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Terrorist attacks: from response to prevention

Hilary Garratt, Director of Nursing, NHS England and Deputy Chief Nursing Officer for England reflects on the impact of the recent devastating terrorist attacks and also looks ahead through the national Prevent programme, at the vital contribution staff and governing boards of NHS funded organisations need to make to ensure everyone plays a part in preventing further attacks, in whatever form.

Manchester is my home city and, like people across the North West and beyond, the Arena is part of my life, a place I go to enjoy time with friends and family.  I am also one of the millions all over the world who loves to visit London, whether for business or pleasure. I have been left devastated by the appalling terrorist attacks of recent weeks, which have felt very close to home.

The response to these attacks – in Westminster, Manchester, London Bridge and Finsbury Park has been poignant and will be long remembered. The courage shown by the public and professionals alike is rightly a source of pride and reassurance for the whole country. We can be particularly proud of the incredible way that the NHS family has time and time again, responded so swiftly and with such heroic professionalism.

Prevention and safeguarding are familiar concepts in the NHS, well understood in relation to health and wellbeing. However, we also know that prevention is also about keeping people protected from harm and it is our duty, as NHS staff, to ensure we identify and support vulnerable people who could be tempted down the path of extremism, whether that is radical Islamism or poisonous far right hatred.

The nature and scope of our work means that NHS staff are uniquely placed to help safeguard those at risk of extremism and those that they might harm. That is why we all have a statutory duty under the government’s Prevent programme to play a part in keeping our country safe. The recent attacks have brought home the fact that we need to make sure all of us understand what this means for the health service and its staff. That includes understanding how these duties are applied across organisations and systems, and from Board to floor.

We have made huge strides in safeguarding over the last three years, from Female Genital Mutilation and Child Sexual Exploitation to modern slavery. These issues were not talked about routinely a few years ago but focused effort, driven by the determination and ambition of NHS staff, has resulted in good standards of mainstream practice and reduction in harm.

In the light of the recent attacks the time is now right to review, and potentially renew, our efforts with the national Prevent programme to ensure we are doing our upmost to identify and support people who are at risk of all forms of radicalisation that can lead to support for terrorism.

NHS England has six Regional Prevent Co-ordinators (RPCs) who help NHS organisations to build the necessary capabilities to combat extremism and radicalisation. They facilitate the crucial links with the local NHS and other key organisations who also play a part in keeping our communities safe.

The RPCs also support my role when I work at policy level with both the Department of Health (DH), the Home Office (HO) and the European Radicalisation Network. I met the Regional Prevent Co-ordinators last week to explore, in the wake of recent tragic incidents, whether we are doing all we can to stop future tragedies or whether there anything we can do more of or better.

I would encourage everyone to do the same. Please do take time to talk to colleagues and staff, and think critically and constructively. I would also urge you to make contact with your lead for safeguarding, or our RPCs to ensure that we are doing all we can to prevent further bloodshed and loss of life.

Together with the national Safeguarding Board we are reviewing some of our approaches and work programmes.  Starting with student nurses in Wolverhampton, we will be piloting some undergraduate training that we then want to apply to other areas, strengthening undergraduate and post graduate clinical education for Prevent. We are also working with Royal College of Psychiatrists, DH and the Home Office and will publish guidance supporting mental health organisations. We will work with the Home Office to review all training. In consultation with the Royal College of General Practitioners, we will develop a bespoke programme of support for primary care.

Finally, we will be aligning efforts across all Arms-Length Bodies such as NHS Improvement, Health Education England, Public Health England and Care Quality Commission to ensure organisations and the people within them can be the best they can be, just as they were and continue to be in responding to the recent atrocities. We want staff to feel able and confident in their contribution to preventing another Manchester, another London, another attack anywhere in our country by keeping people safe.

However, it is down to each and every one of us to ensure that we are playing our part. As a member of a community deeply affected by the recent terrorist attacks, as a mother of children who could easily have been injured or killed, as a friend of someone who was, and as a professional profoundly grateful and proud of my colleagues, I know we can stand together as professionals for our own communities, our families and friends and those we care for. I do thank you all in anticipation of your support.

Hilary Garratt

Hilary Garratt CBE, BSc, MSc, RGN, RHV, PGCE is the Director of Nursing in NHS England and Deputy Chief Nursing Officer for England.

Hilary leads a nursing and midwifery team in NHS England that focuses on a number of national statutory functions and professional development priority areas.

She is a registered Nurse and Health Visitor with over 30 years’ experience of working in the NHS. Hilary has held a number of director posts and a deputy chief executive post in both Commissioning and Provision and has been working at National Director level for the last four years.

From 2013 – 2017 Hilary also volunteered for BBC Children in Need and was a committee member that undertook grant making for the North of England. She is also a trustee of a charity, “Giving to Gambia” and enjoys working in the Gambia for a short time each year as a volunteer to support initiatives that improve health and wellbeing.

Hilary worked in the Calais refugee camp in 2016 and witnessed the reality of individuals, living through unimaginable trauma. She saw children being lured into the hands of criminals for want of a better life and seeing this first hand brought home the sheer importance of the NHS and other organisations across the health and care system working together to protect the most vulnerable people in society.

Hilary received a CBE in the 2017 New Year’s Honours for services to nursing, particularly her work to safeguard some of the most vulnerable people in society

Follow Hilary on Twitter: @HilaryGarratt.

One comment

  1. Tony Clayson says:

    Brilliant inspirational words Hilary, I take my hat off to you and I am proud to know you and respect immensely your commitment and vision
    Tony