Physical Security and Technology A Healthcare Perspective by John Currie

As Healthcare Security Management Specialists, we are responsible for ensuring a ‘Safe and Secure Environment for our Patients, Staff and Visitors’ and as such, the integration of Physical Security and the use of technology is an important aspect in ensuring this.  The challenge arises however, when security has to be balanced with a 24-hour service and unrestricted access by the public.  The physical and technological solutions must be robust enough to deliver bespoke levels of security – secure access-controlled staff only areas, along with a setup that provides the ability to secure the Out Patient clinics at the end of the day, and general public spaces at very short notice, including all access and egress points in the event of a security or terrorist incident for example. 

Hospitals routinely have differing levels of security and physical protection dependent on the location, the asset(s) being protected, and the critical nature of the location to the Hospital’s infrastructure; for example,  an IT server or telephone exchange / frame room.  The integrity and security of these areas is essential to the running of the organisation and so we often see multiple layers of physical and technical security being deployed.  We are not talking ‘Mission Impossible’ style measures, but the use of physical locks, strong doors and robust key control are a good starting point.  Where swipe card or proximity type access cards are used, specific restrictions may be put in place such as the creation of restricted zones and even biometric functionality to further enhance and bolster the system. 

The improvements in the field of technical security, biometrics and intelligent systems mean that integration has moved on from the first-generation Physical Security Information Management (PSIM) systems.  It is also worthy of note that as a direct consequence of the availability of extremely user-friendly platforms, choosing the right system that is capable and competent to seamlessly integrate, is somewhat difficult.  Having looked at a number of systems and integration platforms myself, it is clear that having the ability to link our CCTV system to the electronic door access and fire systems so that any activation of an alarm brings up the location schematics, CCTV view and links to surrounding and adjoining cameras, allowing the operator to easily follow and track an offender or suspect, as they move through the area, and from camera to camera is extremely desirable.  The ease of use and functionality makes such activity simple and very quick to achieve.  The other challenge for all Healthcare Security Management specialists and their organisations is justifying the expenditure and being able to show the full value of investment in the system and the merits of integration.  The ability to link the Building Management Systems (BMS) allows the CCTV operator and Security control room to accurately report, view and action any issues identified by the BMS, a non-security system, identify any persons in the area via the access control system and CCTV, which in the event of a gas leak, fire or electrical fault could prove invaluable information for the Emergency Services.  The benefits of this approach are endless and allow the Security service to do a great deal more with less.

In relation to the Physical Security aspect, guidance and Crime Reduction approaches such as Crime Prevention through Environmental Design (CPTED) and Secured by Design (SBD) make the job of Healthcare Security Management Specialist a lot easier, and the implementation of the Secured by Design (SBD) – Hospital guidance (issued in 2005) is one way of defining a security solution and master plan.  The standards allow Healthcare Security Management Specialists to define the requirements against clearly tested and defined benchmarking British Standards Institute (BSI), Security standards, and SBD advice.

In 2019 the SBD standards were reviewed by the NAHS Executives and working collaboratively with the SBD team, a draft and more inclusive Healthcare guidance document was created.  The new draft standards address the security requirements for all Healthcare premises and not just acute Hospitals, and have taken into account the changes in crime and criminal behaviour, such as the theft of lead and other metals, and the organised thefts of Nitrous Oxide.  It is understood that these new standards will be issued later this year and once launched, NAHS will be providing briefings on some of the key areas and updated sections of the guidance.  It is also worth noting that the incorporation of SBD standards and installation of security rated windows, doors and locks for example, can reduce the insurance premiums payable.  If anyone is in doubt regarding the strength of the SR range of security doors, windows, shutters and locks, point them in the direction of the BRE website and the videos of the testing being undertaken with a range to hand tools, power tools as well as sledge hammers and axes.  The testing team do not mess about and attack their target to push the item to its limit.  I have personally watched a tester who had to stop as the large sledge hammer and axe were not having the desired effect.  He was getting nowhere and was dripping in sweat from the exertion.  The test piece got my vote that day!  

As mentioned earlier, getting the balance right between allowing appropriate access to Healthcare premises and providing the Safe and Secure Environment our staff and patients deserve and expect is the key to success and has to be based on an assessment of risk.  In addition, other factors, such as the location, patient and visitor demographics, crime and incident pattern analysis need to be taken into consideration. 

The need for both physical security and technology in the protection of medical gasses is one very current and topical area.  Organised Crime Gangs now target Hospitals and Healthcare premises in order to steal Nitrous Oxide cylinders.  The gas, often referred to in the media as ‘Hippy Crack’ is sold on at huge profit with a large cylinder filling hundreds of balloons and so the motivation for this crime is clear profit.  Nitrous Oxide is also packaged in small silver cylinders that are used in Coffee shops for powering the cream spray cans.  Poorly secured medical gas stores are an easy target for a determined thief as the thieves come prepared with battery operated disc cutters, crowbars and heavy-duty bolt croppers.  Non-Security Rated (SR) locks, doors and padlocks offer little protection or challenge to such equipment but if the store is fitted with a louvred LPS1175 SR2 door (or better), with integrated hinge bolts an astragal plate to protect the gap between the door(s) and the deadbolt, the protection is increased and the risk reduced.  If the area is regularly patrolled by well-motivated and engaged security officers and the store is alarmed and monitored by CCTV the risk of it becoming a target is reduced.  Increase the risk of capture and the amount of work and effort needed to break in, and you reduce the pay-off.  The vast majority of thieves prefer to do the least amount of work with a good pay-off and little or no risk of capture.

In conclusion, technology is improving each and every day along with our general reliance on technology to solve everything; a visit to any of the trade shows will illustrate this.  However, no matter how technical and specialist a security system is, they still require a human interface and a person to respond.  Tailoring our physical security features supported by boots on the ground and linked via technology, is fast becoming the go-to solution for organisations.  

John Currie: NAHS Executive Director for Publicity, Social Media, IT and Membership & Head of Security and NHS Accredited Local Security Management Specialist (ASMS) for Lewisham and Greenwich NHS Trust

John is a former Royal Air Force Police Special Investigator (CID and Drug Squad). He ran the Drugs and Criminal Intelligence cell and left the military in 2006. He gained his NHS Security Management ASMS accreditation in 2007 and has worked across all sectors of the NHS. He has a particular interest in the integration of SBD, BREEAM, Security Master Planning and incorporating proven target hardening measures into new build and redevelopment projects. Experienced in Mental Health Acute and Forensic services, he now works closely with two Mental Health Trusts who are hosted on his acute hospital sites. In addition to the ‘normal’ day job John delivers Lone Worker Training, Personal Safety skills and PREVENT and Counter Terrorism awareness training –