Peter Finch CPP is the new chairman of the National Association for Healthcare Security. Mark Rowe visited his office for tea.
As reported in the May issue of Professional Security, Peter Finch took over as NAHS chairman from Somerset-based Nick van der Bijl, who becomes association president. Peter spoke then of two themes: โpromoting professionalism through education and membership of professional institutes and associations, and the provision of appropriate training for security managers and officersโ. As Peter began by saying: security is one element of the role; management is another. โBut a security manager has to be both, and this is widely overlooked.โ The security manager has to assess risks and respond accordingly. The security half of โsecurity managerโ requires you to be qualified, professional, with relevant training and development, and to be a specialist. The NHS has required each of the hundreds of trusts to have a โlocal security management specialistโ; Peter is LSMS for Sandwell & West Birmingham Hospitals NHS Trust: which comprises two acute hospitals in central Birmingham and West Bromwich, and a community hospital in Rowley Regis, four miles apart, with in total about 1000 beds. We are speaking in his upstairs office on the City Hospital site on Dudley Road, one of the main roads into Birmingham city centre. Around his neck he wears his colour ID badge on a blue NHS lanyard; a classical music station is playing on the radio on the window sill. Among the usual pieces of paper on a pin-board is a Birmingham Mail front page from 2006, with the headline โHospital gun siege terrorโ, relating to City Hospital. Leaving aside the daily newspaper sensationalism, as a big inner-city hospital, City Hospital (like others in other cities) may have to deal with machete, knife and gunshot injuries, and the related local gangs, besides Thursday, Friday and Saturday night-related drink casualties. I mention the Counter Terror Expo in London in April, that Peter went to; among the speakers, one spoke of how life is complex, and inter-connected. As an acute hospital, if something happened, even miles away, to cause injury in the city centre, it would affect the hospital. Peter says: โWhile there is no direct terrorist threat to the NHS, an act of terrorism can indirectly and very quickly impact on nearby hospitals.โ If mass casualties arise, hospitals in other cities may have to take patients.
Peter runs through the skills of a security manager: inter-personal, communication, motivational and presentational. Being persuasive and influential. Business planning. Risk and health and safety management. Governance. Finance and budgets; human resources; asset management. โOne thing that I definitely know I have to be, if I am none of those things,โ Peter adds, โis problem solver.โ His job: to keep his piece of the NHS running, by keeping staff and patients safe, and protecting the hospitalsโ assets. He argues that you manage security without also being a โmanagerโ. You may assess risk and see a need for physical access control. โBut you may then need to write the paper to influence the people who hold the budgets, to give you the money. Itโs all very well, me saying, โI want to put a lock on your doorโ; unless they [NHS workers] understand why, they may not operate the lock on the door.โ That is, you have to explain to staff why locks needed to be fitted: for example, to keep visitors from attacking patients and staff, or to keep in risk-assessed potentially dangerous, or vulnerable, patients (a danger to themselves or others) who in medical terms โlack capacityโ. Itโs not in staff interests to wedge doors open for the convenience of walking through freely. As Peter says, thatโs a simple example.
Peter goes on to lock-down. Thatโ the process of reducing vulnerability of a site as part of a proportionate response from a variety of threats and hazards; to safeguard staff, patients and visitors. At City Hospital, a 52-acre site, the ground floor of the main building is a quarter of a mile long and has 20 external doors, open to the public from 6am to 10pm. Here as elsewhere the NHS is committed to be open, warm (literally and in terms of welcome). That alone could be considered a compromise for security. Patient, staff and visitor flows all conflict; but all have to be satisfied. Hence, to enforce a lock-down, you need to be a persuader, a team player โ and Peter adds, a good listener. Staff or others may have good reasons why you, the security manager, need to come up with something else; in a word, a compromise. โIf you donโt get your buy-in, it isnโt going to work,โ as Peter says. And that applies not only to the National Health Service, whether itโs physical security, a policy or procedure, or use of security officers. If your security is fundamentally restricting the way your organisation works, or is overly intrusive, you wonโt get buy-in. Indeed your professional capability may be questioned.
โWe can all be security specialists, but [to be] a security manager in my mind, you have to align the role of security in your organisation, with the business objectives of the organisation, and if you donโt know how to do that, you canโt be effective as a business manager.โ And while not knocking the work and the security-specific qualifications offered by ASIS or The Security Institute โ he has staff taking, and having taken, the instituteโs certificate and diploma โ he returns to the second half of this phrase: a security manager. How much of a security course is given over to management? Not that, he and I agree, security is alone in this; do other sectors, health and safety, risk, in fact any sort of risk-related work, train managers in management?
As for training: historically the NSH has under-invested in security. Security has (for understandable reasons) not been seen as a core function. โIn this trust my security officers โ an in-house team, 36 of them โ will all be SIA door superviser qualified by the end of next year. My eight team leaders are all door supervisers and CCTV public space surveillance qualified. By September all of my security officers will have completed their Criminal Justice and Immigration Act 2008 accredited authorising officer training for dealing with nuisance and disturbance behaviour on NHS premises. They are all fully trained in the management of actual and potential aggression (control, restraint and break-away). Some staff have completed the Institute of Leadership and Management level five โmanaging for managersโ; course and more are keen to do so.
