Our position on Oxevision, the new monitoring system in mental health units
30 November 2023
New monitoring systems have been introduced in mental health units across the country in recent years, prompting concerns from campaigners. The technology, known as Oxevision, uses infra-red sensitive cameras in people’s bedrooms to help staff visually confirm a person is safe, measuring vital signs - such as their pulse and breathing rate - without disturbing their sleep.
Having met with members of the campaign group Stop Oxevision, as well as Oxehealth, the company that produces Oxevision, people with lived experience and policy makers, our Director of Policy and Practice Lucy Schonegevel sets out our current position, which is likely to change as developments occur.
“We need to openly discuss both the opportunities and risks posed by the adoption of new technology to support the care and treatment of people severely affected by mental illness, such as monitoring systems like Oxevision. There are already fault lines, and this is an issue that will only intensify in the years to come. In the case of Oxevision, we think it is helpful to understand the status quo. As things stand, people in inpatient services are routinely checked day and night to make sure that they are safe and well. At times, people may need to be observed much more frequently. Oxevision can allow staff to check on someone's welfare remotely and check their vital signs, without disturbing their sleep. Some people might prefer a less disruptive method of observation that helps to keep them safe, and may wish to give consent for Oxevision to be used during their treatment.
“However, there are also risks, as identified by Stop Oxevision campaigners, around its use being a form of restrictive practice that breaches people’s rights, with potential short and longer-term effects on people, even when the camera is not in use. The concerns identified around data usage and consent risk compromising privacy for all, with specific risks for marginalised groups, including trans people and those whose religious beliefs prohibit them being observed by members of a different gender. We are also concerned about its potential impact on people living with OCD, psychosis or paranoia, and those who have experienced trauma, in that its use can be triggering and re-traumatising. Therefore, we believe these monitoring systems should only be used where there is regular, specific consent gained from people who have been given all the information about how their data, including any video footage, is used within services. This information must be presented in a clear, digestible format, for example with easy read versions and video talk-throughs available. Where someone lacks capacity, it is essential that clear safeguards are put in place to ensure its use is in the best interest of the patient’s safety, for example that it is used for the shortest amount of time possible, and that family and carers’ views are sought. In order to have faith in new technologies and ultimately have them used in a way that helps rather than causes harm, this must always be the basis of their use.
“Alongside the debate around new technology sits the complex issue of workforce. With mental health services facing widely documented staffing shortages there is also a danger that technologies such as Oxevision could be used by providers to “short-circuit” the kind of person-centred care people need. This would be unacceptable when too often we have seen restrictive practices being imposed on people.
“We are pleased that NHS England and the National Mental Health and Learning Disability Nurse Directors Forum will be reviewing the consent model used around Oxevision. We hope to be part of this review and have agreed the importance that it is co-produced in partnership with those with lived experience, families and carers, including people who have already experienced the use of Oxevision as part of their care – an approach we know Oxehealth fully supports. We also believe further guidance is needed around the information provided to people that sets out how this kind of monitoring works, with different formats and languages available to ensure consent is fully informed.
“Above all, use of this kind of technology should always clearly be in the best interests of the person being treated, who should have an informed choice and be able to withdraw consent at any time. Good and safe care is built on the principles of co-production, with people in services and providers working together to develop good standards of safe care.”