Original subtitles

-Calm yourself down. -[male patient shouts]

Calm yourself down.

[narrator] Every eight minutes, there is a violent incident in a UK hospital.

Whoever wants to fuck with me, fuck with me right now! You shitbag!

I've been physically assaulted, punched, kicked, bitten.

[male patient] My mentality...

The safety of our doctors and nurses is increasingly under threat.

Alright!

It's almost deemed socially acceptable to abuse nurses.

[female patient] You're out of order! You didn't even look at my fucking leg!

On Saturday, you threatened one of our doctors with a knife.

But at the Queen Elizabeth Hospital in Birmingham,

they think they have the answer - a dedicated team of security officers.

[male patient] Don't call me "sir"!

[security man] It's not a problem. We'll carry you if we have to.

-[male patient] Fuck off! -[police officer] Calm down!

People would be surprised if they realised the volume of incidents we deal with.

[female patient] You get out of my face!

My brother's fucking gonna blow you up, you fucking cunt!

[security control] It's going to kick off. A&E waiting room straight away!

We do get incredibly violent people that are intent on causing harm.

Unfortunately, it's the times that we live in.

[man] Oh, come on!

Fear's always there. People saying there isn't elements of fear would be lying.

OK, guys and girls.

We've got a young lad in cubicle I

waiting for the police to transport him off to children's.

It's the start of a new shift for the security guards

at the Queen Elizabeth Hospital in Birmingham.

It's been calm for the last couple of hours,

so hopefully you should have a pretty easy shift.

The large team of security officers protect the hospital 24 hours a day,

365 days a year.

They cover a site of over 33 acres

and look after over 10,000 NHS staff.

Right, guys, positions are on the board. Pete, you're in control.

Me and Dave are going to go on patrol first. Stay safe.

-What's the plan for food tonight? -Dunno. What do you fancy?

-Bit of pizza and some fries. -Sounds like a plan.

But hopes of an easy shift are about to prove presumptuous.

Control to Charlie Seven. I need you in A&E as soon as possible, please.

Yeah, that's a receive. Thank you.

We've had a call from staff. An aggressive patient who's been combative with staff.

The patient, called Tony, has decided a bedpan is not for him.

And when he's asked to step away from the basin, he turns nasty.

Upon approaching the area, he was urinating in the sink

and he's throwing chairs around the cubicle.

He started shouting and swearing at me, despite me trying to calm him down.

So I left the cubicle, called security.

Do you want to go in as well? Hello, fella.

[metal clatters]

[nurse] Have you got some screens anywhere?

Take a seat on your bed, sir. Please, sir.

Sit down for me, OK? Sit down for me.

The fear's always there. You've got a large male who is aggressive

and he's trying to throw things and he's trying to cause you harm.

People saying there isn't elements of fear in there would be lying.

But, obviously, that's when your training kicks in.

It's that fear that makes sure you don't get any injuries and you're switched on.

Tony barricades himself in the corner of the cubicle with the hospital bed.

-Calm yourself down. -Once everyone finds it, I'll put it back.

[Tony shouts]

Calm yourself down.

Whoever wants to fuck with me, fuck with me right now!

Wait, wait, wait, wait!

The hospital doesn't tolerate any level of violence or abuse,

so when Tony spat, the security guards called the police.

They are trying to look after you.

He spat in a member of staff's face, which prompted us to physically intervene

and have to restrain him out on the floor until police could come.

-Hello, guys. -Hello.

Good morning. How are we all?

-We intend to get you back up. -If you get me up, I'll kill you.

-You'll kill me? -Yes.

-That might change the way we play now. -I know it will.

[Tony groans]

Ah, that's lovely! Break it. Go on, break it! Go on, break it.

That's painful! That's painful! [Tony groans]

-Put your arm back down on the floor. -It's hurting!

-It's not moved. -It's hurting. It's painful!

It's painful!

-I'm just play acting. -Thanks!

-[Tony laughs] -[nurse] He's assaulted a member of staff.

You're gonna have to take him to another hospital. He's not to be treated here.

We're gonna get you up now and we'll try and do this in a dignified manner.

[Tony screams]

I will call for security pretty much straight away,

as soon as I've got that feeling that there's something bad that may happen.

Tony continues spitting whilst being wheeled off.

What's that all about? What's that all about?

