NHS Trusts Face Scrutiny Over Patient Monitoring Consent

Ten National Health Service (NHS) trusts are under scrutiny and have been referred to the regulator following concerns about consent mechanisms for patient monitoring technology. NHS England confirmed the referrals after a review found these trusts were not adhering to digital principles regarding patient consent. The specific trusts have not been named.

Gareth Harry, NHS England's National Delivery Director for Mental Health, Learning Disability and Autism, stated that concerns had been raised about consent, patient observations, and human rights linked to the use of technology like Oxevision, which uses infrared cameras to monitor patients' breathing and pulse.

An internal NHS England email from 2022 indicated awareness among staff that some trusts were allowing patients to be filmed without their explicit consent. In response to these and other concerns, NHS England issued guidance in 2023 advising mental health trusts against a blanket implementation of monitoring technology. The guidance emphasized that decisions should be made on an individual patient basis, with patient involvement encouraged where possible.

NHS England initiated a review of practices after receiving complaints from the campaign group Stop Oxevision. The review led to the identification of the ten trusts whose consent mechanisms were found to be non-compliant with digital principles. Following the review, NHS England informed the Care Quality Commission (CQC), the healthcare regulator, on October 2.

Lawyers representing bereaved families questioned the time it took for NHS England to address these issues, given that concerns were first brought to their attention in 2021. Harry explained that the day-to-day responsibility for adhering to guidance lies with individual trusts, not NHS England.

During the inquiry, Teniola Onabanjo, counsel to the inquiry, asked Harry if NHS England acknowledged that the drive for innovation might sometimes precede thorough scrutiny of consent and ethical considerations for camera technology. Harry responded that he expected all mental health service providers to operate with a human rights-centered approach.

A CQC spokesperson affirmed that providers are responsible for delivering safe and high-quality care in accordance with guidelines, and that the CQC acts on information of concern. The CQC is scheduled to present its evidence to the Lampard Inquiry on October 7.

In July, Laura Cozens of LIO Health, the company behind Oxevision, testified that the technology must be clearly explained to patients. She also noted its role in preventing serious incidents, such as falls, in a dementia ward.

The ongoing inquiry, led by Baroness Lampard, is expected to continue until October 15, with further hearings for families on October 20. Baroness Lampard has indicated she may issue interim recommendations if urgent patient safety risks are identified before the final report, which is due in 2028. She also stated that she would introduce interim recommendations if she believed there was a risk to patient safety, even before the inquiry's conclusion.