May 2024

To note, the information and quotes in this report are taken from The I newspaper’s investigation on Oxevision NHS psychiatric wards are video monitoring children and adults 24 hours a day, sparking privacy fears (inews.co.uk), first posted on September 24, 2023. The report also summarises The national survivor user network’s open letter Open letter on the use of Oxevision in inpatient settings – NSUN website, first posted on the July 12,2023. 

Cameras that are part of Oxevision monitoring systems used in NHS mental health wards have recently come under scrutiny. Some worry that such systems infringe on the rights of patients who don’t have capacity to expressly agree to allow themselves to be subjected to this remote video monitoring. It has also been pointed out that mental health patients can often be more uninhibited. 

Oxevision was introduced into NHS psychiatric wards as a pilot study about five years ago. By the end of 2021, this system covered over 1,500 rooms. In one hospital, these video devices were found installed in women’s bedrooms only. Camera systems have been used on some children’s wards too. There are suggestions this can lead to the potential misuse or facilitate the abuse of vulnerable psychiatric patients. Nevertheless, these systems still operate in more than 20 different NHS trust hospitals in England at the moment. Supplier of the system, Oxehealth, stated that it is working with “1-in-3 NHS Mental Health Trusts”. 

Constant digital surveillance is considered by many to be detrimental to a person’s mental well-being and their personal security within a clinical setting. Some past patients, who reported on their direct experience of Oxevision, said it meant that ward staff often used it as an excuse to stop doing their more regular face-to-face physical health checks. These patients felt that as a result, they had inevitably received much less human contact and support during their hospital stay. 

Camden and Islington NHS Trust did stop using Oxevision in 2022 after an internal review. A group of female staff raised concerns about the effect of the scheme on women who had suffered past experiences of sexual violence. Nottinghamshire Healthcare NHS Foundation Trust said, in a FOI Request, that it had decommissioned the system “following a review”. 

Two months ago, a Care Quality Commission (CQC) inspection report on Essex Partnership University NHS Foundation Trust found that in one adult psychiatric ward, “Managers told us it was possible to see a patient unclothed following a shower in their bedroom, on the contact-free patient monitoring screen”. Separate anecdotal evidence suggests even hospital visitors on a guided tour have seen naked patients on Oxevision system monitors within one psychiatric hospital. 

As more trusts adopt this monitoring system, there are calls for an independent inquiry to establish any potential risks before it is used in any more hospital settings. But at the moment, there appears to be little NHS centralised policy on whether to continue using systems like Oxevision. It is apparently all down to the individual trusts concerned as to whether or not to implement such video monitoring systems. 

The video surveillance of children and adults in psychiatric distress is a “violation of that person’s rights”, according to Dr Jay Watts, a clinical psychologist working on acute psychiatric wards. “If staff are acting unprofessionally with a patient – in person – that patient can object or complain but, if it’s electronically being recorded and you don’t even know, it’s like a perfect crime – a perfect scenario [for an abuser]. It’s very, very troubling”. 

“Patients with particular mental health problems can do things like wandering around naked or other disinhibited stuff. For those with a history of being sexual assaulted, monitoring them on camera could have a negative impact on their recovery” said Dr Watts. 

Other campaigners believe that patient consent is not being properly obtained by some hospitals. “In some places, it appears that patients aren’t given very comprehensive information about how Oxevision works. In other places, people are saying they don’t want this technology to be used, [but] they’re not given the right to decline that”. When questioned about any policies being in place regarding the system used, one trust said that it “had no policy or procedure in place prior to their system being decommissioned”. 

Another trust stated that “all relevant patients and their carers or families should be informed, but that consent for its use whilst within inpatient services is deemed implicit upon admission”. This is insufficient according to some critics, as it may be somewhat subjective as to who decides on the capacity to consent or not. For example, patients under Section 3 of the Mental Health Act 1983, who may pose a risk to themselves or others, can be detained, for up to six months in a psychiatric unit and can be treated against their will. 