So he's fitted with a mask for his journey to the police station.

We have a zero-tolerance policy

and there's only so much behaviour that you can put up with, I suppose.

That was completely unacceptable

and he was scaring other patients in the department and that isn't safe.

Control, Charlie Seven. Not sure, but it looks like this male is drinking alcohol.

Alcohol is not allowed inside or outside the hospital building.

Don't know whether he's booked in or, erm...

whether he's just hanging around.

But I've got him on camera at the moment. Just going to monitor for a while.

The man caught on camera -­ Dean - is well known to the security team.

He's a regular visitor, with a history of violence towards the staff.

So nobody's seen you?

Just three weeks ago, in one 24-hour period,

Dean was responsible for three separate incidents.

First, he made verbal threats to a security officer.

Listen... Listen, calm yourself down now. OK, calm yourself down.

Then he became aggressive towards members of the public and had to be restrained.

Finally, Dean tried to grab a security officer...

What are you playing at? Your behaviour all night has been appalling. All night.

..and was taken away by the police.

Yeah, Charlie Seven, Bravo One is going to attend that area.

Pete sent Zoe, one of five female security officers on the team.

[Pete] I've known her for about three and a half years.

She's like the mother of the unit, really. Always buying us chocolates.

It's becoming more common that you get female security officers now.

She's really doing well.

It's been noted on CCTV that there's a gentleman up there consuming alcohol.

So I'm going to go and speak to him

to see what his purpose is for him being here.

As a female, sometimes it does work to your advantage.

It's a good tool to have. People do, kind of, show more respect to females.

Hopefully, this will work for this situation.

Control, Bravo One. Just be advised the male has put the can

into his left pocket.

He's walked out from the doors

and he's currently stood by the posts.

Yeah, I can see him. It's OK.

See if he's got any reason to be here. If not, we'll get him to leave.

Is that your can of beer?

Dean knows he's not allowed to drink alcohol at the hospital.

Tonight, he's just pushing his luck.

You know if you want to seek treatment, you don't need to call an ambulance?

You can just walk straight into A&E.

Dean repeatedly comes to the hospital. This is his second visit of the day.

[Zoe] He's a nuisance patient. He's booked in numerous times.

He's been quite abusive, quite aggressive. He refuses to leave.

He's always booking in.

Gets cleared and when it's time for him to leave, he doesn't want to leave.

[Pete] It's very irritating when you get your regulars coming in and out.

Each time they come in, it's about £900 for them to be seen by doctors and nurses.

And then they just sit here for about three or four hours.

Get seen, discharged and then they come back again. It's so frustrating.

But there's nothing you can do about it because you've got a duty of care.

For the moment, Dean's behaving.

But with his history, the security team know things could change in a moment.

Control to Charlie Seven. I need you in A&E as soon as possible, please.

Last year, there were over 67,000 assaults on hospital staff across the country.

In Birmingham, a team of highly trained security guards

is constantly on call for when patients attack.

Yeah, restraint in place! Restraint in place!

The team uses a bank of CCTV cameras.

Jevan's been working in the control room for six years.

He's just spotted trouble in the A&E waiting room.

A&E waiting room, straight away! They're going to kick off.

A&E waiting room straight away!

This white guy is trying to basically kick off with an Asian guy.

I don't know what for.

It looks like his girlfriend or his wife is trying to stop him and hold him back.

I've literally just sent everybody that we've got,

cos these two are going to kick off in a minute.

It's a potentially explosive situation

because the aggressive man is hurling abuse.

The security team arrive just in time.

-Got him then? -Yeah, yeah.

[man] Oh, come on!

[Lee] The most challenging part of the job I think is the restraints.

You've gotta time them, you've gotta have coordination with your colleagues.

Mind your arm!

[Lee] He was quite a big bloke.

Three-man restraint. One on each arm.

And one on the legs to stop him lashing out, but all he wanted to do was fight.

If you don't get off me, when you do, I'm gonna...

-Are you making threats, are you? -Yeah, he is, yeah.

-No, I'm not. -Listen...

You are being held like this till the police come, yeah?

Then we'll sort it out from there, won't we?

Within a few minutes, the police arrive.

-Let me go then! -Relax.

-It's time to let me go! -Relax...

I'm detaining you on suspicion of assault.

