HIV and policing policy

Report: 07
Date: 16 October 2003
By: Commissioner

Summary

This report provides further details on HIV and policing issues, following the presentation of a report to the Board in May, and a commissioning note for the Board in July. (The Board agreed to defer consideration of matters until October, while the existing HIV policy was revised, in consultation with the main stakeholders.) In particular, this report:

• Presents a revised HIV policy, at Appendix 1,drawn up in consultation with all the main stakeholders; and
• provides details of how relevant information is made available to officers who notify the MPS Occupational Health (OH) Service of the fact that they are HIV positive.

The report also responds to the Board’s earlier request for further details of:

• The MPS policy for dealing with victims, detainees or offenders with HIV;
• consultation carried out with representatives of the HIV community in drawing up the policies; and
• occupational health and employment policies related to people who are HIV positive.

A. Recommendations

That -

1. Members note the contents of this report.
2. the revised policy be endorsed.
3. the arrangements for monitoring the effectiveness of the policy be noted and a further report on this aspect be submitted in six months time.

B. Supporting information

1. The MPS policy to cover its employer responsibilities for staff who may be HIV positive (hereafter referred to as “the policy”) was drawn up in July 2000, in consultation with the (then) Lesbian and Gay Police Association and the Terrence Higgins Trust. A copy of the policy was placed before the Board in May this year. The policy applies to police officers, police staff (including PCSOs) and special constables (hereafter referred to as “members of staff”).

2. The policy provided basic information to all members of staff about HIV and how it is transmitted, established the principle that there should be no discrimination against any member of staff who was either HIV positive or affected by AIDS and set out the support available, on a confidential basis, through the MPS OH Service. The policy was published in a special booklet and then placed on the MPS Intranet.

3. The policy made a good start in seeking to raise awareness across the MPS of HIV-related issues. In July, Gordon Davison, Director HR People Development, commissioned a revision of the policy, with the following terms of reference:

• To review the existing policy in order to ensure that it covers all the main employer responsibilities towards police officers and members of support staff who are HIV positive. In particular, bearing in mind the duty of care to other police officers and members of support staff, to ensure that it emphasises the support that is available to those who are HIV positive.
• To consider whether anything more needs to be said in the policy with respect to confidentiality and whether the policy needs to state explicitly that members of staff may approach OH and managers through a third party.

4. As will be seen in the revised policy, at Appendix 1, we have strengthened those parts dealing with confidentiality and support. The policy was revised in close co-operation with the Terrence Higgins Trust and the Gay Police Association.

5. Thus far, only a few members of staff with HIV have approached OH. One of them, a serving police officer, gave details of his experience to the Board in May. We understand that this may be because members of staff have concerns about approaching OH or management about their condition. The greater reassurance given in the revised policy may encourage them to be more willing to come forward, and we will monitor this.

6. The Board asked how “relevant information” is made available to members of staff who notify OH of the fact that they are HIV positive. All members of staff are dealt with personally by the Senior Occupational Physician, Dr Eileen Cahill-Canning. This ensures complete confidentiality. Dr Cahill-Canning provides information on the full range of support that is available, both through the primary care agencies, and then through the MPS OH Service, for individuals with HIV. Specific examples, suitably anonymised, of the support that has been given to those under Dr Cahill-Canning’s care will be provided at the meeting.

7. The Board also wanted to know whether it is possible for a member of staff with HIV to go through a “third party” to OH or management. Certainly, any member of staff could ask a friend, a welfare officer, a staff representative or an outside support organisation to make contact with OH on his/her behalf. The revised policy addresses this question. However, it is considered advisable that written consent would be needed before OH could enter into discussions with a “third party”.

8. In addition, the Board wanted to know how the policy was being implemented. That is difficult to judge because, as explained, currently only a few members of staff have approached OH. With the assistance of support organisations, both within and outside the MPS, we may be able to monitor the effectiveness of the revised policy. In particular, we think that, once a member of staff who is HIV positive has approached OH, he/she should be asked at regular intervals whether he/she is receiving the support and confidentiality, as laid down within the new ‘HIV Policy Managers Guidelines’ at Appendix 2. It is also considered that those outside the MPS involved in counselling members of staff who are HIV positive may also be able to provide constructive feedback on the effectiveness of the policy.

9. The MPA commissioning report produced prior to the Board meeting in May, queried whether there were any specific policies for dealing with victims, detainees and offenders with HIV. The MPS policy is a support policy for members of the MPS staff. Detainees and offenders will be seen by the Force Medical Adviser (FMA) where there are any medical issues associated with their HIV status. Members of staff are advised to act at all times in accordance with the MPS Control of Infectious Diseases Policy. Where detainees and offenders are not seen by the FMA, it is considered that staff in police stations should have leaflets and explanatory material available to pass on.

