In good health

Up until two years ago Royal Berkshire Hospital had very limited security, with just a few surveillance cameras in the Maternity Unit and one guard on duty in Accident and Emergency during the evening. Now, the Trust has a 35-strong manned security team and has installed new access control and CCTV systems.

When the project is completed, there will be more than 200 cameras trained on Royal Berkshire Hospital. Control room staff will be able to track staff, patients and visitors from the moment they enter hospital grounds, either on foot or by car, to the moment they leave.

The Trust has contracted BWS Security Systems to specify and install the cameras, along with other new systems.

Jim Roy, Trust risk manager, is masterminding the security project.

Roy recalls: "Two years ago we were described as a 'crime hotspot', but not anymore. We're no longer an easy touch."

Despite Roy's determination to cover most of Royal Berkshire Hospital with cameras, he pledges that CCTV won't invade the privacy of staff, patients and visitors. Cameras haven't been installed in surgical and medical areas and security is provided as discreetly as possible, he claims: "Anyone who looks around for security will think, 'Oh my god, it's Fort Knox!' But that's not the case."

The new Data Protection Act, however, has undermined the Trust's efforts to keep security discreet, claims Roy. "The Act requires us to put signs up everywhere that we're using CCTV. It detracts from what we're trying to achieve," he says. "We're happy to put signs up at entrances to buildings, but the Act goes too far."

Air assistance arrives

Improved security has led to an increase in crimes being detected and reported. While Roy claims physical assaults on staff are rare, verbal abuse – particularly in Accident and Emergency – is a common occurrence. "With verbal abuse it tends to be from people under the influence of alcohol or drugs," he says.

CCTV is a valuable detection tool and deterrent (there's a 17-inch JVC CCTV colour monitor in A&E, visible to all), but it can only do so much to combat aggression, acknowledges Roy. So he has backed up security systems with a manned guarding team and an on-site police officer. Roy admits he has used a number of guarding firms since he became Trust risk manager in 1992, but he's confident he has finally found the right company.

Last November, the Trust contracted International Consultants of Targeted Security (ICTS) to provide manned security round-the-clock and manage the Trust's car parks. The Trust, says Roy, sees ICTS as a partner rather than as an external contractor. The company, which employs 1,500 staff in the UK, specialises in providing public access security at hospitals, universities and airports. Contracts include London's Heathrow, Gatwick and Stansted airports and Manchester airport.

Shai Meirav, general security manager for ICTS, reckons the company's aviation background has benefited the hospital: "We are now applying our specialist experience to other sites – such as Royal Berkshire Hospital – which are high-security but need to maintain an open and friendly environment," he says. ICTS staff don't dress in police-style uniforms, although they do wear high-visibility jackets labelled "security".

ICTS security officers and supervisors work eight-hour shifts at the Trust's hospitals. In the Maternity Unit, there's security officer coverage 24 hours-a-day; in A&E, there's 10 hours of coverage between 9am and 7am (which Roy calls "sensitive hours"), seven days-a-week.

James Dewane, ICTS contracts manager, says: "We respond to any calls or incidents within five minutes, which is the time it takes to get from one end of the hospital to the other end."

In addition to providing manned security, ICTS trains the Trust's staff how to handle aggressive patients or visitors. The company has adapted its DETR-regulated "aggression management" course for airport employees to suit hospital staff.

"Village bobby"

There is one extra member of the hospital security team. For the past two years the Trust, for an annual fee, has hired a police constable from Thames Valley Police to patrol Royal Berkshire Hospital; the hospital is the constable's only beat.

It has been money well-spent, says Roy, who has dubbed the constable – presently PC James Willis – the hospital's "village bobby". He explains the benefits Willis brings: "Previously it was pot luck as to whether anyone would come out and investigate a reported crime, but now, all crimes get police intervention and investigation. It's led to improved arrests and convictions."

The Trust is also working towards a tri-pact agreement with Thames Valley Police and the Crown Prosecution Service, reveals Roy. "We hope to agree that all acts of crime against the health service will be prosecuted, instead of criminals being arrested in Accident and Emergency and then let free at the end of the road," he says. In addition, an "Exclusion Policy" enables the Trust to ban anyone constantly committing crime at either hospital. The policy, says Roy, was planned long before the Government launched its Zero Tolerance Campaign last November against hospital violence.

Trust funds

Implementing new electronic security systems can be an expensive exercise, as the Trust has discovered.

Although Roy has been given substantial funding to spend on the security project, the budget hasn't stretched far enough for him to introduce proximity cards or smart cards for access control. Instead, staff are issued with magstripe ID cards. Roy doesn't see magstripe as a compromise, though: "Magstripe is OK. It does the job," he says.

Digital recording of CCTV footage is out of the Trust's price range, too. "Digital is very nice, but for now, we'll use analogue," says Roy, who claims most other NHS hospitals can't afford digital recording either: "It's Catch 22. A lot of security managers can't afford digital until the price comes down, but manufacturers are saying that the price won't come down until people buy it." He adds: "If one manufacturer was to bring the cost down, they'd corner the market."

There's no shortage of cutting-edge technology in Royal Berkshire Hospital's new multi-storey car park, however. There are cameras on every level and any driver in need of assistance can use one of the audio help points situated on each floor.

The measures have paid off: no car crime has been reported in the car park since it opened. Roy marks the success down to extensive CCTV coverage. "I feel we've been vindicated in putting in cameras," he says. "The cameras enable us to see in every crevice." The Home Office and ACPO have been impressed and will shortly award the car park "Secured By Design" status.

Building site

Situated near the multi-storey car park is the main security control room, housed temporarily in an elevated Portakabin. A new control room is being built, but security staff won't move in until the middle of next year.

Inside the Portakabin there are nine CCTV monitors: one monitor is split into nine different segments enabling CCTV operators to track somebody in sequence as they move through the hospital. Roy wants to integrate security further still: "Our plan is that if a door is forced, an alarm will sound and it will trigger CCTV. Eventually, we want it so a map will appear and we know where someone is within the building."

The control room is also where ID cards are issued to employees and contractors.

With a control room and a number of other buildings under construction, much of Royal Berkshire Hospital resembles a building site. "It has meant we've had to introduce new security measures piece-meal," says Roy. "It would've been easier if we were installing security systems in a brand new hospital."

Installing new systems has also been a challenge for Andrew Davies, system design executive for BWS Security Systems. "In the Maternity Unit, we had to install the new access control system while keeping the original system up and running. Otherwise, security would've been compromised," says Davies.

The construction phase also brings fresh security challenges, reveals James Dewane of ICTS: "We've had Friday night revellers trying to climb scaffolding. We have to keep a close eye on the building sites round-the-clock."

Although the refurbishment is far from complete, Jim Roy makes an open invitation to other NHS security managers to visit Royal Berkshire Hospital and share ideas. Roy, a member of the National Association for Healthcare Security, began his NHS career in 1970 as a clerical officer at Princess Marina Hospital in Northampton.

He says: "Since NHS hospitals became Trusts there's been less sharing of best practice. I'm not saying the security we've got here is the way to go, but if anyone wants to look at what we do, I'd be happy to let them."