No, no, no, no, no!

-Don't struggle. -No, no, no, no, no!

Don't struggle! Stop struggling!

Pass your hands to your back.

Even with handcuffs on,

the man is still not calming down and his threats are increasing.

I'm coming back for you, you cunt! Get off me!

-Stop kicking out! -I'm not kicking out!

I'm trying to straighten my legs.

-Don't straighten your legs! -Oh, fuck off!!

-Calm down! -Oh, bollocks.

-Let go of the cuffs! -Oh, fuck off.

The police decide to strap his legs to take him to the station.

Get this cunt off me! You cunt!

Pal, one on one, you're fucked.

[Jordan] We get a lot of aggressive patients

being aggressive towards staff and ourselves.

-Yep! Alright, sonny. -No worries.

[Jordan] When someone does make threats against your life,

it's not pleasant, but you can't take it personally.

It's just part and parcel of the job.

It's a new day at the hospital.

Security guards Zoe and Steve have been called to an incident on Ward 514.

-Officially discharged, yeah? -Yeah. Hold on, mate.

Good to go.

It's another patient called Dean.

He's become aggressive because he's been discharged after two weeks of treatment,

but he says he's got nowhere to go.

[Djuna] It started kicking off. It's part of the policy

that we need to get security involved if you've got a very challenging patient

and they're getting really physically or verbally abusive.

He's been rude, swearing at staff and sometimes he just kicks off big time.

I was surprised at the amount of abuse that we receive as a department

and the medical staff also, nurses and doctors,

that they receive purely because...

You come here for a reason, you come here to get medical attention,

so these people are here to help you. It's a place of safety.

I've been called a C-U-N-T.

People have called me, like, four-eyed prick, things like that.

But it comes with the job, I suppose.

-Bad, mate. -Lee...

In an ideal world, we wouldn't have to be here.

Wouldn't have to be walking round in protective stab vests,

but we do get incredibly violent people that are intent on causing harm to us,

staff, other members of the public, patients.

And, unfortunately, it's the times that we live in

that we do require to be in a hospital with protective stab vests on.

I'll ring you back, mate. I'll ring you back, Mum.

Dean's girlfriend, Stacy, is trying to help him.

Before we come into hospital he was really ill.

Like, he looked like he was on death's doorstep.

And today, he knew he was going to get discharged,

but he wanted to find out where he was going to live.

Do you know what I mean? Because these weren't... They never told him anything.

They would've let him out back on the streets

and he's gonna go back to square one.

You've been discharged. You need to leave.

If you need to put a complaint in about it, you can go through PALS.

But youse up here, what are youse gonna do?

-Well, if necessary... -What are youse gonna do?

I'm a sick patient, mate. You can't do nothing.

You've been discharged. You need to leave.

Shall I show you the way? It's down this way.

Dean, I need to get my other suitcase.

She's got her suitcase and that.

I heard the nurses on the ward saying they think he's had drugs

because the colour of his eyes were red. Well...

I know for a fact, when you have drugs

no drug in this world will make your eyes go red like that.

They're just contact lenses that glow in the dark.

The hospital can give Dean some money for the bus.

They said they had nowhere for me to stay.

They've discharged me, I've packed all my stuff and that's it.

I can't get home. How am I supposed to get to where I'm supposed to go?

-I don't know. Where are you going? -I don't know.

Here's his paperwork. I'm just looking if there's any way of getting any bus fares?

The staff had given him options and informed him of which paths to go down,

to obviously help himself to get sorted, to get back on the right track.

Fingers crossed to get him back on track. Thank you, anyway.

-Take care. See you later. -Thank you.

I love my job.

I like being at the hospital, I like looking after the patients and staff.

John's one of the most experienced members of the security team.

An ex-army man, he has a very personal reason

to protect staff at the Queen Elizabeth.

My partner's a nurse. People come into the hospital

and sadly sometimes they lose it with the staff and we've got to protect the staff.

John's on patrol with his duty manager, Pete.

[man shouts]

They hear a man shouting in the Clinical Decisions Unit corridor.

-[patient shouts] Why? -Excuse me, sir.

He's frightening the staff and other patients.

Don't call me "sir"! All I want to do is go home!

Don't you and you talk to me!

-Stop. -No, no, you don't talk to me.

-Hey, you! You talking to me? -Yes, sir.

