Piloting the use of body-worn cameras in the emergency department – consultation feedback report
- Foreword
- Background
- Consultation process
- Summary of feedback
- Themes emerging from the consultation feedback
- Concluding remarks
- Next steps
Foreword
Ensuring a safe and supportive environment for both patients and staff within our Emergency Department is a top priority. Healthcare professionals frequently encounter situations of violence and aggression, which pose significant risks to their well-being and the delivery of quality patient care. Recognising these challenges, we have explored a range of strategies aimed at promoting safety and respect within our hospital.
The introduction of body-worn cameras for senior nurses in the Emergency Department is to be piloted as part of a wider toolkit to deter and respond to incidents of violence and aggression. This initiative has been approached with careful consideration, ensuring that the principles of professional practice, patient dignity and regulatory compliance remain central to its implementation.
Throughout this consultation process, we have welcomed the perspectives of patients, staff, advocacy groups and healthcare professionals. Their valuable feedback has shaped our understanding of the potential impact and practicalities associated with the use of body-worn cameras in an Emergency Department setting. Key concerns, including privacy, consent, operational procedures and the broader cultural implications, have been thoroughly examined to ensure transparency and accountability in decision-making. Our commitment remains to fostering a healthcare environment where staff feel protected, patients feel respected and care is delivered with integrity.
As we evaluate the outcomes of this pilot, we will continue to engage with stakeholders to refine our approach and ensure that any measures taken serve the best interests of our hospital community.
We are grateful for the constructive dialogue and engagement from all who contributed to this consultation. Moving forward, we will remain guided by principles of ethical practice, regulatory compliance and our unwavering dedication to providing safe, compassionate healthcare.
Suzanne Pullins
Executive Director of Nursing, Midwifery and AHPs and Divisional Director Paediatrics, Women’s Services and Corporate Support
Audrey Harris
Director of Medicine and Emergency Medicine
For further information, this Report should be read alongside our consultation document ‘Piloting the use of body-worn camera devices within the Emergency Department’.
Background
Violence and aggression is the greatest risk which Trust staff are exposed to with a total average number of incidents in excess of 1500 recorded over the last number of years. A significant number of the incidents recorded occur in the Trust’s acute hospitals, in particular, areas of high interface with the public such as Emergency Departments. While staff in the ED are trained or being trained in managing incidents where individuals may become violent or aggressive, there are occasions when experience and expertise are not enough to defuse a situation. In such cases, having a Body Worn Cameras (BWC) would provide additional support and an added layer of safety for them and those in proximity. The fundamental idea behind introducing BWC is for the camera to act as a deterrent against aggressive behaviour and to provide evidence in cases where incidents have occurred.
In preparation for a public consultation and potential pilot of the use of 12 cameras in the ED AAH, a Trust group was established in November 2023. This group developed the necessary documentation to ensure compliance with legislative and policy requirements regarding privacy, Data Protection, Freedom of Information, Equality and Human Rights. The BWC pilot group considered existing evidence from key stakeholders, including local HSC Trusts, NHS Trusts in England and Trade Unions. Considerations included scoping of existing regulatory and compliance requirements, BWC hardware and software options, resource implications (such as financial, training, staffing and estates) and continued with stakeholder engagement to develop the drafting of key documentation and Trust plans, with consideration of any known learning or implementation challenges.
The Northern Health & Social Care Trust (NHSCT) Board gave approval on 23 January 2025 for the BWC Project Team to enter into a 14 week Public Consultation commencing on 23 January, closing on 01 May 2025. Trust Board will now be asked to consider the outcome of the consultation and to provide approval to proceed to the pilot phase.
This paper shall focus on the outcome of the Public Consultation and the Trust responses to concerns and queries raised in relation to the use of Bodyworn cameras only.
Consultation process
On 23 January 2025 we commenced a public consultation on piloting the use of body-worn camera devices within the Emergency Department. The consultation closed on 1 May 2025. We extended the length of the consultation to 14 weeks given the Easter period during the consultation period. The consultation was an opportunity for interested parties and members of the public to comment on the proposed pilot and to share experiences, knowledge or ideas that help to inform decision-making.
