Safeguarding in the virtual environment Safeguarding team LHCH

Safeguarding in the virtual environment Safeguarding team - LHCH 08/09/2021 1

Case study Patient known to Safeguarding Services with a complex family background. At a recent virtual clinical appointment with the Psychology Team the patient disclosed claims of historical abuse within the family. This information was then shared unsecurely (email, mobile messaging) to various members of staff within the organisation. 08/09/2021 2

Background at LHCH • Pre Covid 19 no virtual appointments were undertaken at LHCH. • During Covid 19 the trust moved all psychology appointments online via the Attend Anywhere platform. • Post Covid 19 approximately 60% of all LHCH appointments are now virtual. 08/09/2021 3

Supervision During a safeguarding supervision meeting between the Strategic Lead for Safeguarding and the Head of Psychology services a discussion was had regarding the appropriateness of emails relating to a recent case and the content of emails between the Psychology Team and various members of staff within the organisation. There was also a concern about the safety of the patient at home whilst disclosing the alleged abuse to the staff member and a lack of process for cyber security. Assurance was required and couldn’t be given at this stage. 08/09/2021

Cyber Security Meeting Following the supervision meeting a further meeting was arranged with the Cyber Security Manager for LHCH, the Safeguarding Team and the Head of Psychology. The concerns raised included: • • • 08/09/2021 Appropriateness of virtual meetings Meeting etiquette Process checklist – On boarding/Off boarding No well being after calls to the patient/s No checking for signs of others in the room with the patient/s Triggers for safety for both staff member and patient/s Security of information sharing – emails, call logs, patient records, mobile messaging – Whats. App, text messages on a non secure personal mobile End location security – recording devices, telephones, alexa/siri/google devices Loss of indicators online – body language, triggers etc. 5

Future process planning • • • 08/09/2021 Process mapping – Cyber Security Manager met with the Head of Psychology to formalise a process for virtual appointments Patient hotline Drop in face to face appointments for vulnerable patients after virtual appointment Development of a standard operating procedure for virtual clinic appointments Consideration that a patient must have a face to face appointment after so many virtual appointments Consider legalities of appointments to prevent data breach claims 6

Outcome & Discussion • Development of a patient and staff risk assessment form • Development of a standard operating procedure • Development of patient record documents – various security permissions depending on information gathered • Further staff training for safeguarding – level 3 • Development of a traffic light system – patient triage and risk/staff supervision • Reviewing other virtual platforms – blurring of background for staff – lone worker risks • Psychology Database • Development of an escalation plan • Governance – follow up if unable to complete virtual appointment • Development of a department risk register 08/09/2021 7

Best Practice for Safeguarding Patients in the virtual environment • Ensure information is given to the patient pre appointment- what to expect, what happens if the appointment fails, confidentiality, risk assessment. • Ensure the meeting is held in a secure, quiet space – patient and staff member • Ensure all voice activated devices are switched off – siri, alexa, google • Mute laptop notifications – be mindful of screen sharing – close outlook/emails • Anonymise PC working environment – no personal items/picture in background/landmark identifiers (windows with scenery). • Ongoing risk assessment during appointment – Stop conversation if you don’t feel safe, monitor patients triggers/behaviour • Develop your own standard operating procedure relevant to your workplace with an escalation plan 08/09/2021 8