Eh, you shitbag! I'm not a sir!

When we arrived he'd got a mental health nurse backed up against a wall.

Despite his best efforts to try and verbally calm him down,

it wasn't working and we had to step in and restrain him.

The elderly patient has been assessed

and for his own safety is not allowed to leave the hospital today.

Do you want to 22 him? 22. Let's go. Come on.

Eh!

A nurse has asked the security team to take the man back to his bed.

Come on. We'll carry you if we have to.

[Pete] The most challenging part of the job is dealing with confused patients.

You can be called anything under the sun.

They'll use any sort of language to try and rile you

and make you get angry,

to try and force you to become unprofessional.

And our job is to remain calm

and remain in a professional capacity while we deal with these sort of people.

Can you leave my arm?

No, you are getting too violent, sir.

Do you know, you, I'll smack your fucking head in!

I'm more reluctant to put hands on the Alzheimer or the dementia patient

because sadly they don't know what they're doing

and a lot of times, if you can talk them down, fine.

Don't you! Leave me!

Do not... Do not!

Shithead!

[Pete] I've spoken with his doctor and his mental health nurse

and they've advised me that they are going to give him some sedation.

So they've just asked us to remain in the area and just monitor him.

If he won't take oral medication,

they'll have to give him an injection so we may be required to help.

-Before you... -Sit down.

Shut up!

Don't you talk to me like that!

You shitheads!

Ooh, look at him! Hard man, eh?

You won't be hard. I'll knock your heads straight through the brick wall!

[John] In some respects, I can take the abuse because

they're at an age where they've earned the right to be nasty every now and again.

So, yeah, I'm, you know... But obviously there is a limit.

[Pete] The patient's a lot calmer now.

He's taken the sedation orally,

so we weren't required to intervene, so we're going to stand down.

It's Saturday night and controller Pete Bridge is monitoring the cameras.

Pete never uses the word "quiet", that would tempt fate.

When anyone uses the "Q-word", it seems to go mad.

So we never say it in the control room. It's sort of like a banned word.

Pete's just spotted a familiar face on CCTV.

It's A&E Dean and he's drinking again.

Are you making your way back to the front of house, please?

Security Officer Zoe is on Dean's case.

He's just been assessed by A&E as well as the mental health team

and there's nothing wrong with him.

Dean, this is where we stand at the moment.

You have been discharged.

I informed you that you shouldn't be drinking on site

and at the moment, obviously, you've got no need to actually still be here.

-I've got nowhere to go. -And I totally understand that.

At the hospital, we do have frequent patients that will come in.

We'll see them sometimes on a weekly basis.

Sometimes we'll see them more than once a day.

You've been discharged medically and mentally you have been discharged.

Every time he's discharged, there's always some kind of issue with him

not wanting to leave, so then we're called and we have to intervene.

We've been round in circles now. What time was it when you rebooked here?

It was about eight o'clock and now we're at nearly three o'clock.

I understand where you are coming from

and I understand that you are having a bit of a rough time,

but at the moment you've got no need to still be remaining on site.

So there's two ways we can go about it.

And I'd like it to be the first way. I don't want it to be the second way,

because you're a nice enough lad and we've got an understanding going on here.

I don't want to have to physically remove you. OK? Come on, Dean.

Dean finally leaves the hospital site and Zoe and the team stand down.

But just a few minutes later, he's back.

This time, he's on the phone calling himself an ambulance.

[Zoe] Who are you on the phone to? Do you want me to speak to them?

Hiya. You are speaking to one of the security officers at the Queen Elizabeth.

Yeah, this gentleman's been booked in twice within the department today.

Zoe spots a police officer and asks for back up.

He keeps calling ambulances. We have told him he needs to leave.

He's just on the phone to the ambulance service at the moment.

[policeman] Terminate your call because, obviously, I'm a police officer...

Yeah. No worries. Thank you. Bye.

OK.

Dean has occupied the security team for seven hours this evening

and he's also managed to avoid paying for travel home.

The police officer kindly drove him.

[Zoe] So, all-in-all, a decent outcome.

No restraints, no violence, no aggression, no paperwork.

[phone rings]

Good evening, Cofley Security.

[Becki] Hi, it's Sister in ED.

I've got a very abusive woman at the main reception desk.

