SERVICE-USER SAFETY and a sense of being watched.1 This can
be particularly distressing for individuals already dealing with conditions that involve paranoia or trauma. Awareness of being recorded can
influence a patient’s behaviour, potentially negatively impacting them on their journey to recovery. Patients may feel inhibited, less likely to engage in natural behaviours, or even avoid certain activities altogether, such as changing clothes or engaging in personal care routines.8
There is also the
risk of misuse of the recorded footage. Even with strict protocols, the possibility of unauthorised viewing or breaches can lead to a violation of privacy and dignity.8 This is particularly concerning in the context of mental health, where the stigma and sensitivity of the information are heightened. Regulatory and Ethical Review incidents have prompted regulatory bodies and mental health charities to call for a suspension of such monitoring systems until a thorough review of their use and the human rights implications can be conducted.9
The CQC (Care Quality
Commission) is exploring how it regulates this new era of mental healthcare that is supported by technology, and in doing so, seeking alternative methods that respect patient privacy while ensuring safety.
Ethical framework considerations in patient monitoring It is understood that vision-based monitoring systems, while life-saving, rightly raise ethical concerns. Patients express discomfort and a sense of violation, with one stating: ‘I don’t feel comfortable getting changed in my room, knowing there is a camera. It makes me feel paranoid, uncomfortable, and dehumanised.’ Balancing technological possibilities with ethical considerations required open dialogue and sometimes tough compromises. However, Safehinge Primera took these challenges head on. To ensure the ethical integrity of Project X we carried out an independent assessment from a prominent expert in ethical framework validation, Professor Suzanne Shale, who has advised a variety of NHS bodies and private healthcare organisations on ethical and patient safety issues, and provides support to NHS ethics committees and Integrated Care Boards. This validation process confirmed that Project X adheres to the highest standards of ethical practice, reinforcing its right of place in mental healthcare environments. As we are testing Project X in live
environments, our business is committed to meeting NHS ethical appraisals. Our design principles prioritise reducing restrictive practices, improving patient autonomy, privacy, and safety, and ensuring that all stakeholders are fully informed and empowered throughout the process. Extracts of the framework highlight:
“The intuitive software application delivers THE NETWORK | MAY 2024
real-time updates on patient location and activity, alerting healthcare staff to potential risks such as falls, sensor tampering, or excessive time spent in high-risk areas. Crucially, the application prioritises patient safety while respecting their privacy, displaying pseudonymised data on handheld devices without revealing patient identities. “Project X complements therapeutic
observation by offering non-invasive monitoring, fostering a sense of protection without compromising human connection. Patients are provided with relevant information about Project X, empowering them to participate in their care decisions and fostering trust between them and healthcare providers.” Project X is well positioned to forge
ahead into the future. Its robust product roadmap outlines a number of future developments and improvements, such as an integration with our market-leading door alarm, that will further cement its purpose in supporting positive outcomes in mental health. Guided by the foundational principles of co- production, and a deep comprehension of how emerging technologies can amplify the invaluable work of mental health practitioners, the project is set to revolutionise the landscape. Through ongoing collaboration and innovation, Project X is committed to unveiling ground-breaking solutions that empower practitioners and enhance the delivery of mental health services. The journey ahead promises a tapestry of innovation, woven with the threads of compassion, expertise, and cutting-edge technology.
Innovation ‘not just about technology’ In the journey towards transforming mental healthcare, let us remember that innovation is not just about technology; it’s about people. True co-production in healthcare emerges as a guiding principle that ensures solutions are not only effective, but also ethical and patient- centred. Safehinge Primera’s Project X exemplifies the power of collaboration in addressing critical needs and driving innovation in the mental healthcare sector. Project X is a non-camera-based patient observation safety aid that prioritises patient privacy and dignity, offering 100% coverage in high-risk areas 100% of the time, providing actionable insights. It also helps reduce restrictive practices, and fosters empowerment and engagement
for all stakeholders. The system has been ethically validated by independent experts, and has received positive feedback and testimonials from customers and end- users. By continuing to prioritise co- production and collaboration, we aim to drive positive change in mental healthcare, and improve outcomes for patients and clinicians alike. It’s a reminder that in the world of
healthcare, technology should serve as an extension of our humanity, bringing us closer together and lifting us towards a brighter, more caring tomorrow. Come and see us at this Year’s Design in Mental Health exhibition at Manchester Central, where we will be showcasing Project X.
By incorporating diverse perspectives and experiences from the very start, we have ensured that Project X is genuinely reflective of the needs and preferences of users… The message was clear – people wanted and needed a safety aid, but this must maintain their privacy and dignity
Philip Ross
n
References 1 Batty D. NHS Trusts criticised over system that films mental health patients in their bedrooms. The Guardian 13 December 2021.
https://tinyurl.com/uth5ktcj
2 National Confidential Inquiry into Suicide and Safety in Mental Health Annual Report 2023. Healthcare Quality Improvement Partnership. (HQIP) https://tinyurl. com/2c84et4p
3 Maghsoud F, Rezaei M, Asgarian FS, Rassouli M. Workload and quality of nursing care: the mediating role of implicit rationing of nursing care, job satisfaction and emotional exhaustion by using structural equations modeling approach. BMC Nursing 8 October 2022; 21 (273).
https://tinyurl.com/mryx7zhd
4 Liberati E, Richards N, Parker J, Willars J, Scott D, Boydell N et al. Remote care for mental health: qualitative study with service users, carers and staff during the COVID-19 pandemic. BMJ Open; April 2021: 11(4).
https://tinyurl.com/3r4r58xj
5 NHS Long Term Plan. Chapter 5: Digitally- enabled care will go mainstream across the NHS.
6 United Nations Universal Declaration of Human Rights.
www.tinyurl.com/25y7678k
7 The mental health nurse’s handbook. NHS England. Published 11 November 2022.
https://tinyurl.com/ycx4nmsw
8 Pring J. ‘Deep concern’ over high-tech system that allows ‘covert surveillance’ of service-users. Disability News Service. 25 November 2021.
https://tinyurl.com/ yveakkz3
9 Strudwick P. NHS chiefs tells mental health services not to use a controversial video-monitoring system in ‘blanket way’ i News. 28 September 2023. https://tinyurl. com/3xyfp7j5
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