We made all attempts to ensure the consultation document was easy to understand through providing an ‘Easy Read’ format along with a ‘Frequently Asked Questions’ document. To support those consulted to make an informed view we provided additional key information. This included an Equality Impact Assessment and Rural Needs Impact Assessment, along with a Data Protection Privacy Impact Assessment (DPIA).
We used several different methods of engagement, which are detailed below to encourage interested groups and individuals to provide feedback.
Consultation breakdown
- Consultation period: 23 January 2025 – 1 May 2025
- 2 listening events
- 17 listening event attendees
- 445 regional organisations and representative groups were informed
- 684 local groups and organisations were informed
- 114 responses received
- 5748 accounts reached on X
- 2374 website views
- 323,773 accounts reached on Facebook
Requesting responses from individuals and representative organisations
To raise awareness of the consultation process, we publicised the consultation documents and information about the listening events through our regional consultation list, the Trust website, social media and posters which were placed around the Emergency Department to encourage service user engagement with the process.
Our regional consultation list is made up of 445 organisations and representative groups and in addition through 684 local groups and organisations including all Trust service user and carer groups and all MLAs, MPs, Councils and GPs were sent information about the consultation and listening events.
A letter was also sent to consultees reminding them of the closing date for consultation. Consultation documents were made available on the Trust’s website (i.e. available to the public) and intranet (i.e. available to Trust staff). Documents were also available in hard copy or in different formats on request.
An on-line proforma, hosted on Citizen Space, was available to complete. We are mindful that to engage through Citizen Space individuals need to have access to a suitable device, broadband and knowledge to complete an online proforma. We have therefore accepted responses in other formats including hard copies of written or typed responses, sent in by post, or email and we welcomed responses provided over the telephone.
Listening events with service users, carers and interested parties
Mindful that online engagement has the power to reach new audiences, we held a virtual listening event on Wednesday 12 March 2025 at 7pm. We also held an in person listening event in Antrim on Thursday 13 March at 7pm.
Both listening events followed the same format. Registered participants had the opportunity to view the background information and an opportunity to speak to the service leads through live chat sessions. The online listening event included 17 participants. While an in person event was held, no individuals attended this event, with the exception of media representatives being present.
All feedback we received at the listening events has been included in this report and considered by the key decision makers. We would like to thank everyone who attended the listening events.
Meetings with staff
We recognise the importance of involving our staff in any change to services and accordingly have engaged inclusively and constructively with our internal stakeholders to consider the use of body-worn camera devices. Our staff were involved in a range of meetings, briefings and workshops. The staff who work within the Emergency Department have helped to consider the concerns, fears and misconceptions relating to the use of body-worn devices. Staff, particularly those who work in the Emergency Department in close contact with services users, are in a great position to know what will work and to suggest the way forward.
During the consultation process we held staff engagement meetings, attended by staff members. The group engaged early with ED staff and Trade Union Staff (RCN, UNISON and BMA) to ascertain initial/early viewpoints and with a recognition that the pilot, for some, could be interpreted as controversial and carrying risk of impacting negatively of the nurse-to-patient relationship. A meeting was held with both band 6 and band 7 Nursing Sisters (on 16/02/24) and then with ED Band 5 Nursing staff (04/04/24) approximately 35 staff in total. On both occasions the project was received well and the project group representatives were not met with apprehension; staff were welcoming of the pilot viewing it as a signal of support from senior leadership. NIAS Representatives attended the latter session and provided a presentation of their BWC pilot “successes”. During these discussions with staff, there was opportunity to address initial queries. They also had the opportunity to handle the device currently used by NIAS. In addition, a meeting was held with key internal stakeholders from both within ED and across the division and wider Trust services (on 05/08/24) to provide an update on the pilot. At this event a presentation was delivered with a Q&A thereafter. No concerns were raised throughout the session. Trade Unions were kept informed through this engagement.
Promoting equality and rural needs
We are committed to promoting equality of opportunity, good relations and human rights in all aspects of its work. In keeping with our legislative requirements, the Trust completed and consulted on an Equality Impact Assessment (EQIA) on pilot.
Summary of feedback
This consultation process has provided us with feedback on the broad range of views that exist on piloting the use of body-worn camera devices within the Emergency Department. In addition, it has provided an opportunity for interested parties to comment on the proposed pilot – telling us what aspects are of the most importance to them, letting us know if they have any concerns and/or what the benefits might be.