Yes, Becki, I'll have a word.

-Thank you very much. Bye! -Thanks a lot. Cheers. Bye.

It's 10:00pm at the Queen Elizabeth Hospital in Birmingham.

Control to Charlie Four.

-Send it. -A&E main waiting for a middle-aged female

being very aggressive towards staff. Will you go and have a word?

The aggressive woman says she has a sore foot.

Nurses have confiscated her alcohol and she's not happy.

John's been sent to keep an eye on her.

-Will she be getting an X-ray? -No, probably not.

-It's probably likely to be soft tissue. -Yeah.

She's drunk, basically.

Staff in A&E spend a quarter of their time dealing with alcohol-related incidents.

There's a high level of verbal abuse within the A&E department.

It's almost deemed socially acceptable to come into an A&E

and swear and abuse nurses because some people, unfortunately, deem it

that we're there for them and we'll put up with the abuse.

The woman with the sore foot wants to see a doctor immediately,

rather than sit with all the other patients in the waiting room.

I'm telling you now, right? They're taking the mickey here.

What she's saying, love, is that because you're fit to stay in the waiting room...

How long for though? They told me ten minutes.

-I'm going to miss my bus. -You'll just have to bear with them.

-I'll try. -Alright, then.

[John] Well, I could smell the alcohol on her breath. Spoke to the Sister.

It's not a major injury so she'll probably get it strapped up and discharged,

but her main concern is not... missing the bus.

After calming the woman down, John heads back to the control room.

I love a tea break.

-Here you go, Alex. -Thanks, mate. Cheers.

-How was our lady downstairs? -Ah, yes. She's calmed down.

I've explained to her the situation.

She is aware now that she's going to have to wait her turn, so hopefully she'll...

Not going to miss her bus then, no?

You never know, you never know.

[phone rings]

Hello, Coffley Security. Alex speaking.

Hello, Beki, I'll send our finest down. Bye-bye.

-A&E? -Sorry, mate.

-Not a problem. See you in a bit. -Aye!

John is on his way back to A&E because the woman who says she's hurt her foot

is hopping mad again.

She's disturbing other patients and the Sister in charge has had enough.

-I don't need security, alright? -I do, so...

[Beki] The security team are a really valued member of the team.

Their presence is definitely needed a lot more than they used to be, which is sad,

but they've definitely saved me from a few scrapes over the years.

I'm Beki. I'm the Senior Sister of the hospital A&E at the moment, OK?

You've been verbally abusive to the staff here.

They lied to me though! The nurse lied. She said she'd assess me, but she didn't.

At 21:15, Staff Nurse Alex Coley saw you. She did a very brief assessment on you.

No, she didn't! She didn't even look at my foot.

She said, "Is that alcohol you are drinking?" I said, "Yes."

She said she'd take it away, then she said she'd be back in a minute.

-But where is she? -Well, it's a minor injury.

We did do an assessment.

Whilst she was talking to you she was doing the assessment.

Unfortunately, because you've been verbally aggressive,

-I'm going to have to ask you to leave. -That's rubbish!

Violence and antisocial behaviour definitely feels like it's on the rise,

which is really quite sad. A lot of it is alcohol-fuelled.

I'm going to walk away now, alright, because I've asked you to leave.

You've asked me to leave and you're not even going to examine me?

-I'm not, no. Alright? -Well, I want to see a doctor.

-No, I'm in charge of this department. -Get out my face now.

Because you've just made me wait and you've deliberately...

No, they're out of order!

-They are going to call the police now. -I don't give a shit!

At the news that the police are on their way,

the woman becomes physically aggressive,

leaving Pete and John with no choice but to restrain her.

You, get out of my face! And don't touch my arm.

-Right, on the bed. -I swear to God...

-Sit! -Don't touch my arm!

Don't! Do not...

Are you going to sit down now? Are you going to sit...?

-That was the arm I broke. -Are you going to sit down now?

-Yes. Obviously. -Right, turn round.

There you go now. Sit.

You're a cunt you are. My brother works in security and I swear to God...

-Stop! Stop! -When I fucking see him...

What's your name? You twist up an arm that's been broken?!

You fucking bastard!

You're a marked man.

My brother, he's gonna fucking blow you up, you fucking cunt!

I've faced quite a lot of verbal and physical abuse from patients

and visitors to the hospital.

