders/ agencieswherecareistransferredorshared. Theaboveshouldtakeaccountofappropriate informationprocedures
regulation 24
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Part3:Preventself-assessmenttool
action plan
action plan following Prevent objectives self-assessment
action required Priority (high, medium, low)
Completion date
responsible individual(s)
Completed (Y/n), date assessed and signature
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BuildingPartnerships,StayingSafe
Policies and procedures checklist
Doyourcurrentpoliciesandproceduresincludethefollowingactionsrequiredto addressPreventconcerns?
• Clearancechecksforstaffandvolunteers • Confirmationofregistration • Re-confirmationofelectronicCriminalRecordsBureau(e-CRB)checksand
currentregistrationforindividuals • Equalityanddiversity • Appraisal • Disciplinaryprocedures • RestrictedandresponsibleuseofICT • Whistleblowing(publicdisclosure) • Bullyingandharassment • Useofhealthcareandassociatedpremises/facilitiesonsamesite • Complaintsmanagement,includingvexatiouscomplaints • Accesstohealthcare • Induction,updating,andtrainingandawarenessprogrammes • Dignityandrespect • Safeguardingvulnerableindividuals • Clinicalprotocolsandprocedures • Confidentiality,includinginformationsharing/escalationofconcerns • Accesstohealthrecords • Dataprotection • Consent • Recordkeeping.
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annex 1: Legislation and guidance
Information governance legislation and guidance
• The�Care�Record�Guarantee:�Our�guarantee�for�NHS�Care�Records�in�England (NHS,2011)
• ChildrenAct2004
• Commonlawdutyofcare
• Commonlawdutyofconfidentiality
• Confidentiality:�NHS�Code�of�Practice(DepartmentofHealth,2003)
• CrimeandDisorderAct1998
• DataProtectionAct1998
• DataProtection(ProcessingofSensitivePersonalData)Order2000
• HealthandSocialCareAct2008
• HumanRightsAct1998
• Information�Sharing:�Guidance�for�practitioners�and�managers (HMGovernment,2009)
• MentalCapacityAct2005
• NationalHealthServiceAct2006
• NHS�Information�Governance:�Guidance�on�legal�and�professional�obligations (DepartmentofHealth,2007)
• No�Secrets:�Guidance�on�developing�and�implementing�multi-agency�policies� and�procedures�to�protect�vulnerable�adults�from�abuse�(Departmentof Health,2000)
• Professionalcodesofconduct(asrelevant)
• PublicInterestDisclosureAct1998
• Reference�Guide�to�Consent�for�Examination�or�Treatment�(Departmentof Health,2ndedition,2009)
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BuildingPartnerships,StayingSafe
• SafeguardingVulnerableGroupsAct2006
• TerrorismAct2006
other relevant legislation
• ComputerMisuseAct1990
• FreedomofinformationAct2000
• Multi-agencyPublicProtectionArrangements(MAPPA)2007
• Confidentiality:�Guidance�for�doctors(GeneralMedicalCouncil,2009)
• Safeguarding�Adults:�The�role�of�health�services(DepartmentofHealth,2011)
34
annex 2: Partners for health organisations at national, regional and local levels
• Localauthority • Socialservices • HomeOffice • DepartmentforBusiness,InnovationandSkills • DepartmentforCommunitiesandLocalGovernment • DepartmentforEducation • DepartmentforCulture,MediaandSport • ForeignandCommonwealthOffice • NationalOffenderManagementService • NationalProbationService • Policepartners • UKBorderAgency • YouthJusticeBoard
35
annex 3: Prevent escalation process – raising concerns relating to a colleague
Healthcare worker with concerns related to a
colleague
Line manager
Organisational Prevent lead
(nursing/safeguarding/ governance lead)
Organisational HR director
Local Security Management
Specialist*
NHS Counter Fraud and
Security Management Service
1. Assessment and riskassessment process 2. Decision to review
team or provide internal support
Local police
Prevent lead†
KEY
Internal health process
Decision
External agency
*Corporate policy will direct the involvement of the NHS Counter Fraud Service as necessary. † This is an advisory role and it will be at the discretion of healthcare practitioners and safeguarding leads to contact
police Prevent leads for advice and support as necessary. Police Prevent leads can also assist safeguarding leads and Caldicott Guardians with advice on riskassessment procedures.
36
references
• Caldicott�Committee�Report�on�the�review�of�patient-identifiable�information (DepartmentofHealth,1997) www.dh.gov.uk/en/Publicationsandstatistics/Publications/ PublicationsPolicyAndGuidance/DH_4068403
• Confidentiality:�NHS�Code�of�Practice(DepartmentofHealth,2003) www.dh.gov.uk/en/Publicationsandstatistics/Publications/ PublicationsPolicyAndGuidance/DH_4069253
• CONTEST:The�United�Kingdom’s�strategy�for�countering�terrorism (HMGovernment,2011) www.homeoffice.gov.uk/publications/counter-terrorism/counter-terrorism-strategy
• Every�Child�Matters:�Change�for�children(HMGovernment,2004) www.education.gov.uk/publications/eOrderingDownload/DFES10812004.pdf.
• GuidanceontheDataProtectionAct(InformationCommissioner’sOffice,1998) www.ico.gov.uk/for_organisations/data_protection.aspx
• Information�Sharing:�Guidance�for�practitioners�and�managers� (HMGovernment,2008) www.education.gov.uk/publications/standard/publicationdetail/page1/DCSF-00807-2008
• Learning�Together�to�be�Safe:�A�toolkit�to�help�schools�contribute�to�the� prevention�of�violent�extremism�(DepartmentforChildren,Schoolsand Families,2008) www.education.gov.uk/publications/eOrderingDownload/00804-2008BKT-EN.pdf
• No�Secrets:�Guidance�on�developing�and�implementing�multi-agency�policies� and�procedures�to�protect�vulnerable�adults�from�abuse(Departmentof Health,2000) www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicy AndGuidance/DH_4008486
• Prevent�strategy(HMGovernment,2011) www.homeoffice.gov.uk/publications/counter-terrorism/prevent/prevent-strategy
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BuildingPartnerships,StayingSafe
• Safeguarding�Adults:�The�role�of�health�services(DepartmentofHealth2011) www.dh.gov.uk/en/Publicationsandstatistics/Publications/ PublicationsPolicyAndGuidance/DH_124882
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©Crowncopyright2011 4075891p6kNov11(HSW) ProducedbyCOIfortheDepartmentofHealth
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