The feedback detailed in this report is in relation to the piloting of body worn cameras in the Emergency Department at Antrim Area Hospital and not the Health and Social Care system as a whole.
It is important to note that the feedback received should not be taken to represent the views of the population as whole.
Consultees have contributed their valuable time to respond to our consultation process. Members of the BWC pilot group met on 28 May and 02 June 2025 to evaluate the consultation responses and to ensure key decision makers could consider the feedback in full prior to the drafting of this paper.
During the 14-week public consultation, a total of 114 responses were received. Of note, the majority of responses were supportive of the proposed pilot and those with concerns posed questions which this paper will later address. To further support this, the feedback received from staff and other stakeholders during the held engagement events were reflective of that received through formal consultation questionnaires and narrative responses (emails).
Consultees were asked if they agreed with the Trust’s overall plan to pilot the use of body-worn camera devices within the Emergency Department. 104 said yes, 7 said no and 3 were unsure.
The subsequent section of this paper shall set out a response to themes with concerns and queries raised.
Themes emerging from the consultation feedback
This consultation report summarises public responses regarding the proposal, detailing the perceived benefits, concerns and key considerations across a range of themes.
Given the different forms of responses (questionnaires, narrative responses, surveys, listening events etc.), we have categorised the feedback we have received into respective themes.
The feedback received highlights strong support for safeguarding healthcare professionals, balanced against concerns related to patient privacy, data management and equitable implementation.
Safety of staff and patients
A dominant theme in the consultation responses was the need to enhance staff safety through body-worn cameras. Many respondents emphasised the risks faced by healthcare workers and the potential for cameras to serve as a deterrent to violence. There was a consensus that no staff member should be subjected to aggression or violence while fulfilling their duties. That cameras could serve as a deterrent for abusive behaviour and the presence of cameras may provide evidence of incidents. Personal anecdotes shared by respondents illustrated the harsh realities faced by healthcare workers. Such testimonies serve to humanise the issue and emphasise the urgent need for protective measures such as this pilot.
Several responses highlighted that body worn camera not only have potential protect staff but also the patients they serve. This dual protection is seen as essential, especially in busy settings such as the ED where staff are vulnerable to unpredictable situations. Many respondents expressed that having recorded footage could clarify incidents of aggression from individuals towards staff and help to hold offenders accountable.
While most responses were in support body-worn cameras, a few concerns were raised. Some respondents questioned whether body-worn cameras alone would significantly reduce incidents of abuse. Additionally, there were apprehensions about the potential misuse of the cameras. It was highlighted that the use of the cameras is staff discretion, suggesting the need for guidance. Others noted that cameras should not replace direct interventions to prevent patient-on-patient aggression.
Response
A training programme is in place for all ED nursing staff with a focus on the Management of Violence and Aggression (MOVA) and the use of Bodyworn cameras are seen by the Trust as a compliment to this training and forms part of a wider toolkit which can be utilised by our staff in their response to an incident.
The Trust are committed to care being delivered in a fair, transparent and respectful manner. By default, BWC devices will not be set to record. This means all patient and healthcare work interactions will not be captured. BWC devices will only be activated for recording within the parameters of set Trust protocol/guidance i.e. incidents of violence and aggression.
Privacy
Respondents acknowledged that while staff safety is essential, it must be balanced with patients’ rights to dignity and privacy. There was a theme that individuals supported the use of body-worn cameras with protocols ensuring that recording is only activated when necessary.
Some respondents expressed concerns that being recorded during medical treatment indicating this would an invasion of their privacy, particularly when in vulnerable states. More, there were strong views that emergency departments should remain confidential spaces and patients should be assured that their dignity is upheld.
There was also reference made to management of camera activation and giving considerations to the possibility that there might be vulnerable individuals within the ED setting during the operation of the pilot.
Response
Themes such as of invasion of privacy, the importance of dignity and the vulnerability of patients highlight the complexities surrounding this issue.