If you calm down, he'll leave you alone.

-Same as I will. -Get the fucking Claude Van Damme off me!

I know exactly what you look like, where you'll be,

and I'll fucking come for you.

Someone making those very specific death threats towards you,

naming what they're going to do and when they're going to do it.

I think it can be quite disconcerting,

but after you've been in the job a long time you realise

that the majority of these threats are not serious.

And you! You're out of order! You lied!

You said you assessed me. You didn't even look at my fucking leg!

The police are on their way, but in spite of her injured foot,

the abusive woman decides to do a runner.

[John] She'll be free to come back any time she wants.

Because staff confiscated alcohol off her that was the reason she was abusive.

She's probably gone to buy some more now

and she may be back in a couple of hours' time, who knows?

The lady walks quickly off site, with no sign of her sore foot slowing her down.

At the Queen Elizabeth Hospital, security work

isn't all about dealing with anti-social people.

Some patients become aggressive when they come round from a general anaesthetic.

So we have a gentleman in theatres, Recovery One,

who woke up agitated from surgery.

Guys went up there. They passively restrained him to the bed

while staff sedated him, which knocked him out. Job done!

However, he's then come around 30 minutes later and kicked off again.

The patient, called Scott, is completely unaware of his actions,

but is hitting out at staff and putting himself in danger.

It's a reaction security guard David has seen many times before.

He's woken up a bit confused and in an agitated state.

He has attempted to lash out at staff.

They're now going to look at moving him up to the intensive treatment unit,

so we're going to provide an escort while that happens.

The security team carefully monitor the situation.

[Scott shouts incoherently]

-Security, come in, please. -[Scott] I'm going to wet myself!

And within a few minutes, they are called in to assist.

I wanna get up!

[Scott groans]

Scott's just had a ten-hour operation on his brain.

Well, I had a brain tumour and they removed it,

and it's just come back now after 11 years.

Now I've had another operation. They've gone up through me nose.

I got told by the security that I was fighting with them,

pulling all the cannulas out and the drips.

I just can't remember a thing, to be fair.

Scott, Scott.

Just relax.

You need to stay in your bed, please.

[Scott groans]

[Scott groans loudly]

[David] When we were in there, we did have to restrain the patient

to make sure that he was in a safe position for the staff

to administer further medication for his own well-being.

Yeah, it was crazy. If it wasn't for them, I could have injured myself,

fell out of bed, anything could have happened really.

Thanks to the security team, Scott's come through his operation unscathed.

In the control room, Pete's in charge.

I've got 28 monitors and cameras to see all across sites

and nothing really gets passed me. We've got eyes and ears everywhere.

Security control emergency line.

Er, which lady is she?

Right. OK, I'll get somebody up to you straight away.

In A&E, a woman is trying to leave,

but the nurses are concerned about her mental health and want her to be assessed.

David is sent to help.

I just knew that something wasn't right.

And once I sat down and started speaking to her, her speech was very pressured.

She wasn't responding to me and I could tell she was quite psychiatrically unwell.

The patient needs to be officially assessed by the mental health team

to find out if she has the capacity to make the right decisions

about her own welfare.

David speaks to the mental health assessment team.

[Pete] The female has just come out into the waiting area,

but we've been told she lacks capacity,

which means she is not fit to be out and about on her own.

We can then stop her from leaving.

With fewer dedicated mental health units,

more and more people in need of psychiatric help

turn up at ordinary hospitals.

We get it quite regularly, to be quite honest, that they lack capacity.

Normally, after that they would then probably section them,

which obviously gives us more powers as well to stop them.

A section means a patient can be kept in hospital for their own safety,

whether they agree or not.

The lady has been assessed and is found to have psychiatric problems.

A few minutes later, she tries to leave again.

One of our officers is having words with her, trying to get her to come back in.

And the other officer is trying to get nursing staff to come out to her.

If she tries to leave, we can obviously escort her back in using a restraint.

It transpires now, she's actually called a taxi to leave site.

She said she was going out for fresh air.

So I think she's trying to pull a fast one on us.

It can take up to hours sometimes with us having to monitor them.

If it wasn't for us monitoring the female, she could have easily absconded

and maybe caused injury to herself.

The security team stands down, as a specialist nurse takes over.

But the control room is told to monitor the lady, for her own safety.

