Mental health trusts reported to CQC over consent for bedroom cameras

Ten NHS mental health trusts have been referred to the Care Quality Commission after a review identified concerns about how patients were asked to consent to camera-based monitoring inside their bedrooms.

The referrals involve digital observation systems including Oxevision, which uses infrared sensors and cameras to measure a patient’s breathing and pulse without a member of staff entering the room. The technology can also provide staff with images when carrying out certain checks and has been introduced by a number of mental health providers as an additional patient-safety measure.

NHS England disclosed the referrals during evidence to the Lampard Inquiry, which is examining the deaths of more than 2,000 people who received inpatient mental health care in Essex between 2000 and 2023. Gareth Harry, NHS England’s national delivery director for mental health, learning disability and autism, said concerns had previously been raised about consent, observations and patients’ human rights.

An NHS England review subsequently found that ten trusts were not operating their consent arrangements in accordance with the relevant digital principles. The organisations have not been publicly named, but NHS England wrote to the CQC on 2 October and shared its findings with the regulator’s inspection teams.

The inquiry was shown an internal email from 2022 suggesting NHS England knew of trusts where patients were not being offered the opportunity to refuse filming. Guidance issued to mental health providers the following year said monitoring systems should not be introduced as a blanket measure and that decisions should instead be based on the circumstances of each patient, who should be involved wherever possible.

Campaigners and bereaved families have questioned why regulatory action took several years when safety and human-rights concerns had been raised as early as 2021. They argue that cameras can be particularly distressing for people experiencing paranoia, trauma or a fear of surveillance and should never replace meaningful contact or physical observations by trained staff.

Supporters of the technology say it can identify changes in a person’s condition without repeatedly disturbing them and has helped prevent serious incidents, including falls. LIO Health, the company behind Oxevision, has said the system must be properly explained to patients and used as part of wider clinical care rather than as a substitute for staff.

The CQC said providers are responsible for delivering safe, high-quality care in accordance with relevant guidance and that it considers all information of concern shared with it. The regulator can take action where services fall below the required standards.

Baroness Lampard has said she may issue interim recommendations before the inquiry concludes if the evidence identifies an immediate risk to patient safety. The issue highlights a wider challenge for the NHS: new technology may support safer care, but innovation cannot be allowed to move faster than consent, dignity and the rights of the people being monitored.

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