The Trust will ensure that it is not processing data that are likely to cause substantial unwarranted damage and/or distress to an individual. Careful consideration has been given to the placement and use of BWC devices for this pilot to prevent any recording which would have a detrimental effect on individuals’ privacy or dignity. While the safety and wellbeing of our staff and privacy of our patients is our ultimate priority, consideration should also be given to vulnerable person (due to illnesses and mental capacity) encounters and where possible, such individuals should be reassured. As healthcare providers we fully recognise that some service users with medical conditions or loss of mental capacity may sometimes display unintended or unintentional incidents of violence and aggression. BWC Operators, being senior and experienced nursing staff will have the ability to factor such considerations when conducting a dynamic risk assessment which in-turn will inform whether a recording is made, ceased or retained. For example, clinical practice will not be recorded, nor will interactions in areas such as bathrooms. Sensitivity will also be given to individuals in a state of undress and distress. Professional judgement will be paramount in determining whether recording is suitable.
Camera use and data management
Camera activation, use and data management was a repeated subject throughout responses.
Some respondents referenced successful implementation in other sectors and suggested they look forward to similar benefits for healthcare staff. This included reference to evidence gathering for prosecutions.
While a few made reference to experiencing rudeness from staff at times, this was balanced by the comments of other respondents who made reference to cameras brining transparency and accountability in interactions between patients and healthcare staff, when activated.
Several respondents raised concerns about data management, including who would control access to footage and queries regarding retention and storage of data and if captured data can be requested and requested by third parties.
It was queried whether the camera was small enough to ensure no harm will be caused to the wear and another enquired if it were possible nursing staff might perceive the camera as creating a barrier between them and their patients.
Akin to the privacy theme, there were references made about the need to have supporting guidance for both camera use and data management.
Response
While the Trust acknowledge the Bodyworn camera device is a piece of equipment and that any equipment can potentially bring health and safety considerations, the specific device chosen for this pilot is relatively small and light and is considered to be one of the less intrusive and weighty options currently available on the market. More, as part of our engagement with staff, we presented a sample device to staff who attended and offered an opportunity for staff to share their initial views on the device. No concerns were raised.
Throughout our dialogue and engagement with staff, no concerns have been raised in regard to any view that the devices might act as a barrier. More, involvement by nursing staff will remain voluntary for the pilot and as part of our pilot evaluation, the Trust will conduct a pre and post intervention survey and such considerations will be given further deliberation.
The Trust take privacy and data management seriously and have a legal duty to keep information safe and confidential, as does anyone who receives information about you from the Trust. In line with legislation, the Trust has a range of measures and strict standards to protect data held. Data will not be kept for longer than it is needed and this is set out within the privacy notice and is in accordance with the Department of Health (DoH) Good Management, Good Records Disposal Schedule. By default, BWC devices will not be set to record. BWC devices will be activated for recording within the parameters set out in the Trust protocol/guidance and as part of this, when BWC devices are being activated for recording, the nurse wearing the BWC will give a verbal announcement that they are activating their device and will briefly reference in said announcement their reasoning for activating the device. A further verbal announcement will be given when the nurse decides to stop recording, typically at a point when the nurse perceives the situation to have calmed/deescalated. Further detail as to Trust considerations are set out in the DPIA, EQIA and other associated pilot documentation. Body-worn camera footage will go onto a secure cloud-based system, which can only be accessed by designated senior staff. The footage cannot be viewed or deleted from the camera itself. Access to data and functionality is controlled via software User Authentication and Permissions. The system retains a complete audit log of system activity detailing all parties accessing data, when data is accessed and how it is processed.
All service users captured on body-worn camera video footage, which was triggered by a violence and aggression incident, will have a right to request a copy of the footage from the Trust. Each request will be given consideration by the Trust on a case by case basis. Under the UK-GDPR you can request access to your personal data. If you want to see the information we hold about you or ask about how we use it, you can speak to the staff or you can request a copy of your information from the Trust Data Controller or Data Protection Officer as identified within the privacy notice. Each request for the release of footage will be considered on a case-by-case basis.
The information Governance Department can be contacted in writing, by phone or email –
Information Governance Department
Causeway House
Route Complex
8e Coleraine Road
Ballymoney BT53 6BP
T: (028) 2766 1293 or
E: info.governance@northerntrust.hscni.net
Individuals will not be entitled to access third party personal data, especially if disclosure of such data could cause harm. Therefore, data will be appropriately managed in accordance with UK-GDPR and the category of information considered when dealing with subject access requests (SARs). Third-party requests for data will be considered on a case-by-case basis. Should data be released, the Trust has access to software that will allow the blurring and masking of images to lessen any impact and comply with associated legislation.