In A&E, the team is dealing with a regular nuisance patient, Fred.

Right, on Saturday you threatened one of our doctors with a knife.

And you tried to hit one of our staff nurses.

So, what we're doing now is yellow carding you.

[John] If patients are repeatedly

troublesome in terms of violence or aggression, then they can be forwarded

for a yellow card system. It's effectively a reprimand,

which means that they are warned.

And if they repeat the behaviour, then they can be banned from the hospital.

We're not giving you a bed in this hospital. You keep attacking the staff.

Fred's been assessed by doctors and psychiatrists,

who say there is no reason he should be in hospital.

[Ash] If he does misbehave again in the future,

they'll withhold treatment for a period of a year.

The yellow card is Fred's final warning.

Despite all of his disruptions,

a nurse has paid for Fred's taxi out of her own pocket.

The staff can only wait and see if the final warning works.

In the control room, Jevan has just replaced Pete for the night shift

and is monitoring the psychiatrically unwell woman.

Oh, this female's gone.

Control to Alpha One. This female's actually going to front of house now.

Can you please try and stop this female? IC1 female.

Dressed in black jacket, blue jeans.

Jevan deploys his team to try to stop the lady leaving.

She's... She's legging it. She's... She's gone.

I've got an IC1 female, section two patient,

who we've been told by handover to keep an eye on. She's a self-harmer.

She's actually run from the A&E department

and she's heading towards front of house.

And she's apparently run away from her carer.

And she's heading towards front of house now.

I've got four officers who are trying to detain her.

We were called to an incident where a female

who lacked capacity was absconding off site.

She's actually sprinted off into the bushes.

I've got no camera views of her now.

[Pete] It does cause us a problem dealing with mental health patients,

because you don't know how they're going to react to yourself.

It could be that the uniform scares them and they want to get away from you

because they think you're the police or something, you're going to arrest them,

but you're just there to try and preserve their safety.

The security team finds the lady hiding in the bushes.

We removed her from the bush. I think she was just very confused

and scared of what was going on due to her mental state.

[Jevan] She's been on our radar all day and night. Obviously, since I've come on.

We've managed to stop her from escaping

and she's back with us until they can figure out what to do next.

The vulnerable patient is transferred

to a secure mental health unit later that night.

The Queen Elizabeth Hospital treats a million patients each year,

the majority are well-behaved but some are not.

The security team has been called to A&E.

Fred's back and, despite being on his final warning,

he's threatening staff again.

Fred, what's happening today? Fred?

This time, he's crossed the line. He's assaulted a nurse.

43% of A&E staff have been physically assaulted at work.

-Can I have my cigarettes? -Who's got your cigarettes, Fred?

You go outside. Who's got your cigarettes?

-That Sister! -Alright.

Earlier, Fred tried to smoke in the corridor.

When staff confiscated his cigarettes, he got violent.

The hospital staff and security team decide enough is enough.

You were spoken to the other day about behaving when you come to the hospital.

If you come to the hospital and you try and punch the staff,

they're not going to deal with it, are they?

So on this occasion, we've had to call the police, Fred. It's not acceptable.

Do you understand that? Yeah?

Despite the security guards trying to calm him down,

Fred becomes aggressive again and spits in John's face three times.

Another member of staff puts a mask over Fred's mouth so he can't do it again.

Fred tries to take it off. Ash and John have no choice but to restrain him.

Oh, well, you've had your chance, mate.

When we took him to ground, I got his arm under my armpit,

so all my weight is on my body and my elbow,

and I'm just holding his hand here, so there's no weight on his body whatsoever.

Just a way of restricting his arm movement.

Because of his violent behaviour, Fred isn't going home in a taxi tonight.

This time he's off to the police station

and an appearance in court tomorrow morning facing charges for assault.

He came in four times yesterday, 40 minutes each time,

that's a delay of half hour, 40 minutes, on anybody that's in A&E

with a real illness, because staff are looking after him.

There are many challenges for a security team in a hospital.

The team frequently has to deal with mental health cases,

which take special care.

Lee's been called to the A&E corridor.

-What's the matter, pal? -[inaudible]

A young man's behaviour is worrying staff.

His body language stating that he was all aggressive.

The male started to advance towards me

and at that point I was going to put a restraint on.

