Implementing Body Worn Cameras to Reduce Violence Against Ambulance Crew

Objectives Following the launch of its ‘Long Term Plan’ in 2019, the English National Health Service (NHS England) started piloting body worn cameras (BWCs) in ambulance services. The intervention rationale was that BWCs would act as a deterrent and facilitate the prosecution of assailants, thus improving the safety and wellbeing of ambulance crew. This paper explores views on the purpose and value of BWCs among ambulance crews and leadership staff who have used them or supported their implementation. Methods We conducted a qualitative investigation with ambulance crew and leadership staff (N=16) in the first 7-10 months of the BWC pilot. Semi-structured interviews were held online between August 2021 and November 2021. Normalisation process theory was used to guide and structure the data analyses. Results There was only partial shared understanding between crew members and leadership staff on the purpose and value of BWCs. Drawing on their practical professional experiences of using BWCs, crews challenged the theory of change that BWCs function as deterrents while recognising their potential to facilitate prosecutions. Crews also highlighted technical, operational and social factors that are likely to mitigate the positive effects of (the implementation of) the cameras. Conclusions Violence reduction policies for health services should take heed of the variation in theories of change put forward by different stakeholders. Further research is required to better understand the range of factors that affect the occurrence and management of assaults against ambulance crew and the operational challenges and cost-effectiveness of body worn cameras relative to other interventions.