EQIA
The need to apply fairness in respect of the use of BWC was highlighted. It was noted that, when dealing with people of differing understanding, ability and knowledge, the appropriate assessment of each situation before implementing BWC usage is likely to lessen any damage or upset that may be caused.
Reference was made to consideration of neurodiversity and how they may perceive situations.
It was highlighted that Trust staff ability to switch cameras on and off as required was noted as seeming to validate that the cameras are solely for the protection of staff and not patients.
Response
An Equality Impact Assessment (EQIA) was completed for this proposed service reform in line with the relevant law, section 75 of the Northern Ireland Act 1998.
The Trust are committed to providing a safe environment for staff, patients and third parties who visit Trust premises and for care to be delivered in a fair, transparent and respectful manner. BWC devices will be clearly visible on nursing staff uniforms and have a front-facing screen. By default, BWC devices will not be set to record. BWC devices will be activated for recording within the parameters of set Trust protocol and as part of this, when BWC devices are being activated for recording, the nurse wearing the BWC will give a verbal announcement that they are activating their device and will briefly reference in said announcement their reasoning for activating the device. A further verbal announcement will be given when the nurse decides to stop recording, typically at a point when the nurse perceives the situation to have calmed/deescalated. Further detail as to Trust considerations are set out in the DPIA, EQIA and other associated pilot documentation.
General/other
There were also noted queries regarding whether the Trust conducted a review of security staff for involvement in the pilot; that the Trust did not clearly state if an offending patient would be refused medical treatment and that incidents would already be captured on CCTV by security if evidence is required.
Response
At the Emergency Department, individuals presenting for care will undergo a clinical triage process, where their conditions will be assessed to determine the level of urgency and the appropriate care needed. This systematic evaluation will allow clinicians to effectively manage patient presentation by prioritising cases based on the associated risks. By employing this approach, healthcare professionals can ensure that those with the most critical needs receive timely attention, thereby optimising patient outcomes and resource allocation within the setting.
A review of security staff contracted by the Trust did not form part of our assessments given that this is outside the scope of the pilot.
Whilst there are security CCTV located throughout the ED, these are not in all areas and do not offer sound or a first person view of the recorded incidents.
Concluding remarks
In conclusion, the public consultation on the use of body-worn cameras (BWCs) in our emergency department has provided invaluable insights into the perspectives of staff, patients and the wider community. The overwhelming support for the implementation of BWCs underscores a collective recognition of the need to enhance safety for both healthcare professionals and patients in high-pressure environments.
The feedback received has highlighted the potential of BWCs to serve as a deterrent against aggressive behaviour, thereby fostering a more secure atmosphere conducive to effective patient care. However, the consultation also illuminated important concerns, albeit the volume of concerns were in the minority in contrast to supporting feedback. The Trust have considered these concerns to ensure they are addressed to enable the successful integration of this technology. Issues surrounding privacy, data management and the ethical use of recorded footage are paramount and will be prioritised as we move forward. Concerns raised where however in the minority in comparison to the volume of supporting comments.
We are committed to establishing and maintaining clear protocols that safeguard patient confidentiality while ensuring that staff feel supported and protected in their roles.
As we proceed with the pilot program (subject to approval) we will continue to engage with stakeholders, ensuring that their voices are heard and their concerns are addressed. Our commitment to transparency and ethical practices will guide us in evaluating the effectiveness of BWCs and making necessary adjustments based on ongoing feedback.
Together, we can create a safer, more supportive environment for both staff and patients, ultimately improving the overall quality of care within our health trust.
Next steps
Trust Board will consider the feedback received during the consultation process to inform a decision regarding the pilot of Body Worn Cameras in Antrim Emergency Department.
All those who participated in the consultation will receive a copy of the consultation feedback report, which includes a detailed response from the Trust. The Feedback Report, including the outcome of the consultation, will be available on the Trust’s website.
We want to thank everyone who took the time to be part of this consultation.
Alternative formats
This document can be made available, upon request, in other formats including Braille, large print, audio or in another language for anyone not fluent in English. For alternative formats please contact:
Equality Unit
Route Complex
8e Coleraine Road
Ballymoney, BT53 6BP
Tel: 028 2766 1377
Mobile Text: 07825667154
E-mail: equality.unit@northerntrust.hscni.net