Yeah, restraint in place! Restraint in place!

Are you going to calm yourself down?

Staff have removed the man's bed because he'd become so agitated.

They're worried about his mental health.

Yeah, back in cubicle 12. The male has been put back on his mattress.

Where is my phone?

Dunno, mate.

The patient becomes more aggressive.

-Don't touch me! Do not touch me! -Pal, pal...

-Get your hands off me. -Are you gonna allow us to help you?

Alright!

[inaudible]

[nurse] Come and sit in your cubicle, please.

If you carry on being silly like this, we're going to have to call the police.

We want to help you, so if you want help, pop yourself back in your cubicle.

Don't point the finger. That's quite aggressive, isn't it, pointing the finger?

Pop yourself down in your chair. Would you like a cup of tea?

I could do with a cup of tea.

Nurses have called for the patient to have a psychiatric assessment,

as they are worried about his mental state.

He's calm at the moment, so the security team stands down.

The CCTV cameras will be monitoring him because it could kick off again.

[phone rings]

Security control room, can I help you?

In the control room, Pete's having a busy night.

Can I just take your name, please?

A&E is on the phone again. A discharged patient is refusing to leave.

Not a problem. I'll get some officers up to you.

And I'll get cameras in the area. OK? Thanks. Bye-bye.

Zoe is sent to escort the patient off the premises.

Just had a call from the Sister in A&E.

There's a patient there who's discharged refusing to leave.

So we'll go and have a word with them.

-Oh, hello, Dean. How's it going? -Oh, fucking hell!

It's Dean, again.

In regards to this male in cubicle 7,

it's the same male we had on nights the other week, called Dean.

-This way, this way, this way, that way. -That way?

Dean isn't happy to see them and this time, to the relief of the team,

leaves quickly and quietly.

[Zoe] Bravo One, Control. Are you happy to monitor him on camera?

And we'll stand down. If he heads down towards front of house, give us a shout.

Yeah, received. Standing down.

Lee has just been recalled to A&E.

The aggressive young man with suspected mental health issues

has walked out of the hospital after assaulting a nurse.

Last year, there were over 45,000 physical assaults

on NHS staff from mentally unwell patients.

The male patient that I've just been looking after

has just punched me in the stomach.

Tried to assault the doctor also.

And then took a second swing at my face.

He was quite threatening to the doctor, so I need to get him arrested.

It can be very frustrating for us when there's patients

that are quite aggressive.

They want to hit out at us.

It's not nice at all,

cos we are here to look after them and help them.

Yeah, Sierra One, Control. Just to confirm...

Lee heads outside A&E to find the patient and stands guard until the police arrive.

[patient] Leave me alone. Can I have a fag?

-Yes. -Then don't touch me then.

Get out the road.

To stop the situation escalating, they decide to let him smoke

and guide him towards a shelter.

Did you want it to come to this? The police have been called now.

Why?

Because of your aggression in the department.

Just monitoring the male at present while he's having a cigarette.

Nursing staff are inside contacting West Mids Police

because of his continuous bouts of aggression within the department.

He is being compliant at the moment so...

As I say, we'll just monitor and see how far it goes.

[female police officer] What's going on?

I've been a bit stupid, I'll be honest. I ain't gonna lie to you.

Before you carry on, can you just put your hands in the small of your back?

Be arrested?

Well, you're going to have to be, aren't you, now? You know the score.

-Put your hands behind your back. -No.

-I ain't gonna... -Just chill.

-Put your hands behind your back. -Just on suspicion of assault, OK?

You do not have to say anything, but it may harm your defence

if you not mention when questioned something that you later rely on in court.

Anything you do say may be given in evidence. OK?

The police have arrived, arrested the man on suspicion

of assaulting a member of staff. We're standing down. Our job here is done.

I've lost count how many times I've been verbally abused and physically attacked,

but however, as sad as it sounds, it comes with the job now.

As one nuisance patient leaves, another arrives.

Dean's back and has checked into A&E for the second time in an hour.

Dean is medically and psychiatrically discharged again.

His dream of getting a comfy bed for the night hasn't come true.

The best he gets is a quick nap in the waiting room.

The Queen Elizabeth Hospital is open 24 hours a day,

365 days a year to anybody that needs their help.

But for those who cause trouble,

the hospital's security team is always watching.