10. The Board also wanted to know whether any consultation had been carried out with representatives of the HIV community and what the issues identified in the consultation were. As explained in paragraph 1, the original policy was drawn up in consultation with the Lesbian and Gay Police Association and the Terrence Higgins Trust. When the policy was reviewed, the same bodies were consulted, along with the Police Federation, the Superintendents’ Association, the Public and Commercial Services Union (PCS), as well as Linda Van den Hende, Head of Strategic Disabilities Unit. The main issues highlighted by the consultation were the paramount need to maintain confidentiality and, to demonstrate support (both of which are now reflected within the revised policy).

11. It should be noted that staff are not required to declare their HIV status.

C. Equality and diversity implications

The Disability Discrimination Act, currently applicable to police staff is set to apply in employment terms to police officers in October 2004. It is anticipated that the Government will extend the definition of disability under the Act to apply from the date of diagnosis in the case of HIV rather than having to prove that they have a progressive condition. No date for this change has been announced.

D. Financial implications

There are no financial implications arising from this report.

E. Background papers

None

F. Contact details

Report author: Gordon Davison, Director HR People Development, HR Directorate, MPS.

For more information contact:

MPA general: 020 7202 0202
Media enquiries: 020 7202 0217/18

Appendix 1

HIV Policy Statement

1. Introduction

1.1 In accordance with a Metropolitan Police Authority request, the MPS HIV Policy has been reviewed and revised following consultation with Occupational Health Services (OH), the Diversity Directorate and Terrence Higgins Trust (THT). The policy demonstrates that the health and well being of our MPS staff is of primary concern to the MPS. Accordingly, the MPS is determined to ensure those members of staff affected by the virus are provided with the appropriate support and are treated with both dignity and respect.

2. Application

2.1 This policy replaces Notice 21/01 of 23rd May 2001, with immediate effect and applies to all MPS staff (Police Officers, Police Staff, Traffic Wardens, Police Community Support Officers and the Metropolitan Special Constabulary).

3. Purpose

3.1 This policy will ensure that all MPS staff are fully aware of what the MPS can provide in terms of support, advice and necessary workplace adjustments, which are available to support a member of staff who is HIV positive in staying in work as long as possible.

3.2 It provides assurance that all information about a member of staff’s known HIV status is kept strictly confidential.

4. Scope

4.1 This policy is to be applied to all MPS staff (Police Officers, Police Staff, Traffic Wardens, Police Community Support Officers and the Metropolitan Special Constabulary), especially managers, who have a duty of care towards their staff.

5. Policy statement

5.1 The MPS recognises that employees with Human Immune Deficiency Virus (HIV) and/or Automatic Immune Deficiency Syndrome (AIDS) sometimes experience social and professional discrimination and disadvantage. The MPS does not discriminate against people with suspected or known HIV or who have AIDS.

5.2 The MPS is committed to ensuring that all staff who are HIV positive should be given the same levels of support and confidentiality, as are given to anyone affected by any other potentially progressive infection or medical condition and given to all members of staff.

5.3 The Disability Discrimination Act 1995 (which currently applies only to Police Staff, but from October 2004 will apply to Police Officers), ensures that as an employer we have a duty to make reasonable adjustments to prevent staff being placed at a disadvantage. This applies to the physical environment and to work practices.

5.4 As with all members of staff, the MPS will ensure that staff who are HIV positive, receive every support to continue in their jobs and to progress with their careers.

6. Benefits

6.1 The HIV Policy provides an assurance to staff who are HIV positive, that they are treated fairly in all aspects of employment including selection, promotion, training, transfer, career development and retention.

6.2 The policy will reassure individuals that all information provided will be treated in the strictest confidence and therefore safeguards against unauthorised disclosure.

6.3 The information provided ensures all staff and especially managers are aware of their responsibilities, regarding staff who are HIV positive.

7. Responsibilities

7.1 The Human Resources Directorate owns this policy.

7.2 The Human Resources Policy Unit, in consultation with Occupational Health Services, the Diversity Directorate, Terrence Higgins Trust and the Gay Police Association, developed this policy.

7.3 The policy will be reviewed by April 2006 by the HR Policy Unit.

8. Associated documents and policies

8.1 This policy is supported with the following Notice:

• Special Notice 1/00 – Control of Infection in the MPS (add hyperlink to Notice)

Appendix 2

HIV Policy Managers Guidelines

1. Introduction

1.1 In accordance with a Metropolitan Police Authority request, the MPS HIV Policy has been reviewed and revised following consultation with Occupational Health Services (OH), the Diversity Directorate and Terrence Higgins Trust (THT). The policy demonstrates that the health and well being of our MPS staff is of primary concern to the MPS. Accordingly, the MPS is determined to ensure those members of staff affected by the virus are provided with the appropriate support and are treated with both dignity and respect.

