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Superseded documents BuildingPartnerships,StayingSafe–Theprevention ofviolentextremism–pilotprogramme:guidancefor healthcareorganisations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 prevent@dh.gsi.gov.uk

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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BuildingPartnerships,StayingSafe

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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BuildingPartnerships,StayingSafe

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

19

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,

22

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

26

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

28

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

29

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.

32

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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