There was a fascinating interview published prior to IFSEC earlier this summer with Peter Finch, the president of the National Association for Healthcare Security (NAHS), who said managing security in medical facilities was much like doing so in other sectors and industries.
He is better placed than almost anyone to know. He became NAHS president following 14 years in the NHS, most recently as security adviser at Sandwell & West Birmingham Hospitals NHS Trust where he experienced the 2011 Handsworth riots first hand.
But he began his long career in security in 1978 in the Royal Air Force as an RAF Policeman – and he has just taken on the top security job at the Coventry Building Society.
He argued in the interview that the theory of security and security management was pretty much the same in all his roles. Firstly he said crime prevention was pretty much the same, having looked after nuclear weapons in the RAF and harmful pathogens and toxins in NHS pathology departments that could be used for bio-terrorism.
He also said all industries have people and equipment to protect from damage and theft. And he said during the Handsworth riots three years ago, they had to protect and defend the hospital pretty much in the same way as a military base to keep it operating.
It got me thinking what were the similarities and differences from the perspective of physical security measures, such as fencing and perimeter protection, CCTV and access control.
And it made me wonder why healthcare security managers don’t look to other security professionals in the public sector and beyond to innovate in how to protect their facilities better.
Our experience at Zaun mirrors Peter Finch’s in healthcare, military installations and banking, but also encompasses education, utilities, prisons and manufacturing, to name but a few.
And I realise that, by their very nature, hospitals and health centres exist for the wellbeing of the community and need to be accessible, open and welcoming – so intimidating security measures might be frowned upon.
Perhaps the best parallel here is schools. But where most new schools and academies built under the Building Schools for the Future programme have incorporated the Full Monty of physical security, with perimeter security fencing, CCTV and access control at entrances, hospitals rarely use more than trees, bushes and shrubs to mark their boundaries and screen access.
Both are subject to the Safeguarding Vulnerable Groups Act of 2006, which made it a legal requirement to protect children and other vulnerable adults from harm or risk of harm by preventing those individuals who are deemed unsuitable from gaining access to them through their work.
Designing in security
And both face similarly well-publicised safety and security threats. Hospitals are increasingly prone to challenging and abusive behaviour from patients and relatives. Equally school security has been at the top of the agenda ever since the 1996 Dunblane school massacre and Horrett Campbell’s machete attack on a teddy bears’ picnic at St Luke’s Infants School in Wolverhampton three months later.
In my view, healthcare security managers should take a leaf out of their education counterparts’ books and get efficient physical security designed in at the beginning.
A briefing note from Gloucestershire Constabulary says: ‘In order to teach and to learn, staff and pupils must feel safe and secure. Criminal and anti-social behaviour can cause disruption to the work of the school, physical and mental damage to people and damage to buildings. Worse, fear is created amongst pupils, staff and parents, which is out of all proportion to the actual crimes committed.’
Its first recommendation is to provide a substantial secure boundary and limit access points for vehicles and pedestrians, which has now become a key part of Ofsted inspections.
And education faces no less a squeeze on its budgets than the NHS, yet has mastered the skill of making sites secure without seeming fortified, to remain open, welcoming and contributing to the wellbeing of its users.
Considering the specifics
One branch of the NHS which has adopted far tighter security is mental health units, which perhaps mirror more the approach adopted in prisons than in hospitals.
We have recently fitted out mental health units in Scotland, Wales and England, the most recent being one of only six adolescent forensic psychiatry in-patient units in England.
The Ardenleigh secure mental heath unit in Erdington, run by Birmingham & Solihull Mental Health NHS Foundation Trust, has moved into a new £3.5m state-of-the-art building for up to 18 young adults suffering from complex mental health problems.
As inpatients, they receive assessment and treatment of mental health issues – such as depression, bi-polar disorder, psychosis and schizophrenia – and many arrive with or acquire Autistic Spectrum diagnoses as well.
Ardenleigh houses some of the country’s most mentally disturbed teenagers, who have been detained under the Mental Health Act and have usually committed a criminal offence, and was opened in 2003, so was due for upgrading.
Security was paramount given the nature of the young people on site, who might pose a significant risk to themselves or to others. So we installed aluminium sheeting on some of the boundary fencing to provide privacy to the inpatients and to prevent them from being distracted by events beyond the hospital.
And what such different security challenges at such varying sites tells us is that security managers and their advisors need to consider the specifics of aesthetics, security, the environment, the site footprint and budget before working out the best way to deliver what can often be conflicting priorities.
However unusual your requirements, it pays to involve the security specialists right at the start of the design process to build the securest and safest medical facilities that achieve the best rehabilitation and wellbeing outcomes – even if the lessons come from outside the healthcare community.