2. Application

2.1 This policy replaces Notice 21/01 of 23rd May 2001, with immediate effect and applies to all MPS staff (Police Officers, Police Staff, Traffic Wardens, Police Community Support Officers). There are also applications to members of the Metropolitan Special Constabulary, although, of course, they do not sustain an employment relationship to the MPS.

2.2 Managers will need to be especially aware, as they have a leading role in providing appropriate advice and support to their staff.

2.3 MPS staff are not required to disclose their HIV status; an individual who is HIV positive who wishes to seek confidential medical advice, can do so by contacting their Occupational Health Advisor (OHA).

2.4 Staff may ask a friend or a third party to contact OH on their behalf. This nominated person will need to leave their name, so that OH can inform the individual who contacted them.

2.5 Discussions can then take place as to what workplace adjustments are available to support an individual in staying in work.

3. Factual information

3.1 Human Immune Deficiency Virus (HIV) is a virus which attacks and damages the body’s defence system, stopping it from effectively fighting certain infections and tumours. For a certain period of time, which may be several years, the body’s defence mechanism can keep the HIV infection under control. During this time a person with HIV may feel completely well and have no symptoms. However, in the majority of cases, the immune system eventually needs help, in the form of anti-HIV drugs, to keep the HIV infection under control.

3.2 HIV is transmitted through contact with:

• Blood
• Body fluids contaminated with blood
• Semen and vaginal fluid through unprotected sexual intercourse
• From mother to baby across the placenta and by breast-feeding

3.3 Saliva is not considered to be a risk in the transmission of HIV.

4. Risk assessment and safe working practices

4.1 A risk assessment has been conducted and the risk of a member of staff who is HIV positive transmitting the virus to others within the course of operational duties is very low.

4.2 Transmission of HIV in the workplace can largely be eliminated by preventing transfer of body fluids from person to person.

4.3 In an operational environment there is a small risk of transmission of the virus, due to the potential for exposure to blood, or blood products associated with accidents or traumas. Even here, the risk is low and can be virtually eliminated provided staff take “universal precautions”.

4.4 These “universal precautions” are detailed in the MPS Control of Infection Policy (Special Notice 1/00). The “universal precautions” approach means that all blood or body fluids are considered infectious and precautions to avoid exposure to blood or body fluids are taken with all individuals (either members of the public or colleagues) and with all blood spillages or exposure to body fluids.

4.5 In an operational setting, the precautions taken to protect staff from members of the public who may be infected, will also serve to prevent transmission of the virus from staff to others.

4.6 In the event of exposure to body fluids, with a potential risk of infection from HIV, you or your line manager should contact:

• St. Thomas’ Hospital Virology Department on 0207-928-9292, Office hours are, 0900 – 1700 hrs. For out of hour’s assistance, contact the above number and ask for the on-call duty Doctor for the Virology Department to be paged.

5. Employees guidelines

5.1 The MPS recognises that employees with Human Immune Deficiency Virus (HIV) and/or Acquired Immune Deficiency Syndrome (AIDS) sometimes experience social and professional discrimination and disadvantage. The MPS does not discriminate against people with suspected or known HIV or who have AIDS.

5.2 Section 7 of the Health, Safety and Work Act 1974 obliges employees, “to take reasonable care for the health and safety of themselves and of the persons who may be affected by acts or omissions at work”.

5.3 This may mean that you may need to inform your OHA of your illness in order that they can suggest a temporary period of recuperative duties whilst you are unwell and not able to perform the full duties associated with your post.

5.4 If you wish to seek medical advice, you can do so by contacting your OHA direct via e-mail or telephone, contact numbers can be found on the OH website. A Form 6112 does not need to be completed. Once contact has been made with an OHA, they will arrange to see you at a time and police location mutually convenient.

6. Managers Guidelines

6.1 MPS staff are not required to disclose their HIV status. However, if a member of staff notifies you that he/she is affected by the virus, your responsibility as a manager is to:

• First and foremost assure the individual that disclosure of their illness will be treated in the strictest confidence and that any information given will not be disclosed to anyone, including members of a Senior Management Team or OH, unless the individual consents.
• Inform the individual what the MPS can provide them in terms of advice and support, for example counselling and workplace adjustments.
• If the individual agrees, refer them to an OHA.
• Be aware of the Disability Discrimination Act (DDA) 1995 and any impact it may have.

