Ambulances, Assaults, Clinicians and Cameras

Ambulances, Assaults, Clinicians and Cameras

Over the past four years there has been a noticeable increase in the unwarranted assaults on emergency workers and in particular, ambulance crews. These assaults have sometimes been as a result of the assailant being under the influence of drugs or alcohol, sometimes due to a patients medical condition, but predominantly as a result of ambulance crews attending to patients who themselves or their relatives became violent. East of England Ambulance Service is not isolated in these circumstances and assaults on ambulance crews are being reported across the width and breadth of the United Kingdom.

With no sign of these assaults being stopped without practical interventions, different services have been looking at ways and means which might be employed to deter the assailants and where this was not achievable, ways to secure robust evidence that could be used in a court of Law to prosecute the offenders.

The options which began to appear included the provision of body armour (stab vests) as is used in London, Body Worn Cameras (as used by numerous Police Forces) and safety cameras as used by some ambulance services and also some Fire & Rescue Services.

Stab vests are available and aside from the cost, they can be either overt (worn over the shirt) or covert (worn under the shirt). The provision of these defensive items can have a negative effect on the wearer because in warm weather they act as a thermal barrier and prevent body heat from easily escaping, as well as being slightly heavy. There is also the problem of compliance; would the employer have to make it mandatory that the employee MUST wear the protection at all times, that any employee not wanting to wear the protective armour must sign a disclaimer, or leave it to the individual to make a dynamic risk assessment on route to a call as to whether or not they should place the protective layer over their uniform.

If an assault did take place and the perpetrator left the scene, was there any way that their identity could be established and could it prove that they had been on scene and carried out the attack? Finally, would the item of protective clothing spend all its time in the bottom of a locker or in the boot of a car? This subject has been reviewed and discussed at numerous meetings, at several levels and in most ambulance services. Unison Health & Safety has always been involved, working towards a safer environment for our members to enable them to carry out their roles without fear of sudden and unwarranted attacks.

Dash-cams are becoming the must-have accessory in most private cars as well as in corporate vehicles, including buses, taxis, delivery vehicles, and even motorcyclists and cyclist have taken to wearing them in order to record their journeys in case they become the victim of careless or dangerous road users. With their built-in systems the dash-cams can record speed, road names, grid references and also sound unless the microphone is disabled.

With ambulances being very easy to identify (a large green and yellow mass with multiple coloured lights twinkling and variable audible sounds) it is not uncommon for a dishonest motorist to make a fraudulent claim against ambulance services in order to gain financial reward; Dash-cams can and have prevented hefty financial pay outs as well as protected the reputations of the ambulance drivers and the ambulance service corporate body.

Fire appliances are also very easy to identify, but once on scene the fire crews have found that items of equipment have gone missing or that unexplained damage has occurred to the vehicle while it was stationary. There have also been incidents where fire crews have been assaulted or come under attack from feral crowds throwing bricks, rocks or bottles. To counter this, a large number of Fire and Rescue Services around the country have installed safety cameras on the exterior of their appliances so that if any damage or attacks take place during a “shout” their safety team can review the footage in order to identify the events which took place.

Incorporated within the specification of the next generation of ambulance that is scheduled to replace our existing emergency fleet, is a dash-cam, but it will only have the facility to make visual recordings. It will not re able to make audio recordings so that the members of staff in the crew cab are able to have their usual conversations without a sense of “Big Brother” spying on them. However, despite being hard wired into the system it will remain dormant for the time being. There will also be safety cameras providing a 360degree coverage around the ambulance which will have the ability to record all activity in the immediate area surrounding the ambulance, but, as with the dash-cam, the safety cameras will only provide real time views because the recording facility will remain dormant for the time being.

The third safety camera system will be installed in the rear patient saloon area mounted on the forward bulkhead, pointing towards the rear of the interior. This will be activated by anyone initiating the alarm strip which runs around the interior in case of assault or attack. The camera can also be initiated by the clinician if they believe that the patient is likely or known to become violent or make false accusations against clinicians. However, like the dash-cams and the safety cameras the system will be installed but will remain dormant for the time being.

So why is the Trust going to the expense of installing these facilities if they are going to remain dormant and not be able to secure video evidence which could stand up in court and defend our colleagues? Across the UK different emergency services have trialled an assortment of systems and some have been brought onto line, much to the relief of all concerned. However, it is not as simple as selecting one for your own car and having it installed for example by Halfords.

