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August 16, 2010

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New guidance for care record violence markers

The NHS Security Management Service (NHS SMS) has launched new guidance on the use of markers on patients’ care records, which alert staff to the risk of physical violence or aggression.

The guidance stresses that markers should only be placed on a patient records following a reported incident of violence or aggressive behaviour, by either the patient or by someone associated with them.

Those who have responsibility for the safety and security of NHS staff can already place a risk of violence marker on an individual’s electronic or paper care record. But the guidance does not change the need to respect patient confidentiality, and to deliver care without discrimination.

The initiative acts as an early warning system and complements the existing range of SMS guidance for NHS staff on how to tackle violent and aggressive behaviour. It also helps health providers to meet their health and safety responsibilities, by providing security warnings and handling advice to avoid or minimise the risk of violence. NHS staff in need of further advice on the guidance should contact their Local Security Management Specialists.

NHS SMS managing director, Dermid McCausland, said: “NHS should continue to report any incidents of violence and aggression. The more reports we have, the greater the success of the marking scheme, so that patient care can be delivered in a safe and secure environment. Our policy team has put a huge amount of work into making care record markers even more effective.”

The British Medical Association has welcomed the guidance, a spokesperson said: “It is important that anyone who works for the NHS is properly protected against the risk of violence. We therefore welcome this guidance, which clarifies the situation on how markers can be used. We hope all providers of care will use it when reviewing or implementing their own procedures. Nurses, midwives, doctors, and all medical staff  are still expected to treat patients, guardians, relatives or friends of patients professionally. When treating patients, nursing staff are not expected to discriminate in any way.”

Public sector union UNISON believes the guidance provides essential advice. It commented: “UNISON welcomes this guidance, which gives providers essential advice on how patient markers should be used. It makes it clear that the safety of staff and the public is paramount to the delivery of services whilst recognising the importance of patient confidentiality. We hope that all healthcare providers will use it to help prevent or reduce the risk of violence to staff.”

The guidance can be viewed at

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