6.2 Referral to OH
When referring a member of staff with HIV to an OHA, a Form 6112 does not need to be completed. The individual may wish to contact the OHA themselves. Once contact has been made with an OHA, they will arrange to see the individual at a time and police location mutually convenient.

7. Occupational Health Guidelines

7.1 Adjustments to working environment
An OHA can discuss any workplace modifications, which are available to support an individual in staying in work as long as possible if he/she is medically able to. If long-term workplace modifications are required, an OHA will refer an individual to a medical officer for a permanent exemption from shift work, or authorising for flexible working hours etc. These would be reached in consultation with the individual in partnership with the medical officer and a manager. At no time would the individual’s medical condition be disclosed. (It must be noted however, that an OHA’s role is an advisory one and the final decision to any workplace adjustments rests at management level).

7.2 We recognise the stress an individual may be under after being diagnosed with HIV, we also recognise that there are excellent primary care facilities available outside the MPS. That said, we wish to reiterate that any individual wanting support whilst at work can obtain this through their OHA/Medical Officer (MO) or Occupational Health Welfare Counsellor.

8. Confidentiality

8.1 All individuals have the right to expect that details of their personal health and medical history to be kept confidential. They also have legal rights in common law and statute law (Human Rights Act 1998, Article 8) to protect that right to confidentiality (subject to certain qualifications). This is particularly important in circumstances where disclosure of their health status may lead to harassment or victimisation.

8.2 The MPS understands that confidentiality is essential to protect those affected by HIV and promises to treat all information about a person's known HIV status as strictly confidential. We will take all necessary precautions to safeguard this information and to avoid unauthorised disclosure.

8.3 The OHA/MO will maintain confidentiality, when making appropriate recommendations to OHA/management regarding the necessary adjustments or modifications. The OHA/MO will convey these recommendations to management without disclosing the nature of the illness. The OHA/MO is bound by laws governing confidentiality not to disclose the nature of any illness, including HIV, without the explicit written consent of the individual.

8.4 Only in exceptional circumstances where there is intention to self harm, deliberate intent to harm others or a threat to national security it is acceptable under the practitioners code of Professional Conduct, to breach confidentiality.

9. HIV and the Disability Discrimination Act

9.1 Under the Disability Discrimination Act (DDA) 1995, it is unlawful for an employer unjustifiably to treat a disabled member of staff less favourably, or to fail to make reasonable adjustments for the disabled person. In law, this provision does not currently apply to police officers but will do so from October 2004. The MPS would however wish to act within the spirit of the DDA for existing officers who become ill, as far as current Police Regulations allow, before that date.

9.2 The DDA defines a disabled person as someone who has, or had, ‘a physical or mental impairment, which has a substantial and long-term adverse effect’ on their ability to carry out normal day-to-day activities. The definition does not specifically cover any activities associated with employment activities. The DDA does however, cover recurring and progressive conditions, which would have an effect on day-to-day activity if medication or treatment were not prescribed. People who are HIV positive may not normally consider themselves as ‘disabled’ but may be protected by the DDA, because HIV can be a progressive condition controlled by medication.

9.3 Under the DDA, if a person has a progressive condition, he/she is to be considered as having an impairment that affects day-today activity from the point at which any impairment resulting from their condition has any effect, however minor, on his/her ability to carry out normal day-to-day activities. (There are Government plans to amend the definition so employees have protection under the DDA from the point of diagnosis. There is no agreed date for this but an expectation that it could be by October 2004).

9.4 Under the DDA, an employer has a duty to make reasonable adjustments to prevent the disabled person being placed at a disadvantage. This applies to the physical environment and to work practices.

9.5 It is important to note that this applies to all aspects of employment including selection, training, transfer, career development and retention.

9.6 In order to ensure that all staff, especially managers, are aware of their responsibilities regarding HIV positive staff, a clear policy supported by HIV awareness is encouraged. Should a challenge be made, Tribunals will look for evidence to see what arrangement exist within the Service and how managers have followed them.

10. Advice and information

10.1 Further advice, support and information can also be obtained confidentially from:

• The Terrence Higgins Trust THT: Direct 0845-1221200, National Helpline, (calls charged at local rate); info@tht.org.ukcontact.
• Occupational Health Services (contact no’s telephone and e-mail)
• Strategic Disability Team (contact no’s telephone and e-mail)
• Gay Police Association (contact no’s telephone and e-mail)

11. Enquiries

11.1 Enquiries regarding this policy should be directed to Dr Cahill-Canning, Senior Occupational Physician, Directorate of Occupational Health.

12. Associated documents and policies

12.1 Control of Infection in the MPS Special Notice 1/00 (add hyperlink to Notice).

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