โAnd in July my entire security team will be enrolled on an NVQ level two security services training programme; with Telford College.โ Here Peter is wearing two hats (so to speak): for his trust, and the NAHS, which is also looking at the development of healthcare-specific security officer training. Why the SIA training, though itโs not required for in-house staff? And for the doorman rather than a security officer, although the hospital is not selling beer?! Peter stresses his wish for training thatโs accredited, whether by universities or others; and healthcare-specific. As he says, everyone going to an acute hospital feels more stress than if they are going to a shopping centre, or a business park. Either they are attending for an appointment and are concerned for their own health, or they are visiting a patient and are concerned for them. โSo it is critical that security officers have excellent communication and conflict resolution skills, because a key role in an acute hospital for a security officer is dealing with conflict, by de-conflicting situations, and reducing tensions.โ Peter comes on to assaults on staff. As he says, some lower-level assaults โ pulling of hair, biting, scratching โ may go unreported. Staff (and again, not only in the NHS) accept it as part of the job. In a shopping centre by comparison, if a security officer โ โand I have to say I absolutely hate the word guardโ โ suspects someone has stolen something, they can call the police, who can make an arrest and take the suspect to a police cell. If an amputee patient punches a nurse in the face, the doctor is not going to treat the patient inside a police station. In other words, you, the security person, have to manage the conflict on the spot, while the clinical staff are doing โdynamic risk assessmentโ and adjusting the patientโs care plan.
If a police officer is on the scene of the suspect thief, they can use handcuffs, spray or a Taser. โOur security officers donโt have them. So conflict resolution skills are critical.โ In other words, a hospital cannot necessarily ring 999 for the police to take the problem away. Yes, under powers allowed by central government under the Criminal Justice and Immigration Act, accredited persons can eject visitors making a nuisance, as featured in our November 2009 and 2010 issues. But what of people wanting treatment and playing up and bothering others? You have to manage them, whether drug addicts or alcoholics, the mentally ill or someone on detox. Just as the shopping centre security officer is looking out for someone acting suspiciously (who may indeed be a drug addict or drunk), so the healthcare security officer is looking for such signs, but for different reasons. Security is an essential part of the hospitalโs care team, Peter says. He explains. If a patient goes missing โ and City Hospital has beyond its perimeter an A-road, canal and railway line, all potential risks for someone confused – then security search for them and return them to the wards. If a patient turns violent against staff, Security turns up and carries out restraint, within the law, to protect staff โ and indeed to protect the patient being restrained from harming themselves. A security officer may stand on either side of a patient, to prevent them from leaving; or if a patient is agitated, security will even ensure the patientโs privacy and dignity, or assist clinical staff with the patient at meal times.
Peter recalls the November NAHS conference he hosted, when police response times cropped up. Given the impending cuts in his West Midlands Police force, like others, Peter feels the hospital in security terms has to look to stand-alone. And in any case, if after 30 minutes (or more) police arrive, what would they do? Because, to repeat, someone who has come to the hospital for treatment, needs treating. That is what doctors and nurses want to do, and in-patients can rarely be removed at once from the hospital.
Whatโs over the horizon? Accredited security officers, according to the several years old scheme under the Police Reform Act? An NHS Police force, or extra powers for NHS security officers? Is it the old story of the UK doing in a few years what the United States is doing now? In many trusts, security can be tied up with car parking, portering, and other estates or facilities department work. At Sandwell, where porters and security staff were linked, Peter has separated the portering and security functions, and given workers the choice of being porters, or security officers. Peter plans to swap the Birmingham City Hospital, and Sandwell, security officers, giving Sandwell officers the experience of the inner-city hospital. Already the trust has a single procedures manual.
Meanwhile, the trust is planning to move to a new hospital in Smethwick: the recently named Midland Metropolitan Hospital. I suggest that keeping up with the internal changes in the octopus-like (my phrase) NHS โ one of the largest organisations in the world โ could be a full-time job in itself. Quite apart from the Coalitionโs proposed reforms around the (complex) relationships between GPs, hospitals and other providers of services, will GPs, as the new commissioners of care, know to write in security into contracts they are signing? So that their own staff and premises are protected? Peterโs own trust is applying to become a founation trust and is in the interim โreconfiguringโ. The present three hospitals will become โcommunity hospitalsโ; and Grove Lane in Smethwick will be the site of the new acute hospital. Security has to be, ideally, built into the new buildings, at the design stage, and new methods of working will also be designed to meet these new models of providing healthcare. โThere seems to have been constant change since I joined the trust, 11 years ago,โ Peter says.
About Peter Finch
Peter, 52, is a former officer of the Royal Air Force Security (Provost) Branch where his work took in counter-intelligence, counter-terrorism, royal and nuclear security. Peter is the Security Adviser to Sandwell & West Birmingham Hospitals NHS Trust, the seventh largest NHS Acute/Teaching Trust Hospital in the UK. He has served for three years as a Non-Executive Director of the Board of the NHS Counter Fraud and Security Management Service, recently revamped as NHS Protect. Peter is a Fellow of the Institute for Leadership and Management and a member of the Institute for Security, the Institute of Chartered Managers, the Institute of Emergency Management and the American Society for Industrial Security (ASIS) โ he has their CPP qualification. In November 2010 Peter organised and hosted the National Healthcare Security Conference at City Hospital on Dudley Road, Birmingham. Visit –
