There are many situations where NHS staff work alone, either because they are physically separate from other people or through working in the community.
District nurses, midwives and health visitors, mental health staff and GPs have traditionally visited patients in their own homes, and even within hospitals and surgeries some staff work in isolation from others.
The 2006 white paper Our Health, Our Care, Our Say: a new direction for community services envisages more NHS care being provided outside large hospitals. It is likely that this will mean more staff working alone, visiting patients at home or working in small hospitals or centres in the community, where support services such as security are likely to be more informal.
The health and safety of these workers needs to be protected and NHS organisations play a vital role in ensuring their safety.
The legal position
Under the Health and Safety At Work Act 1974 and the Management of Health and Safety At Work Regulations 1999, NHS organisations have the same duty towards lone workers as they do towards those working in a busy hospital. They need to adopt policies to control risks and to assess the risks the individual faces.
Organisations without appropriate procedures to do this - and to communicate them to the staff involved - may be at risk of prosecution by the HSE and could face civil action for compensation from staff.
Risks of lone working
Many lone workers will be concerned about personal safety but that is not the only risk they may encounter and any organisation planning a policy should think about others such as:
- lone workers carrying out tasks that would normally be done by two or more people - examples of this include moving patients or heavy equipment
- health hazards from working in the community - such as fierce dogs or workers who are allergic to pets
- accidents when working in unfamiliar circumstances and surroundings and additional risks from fire and dangerous substances
- car accidents and breakdowns while travelling to see patients or between sites
- thefts from cars of personal or professional materials (potentially including confidential notes or patient details). Clinical staff who are perceived to be carrying drugs may be at particular risk of both muggings and car break-ins
- hazardous weather and driving conditions.
There are also other 'softer' aspects to consider. Lone workers may feel isolated from the organisation's mainstream and 'out of sight, out of mind.'
They may not have the same access to training and development opportunities as other employees and it could be more difficult to ensure they receive adequate supervision, feedback and appraisals.
Employers should also consider their procedures for bank or agency workers who are working alone temporarily.