Because the cameras have the ability record data, they come under very strict Regulations and this requires the user (The Ambulance Service) to draft a robust Policy and Procedures document which aside from meeting the requirements of Data Protection must also comply with the very strict requirements of clinical governance.

The Health & Safety Committee first discussed stab vests and body worn cameras as far back as 2016 and recognising that the level of assaults on ambulance employees did not appear to be decreasing, steps were taken to investigate the potential for safety cameras to be obtained. The subject of body worn cameras was initially discussed by some of our Branch Health & Safety County Lead representatives at a pre-meet ahead of a Health & Safety working group meeting at Barton Mills. We had been informed by our Branch Seniors that under no circumstances were we to approve the go ahead for body worn cameras to be introduced within our service. The reason given was “they might use them against our members to get rid of them”.

However; during the pre-meet we looked at the pro’s and con’s of body worn cameras and safety cameras in general and after much deliberation it was agreed that “there was no health, safety or welfare reason to not support their introduction” which is what we took forward to the afternoon meeting. However; it was made clear to management at that meeting that although there were no health, safety or welfare reasons for not supporting the introduction of safety cameras, we informed them that Unison seniors had stated they were not to be supported in general terms.

Without getting into the why’s or wherefores of this difference of opinion, it must be understood that from a health and safety perspective, the introduction of equipment, passive or active, which improves the safety of employees, should generally be supported. In this case, I believe the reason why our Branch Seniors decided that we were not to support the introduction of safety cameras, comes down to the fact that at that time, and even as I write, there are no robust Policies or Procedures in place to ensure the proper management of the cameras and compliance with the clinical governance requirements. Until such time that these documents have been drafted, viewed, amended, corrected and finally signed off, the cameras can be installed but must remain inactive and dormant.

In the intervening period, the Health & Safety committee have met regularly, as have the health & safety working group and also the vehicle development group. Throughout all this time at every meeting I have repeated the same stand point which is “there are no reasons under health, safety or welfare to not support the introduction of safety cameras” once a robust Policy and Procedures have been agreed and put in place.

During the past year while the concept ambulances have been undergoing trials at various locations within our region, members of staff (Clinicians, AFA’s and workshops) have the opportunity to view the vehicles and to provide feedback to the vehicle development group. As far as I am aware there have been a wide range of positive comments received and a few constructive negative comments. This feedback has been taken on board and where practicable has been incorporated into the final design. There was a lot of support from employees regarding the introduction of dash-cams and safety cameras and I am not aware of any objections to them being installed.

The Ins & Outs of Body Worn Cameras in a Nutshell:

1. There must be a robust Policy and Procedures in place before going “live”
2. They must comply with the clinical governance
3. They can only be turned ON by the WEARER
4. They are not actively recording 24/7
5. They are not recording for the entire shift duration
6. Access to any stored data is controlled by trained and authorised Gate Keepers
7. Unauthorised access to stored data is a CRIMINAL OFFENCE
8. The wearer can activate the camera whenever they feel threatened
9. The camera can be activated by the wearer when they are in an area where they feel unsafe
10. The wearer must inform persons present when the camera is recording
11. The wearer must turn the camera off if a person present does not want to be filmed.
12. The wearer must verbalise the reason for turning the camera off before switching it off.
13. The wearer can turn the camera back on without informing anyone if the situation escalates
14. If there is an incident which requires a Datix to be raised, camera data will support it
15. Footage can be used to identify and prosecute persons who assault employees
16. False and malicious accusations can be refuted by camera footage

The information above is intended as guidance and does not form any part of any document which may or may not currently be in the development stages, but falls into line with Police Federation Policies. The Police Federation has stated that they have seen an enormous reduction in the number of complaints against officers since the introduction of body worn cameras and also a reduction in the number of assaults on officers.

It is my genuine and honest opinion that the introduction of vehicle safety cameras, dash-cams and body worn cameras by the East of England Ambulance Service is a positive step forward in the effort to reduce assaults on our colleagues, to reduce malicious complaints against our colleagues and to reduce the financial burden of fraudulent motoring claims against the Trust. However, there does need to be a concerted effort by The Trust and Unison officers to develop and agree acceptable Policies and Procedures which comply with Clinical Governance before the safety camera systems are allowed to go “live”.


Jeff Pittman


East of England Ambulance

Senior Paramedic

Unison Health & Safety Officer

31 January 2019