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New Guidance given on Care Record Violence Markers
The NHS Security Management Service (NHS SMS) has today issued a press release concerning guidance on care record violence markers. Markers are used on patient care records (electronic or paper) to notify NHS staff if there is a risk of physical violence or aggression from a patient or someone associated with that patient, should they come into contact with them in a treatment setting. The term ‘NHS staff' includes clinical and non-clinical employees of the NHS, as well as contractors working on behalf of the NHS (e.g. NHS community pharmacies)
This ‘marker' procedure is used only where there has been an actual reported incident or where there is evidence of violent or aggressive behaviour from that individual patient. Patient confidentiality and the need to treat all patients without discrimination, still of course applies. This policy allows such valuable safety information to be shared efficiently throughout the NHS. NHS Community Pharmacies need to be aware of the guidance, because if their staff are subject to assaults it may be appropriate to contact the PCT's Local Security Management Specialist (LSMS), to consider whether the marker should be added because of the assault at the pharmacy.
In the majority of instances, the individual will be informed in writing by the LSMS as soon as possible following a decision to mark their records.
NHS bodies have a responsibility to share information on potentially violent patients who may be accessing NHS services provided by non-NHS bodies. Guidance from the Information Commissioner's Office confirms that sharing information relating to a marker between NHS colleagues internally or from one provider to another, to alert staff to the potential risks of violence, is permissible and legitimate, as long as the processing by the provider is fair and justified. A first step should be for the organisation to conduct a risk assessment to identify those individuals and/or providers that may come into contact with the individual and determine who the information needs to be shared with. This should cover all NHS staff that have an input into the care of or come into contact with the individual, potentially including NHS community pharmacies. The NHS SMS guidance includes an example as to how this may apply to pharmacies
"If an individual is likely to receive NHS pharmaceutical services, there may be an agreement with the local primary care trust (PCT) for it to share the marker information with all of its NHS community pharmacies that do not have access to the electronic records system and do not require patient registration. If the patient lives or works close to a PCT boundary, consideration should also be given to information-sharing between PCTs, with the neighbouring PCT being responsible for disclosing information to pharmacies within its area. This protocol should be kept under review as more NHS pharmacies are able to gain access to the electronic records".
Pharmacy contractors will need to ensure that information on the marker shared with them by the PCT is shared only with appropriate staff who may come into contact with the individual. Pharmacy contractors may wish to draw up their own local procedures, having considered the NHS BSA guidance, which is available here -http://www.nhsbsa.nhs.uk/SecurityManagement/Documents/SecurityManagement/Procedures.pdf
Posted 10 August 2010