Opponents are concerned that such systems are being used because of staff shortages. One in six (16 per cent) nursing posts and one in seven (14 per cent) medical posts within mental health trusts are currently vacant, according to NHS England. Yet Cumbria, Northumberland, Tyne and Wear Hospital Trust have revealed, via a media FOI request, that they had spent £837,668 on annual licenses to use Oxevision and a further £115,744 to cover its initial installation costs. 

Some argue that “implementing technology to compensate for low staff levels raises questions and highlights healthcare services are being designed more to benefit staff rather than the individual needs of patients”. Dr Watts believes the use of cameras is symptomatic of psychiatric staffing level scarcity. “If an acute ward is functioning properly, there is absolutely no need to add what is basically electronic surveillance. In whose interest would replacing [staff contact] with an electronic system be for?” she asked. 

Technology use by staff, with decisions being made remotely from another room, also worries the campaigners. Machines can being used in lieu of patient contact. “There are probably cases where it can support safety, but where used instead of, it’s just compromising quality of care. If you don’t have someone checking on someone once an hour [in person], that takes away an opportunity that they have to say, ‘I need support’”. 

An NHS spokesperson said: “Every NHS Trust who chooses to use this technology must only do so in line with legal requirements and ensuring patient and family consent is in place”. 

Music is a uniting force, regardless of what is going on for someone, it’s a means for people to be who they really are. 

Wherever you go in life, it’s a grounding force to come back to, not just the music it’s self but the community and subcultures of different genres. It’s a way to connect with others. It’s been a daily constant, it’s relaxation through turbulent and difficult times. This report poetically explores the importance of music to well-being, individuality, self- expression, recovery and community.

Queue the music?

Hold your breath! Maestro.

One, two, three, four.

Greetings to our universe,

Especially our humble Mother Nature, The Earth and its Humanity.

For the creation of music and all its inspirations.

What does it feel like?

What does it mean to an individual to enjoy their own silence?

To absorb with our senses the multitudes

of sounds and vibrations, that travel through the air.

Listening whilst steady on our feet or whilst sitting down

Quietness or blast?

Research, Monsieur le Reporter,

Calm down?

The noise, found all around the blue planet, the four

seasons with all its denominations.

Smooth or soothing? Shout!

Let it all out! Disturbing?

The story of music, rooted, complicated.

Vocalised or written, alone or in groups.

Then celebrations! The whispers are

all there. Traditions Worldwide. In different

countries or counties?

Eastern or Western?

North or South?

Popular or subcultures?

Engraved in everybody, mind and Soul.

Emotional. Political,

Religious or spiritual.

What is to be found?

What it is all about?

Chinese whispers?

The wind of change?

My first experience with music:

Age 5, 45rpm vinyl, a recording of

Tweety and Sylvester.

An experience or a disturbance?

At 8 years old, I was introduced

to my town’s music centre,

Courtesy of my mother

Fond memories.

Love never dies.

My imagination developed,

Then music came and went,

No Discrimination, I love it all.

Teenage Years:

‘It is a long way to the top

If you want to Rock and Roll.’

I then explored different genres of music

The 1980’s was filled with Johnny Rotten, AC/DC, The Gun Club, The Cure.

The impact on my little grey cells!

The Cocteau twin’s ethereal voices, courtesy of Elizabeth Fraser.

Is anger an energy?

Metal and Gothic, my main muses.

And still today, exploring the music scene in London.

I experienced madness in November

2023, with a pal of mine, at the

Shepherds Bush Empire, a sold-out venue.

I was baptised in golden liquid! Metal heads! Caught in the crowd!

5 years of sobriety, responsibility, Ah!

Insanity! A lesson to be learned?

The fans went crazy. Respect to the

Cavalera tribe. Hey you!

Every morning I set- up my mobile phone

What music will rock my world today?

It is part of my being.

Enjoy the silence.

Queue the music?

Curiosity will not kill the cat,

on this one.

Dear readers and music enthusiasts,

enjoy the sound of your own

understanding.

Gratitude to All.

Y.C.G