How we made it

Sarah Hall, Communications and Media Manager

I was first introduced to the world of access agreements and consent protocols more than a year ago when I met Amy Flanagan from The Garden Productions.

It was clear from the outset that making this documentary series was going to be serious business.  

In all television programmes there is a certain amount of work going on behind the scenes but when you are dealing with vulnerable people it is absolutely imperative they are safeguarded.

As communications and media manager for SLaM the predominant part of my remit is to engage and work with media, but it is also about ensuring patients and staff are not compromised in any way and minimising any adverse impact on patients from press coverage.

As well as feeling incredibly excited about this series, there were various questions forming in my mind in the early stages. How are we going to get consent to film patients who are mentally unwell? How will the presence of cameras affect them? What happens if anyone wants to withdraw consent just before broadcast?

So, where did we start?

Before we could proceed with putting an agreement together we sought the advice of our Caldicott Guardian Dele Olajide, who is responsible for protecting the confidentiality of patient information, and Murat Soncul, who leads on information governance.

After getting their approval we agreed on contracts and codes of conduct with each of the producers. These outlined their responsibilities and were necessary to ensure that any confidential information about a patient was not passed onto anyone else during their filming process. We also received approved criminal record checks from each producer.

Consent

The production team developed an extremely detailed consent protocol in close collaboration with Channel 4 and SLaM over many months.

Decisions about who to approach were always made in discussion with and only with the support of the clinicians in charge of the patient’s care. The Garden Productions always followed the basic principle that patients using mental health services are entitled to privacy and confidentiality and that only when a patient waives that could he or she feature in the finished programme.

If a clinician deemed a person fit to consent the producers were able to proceed. Each time the patient is filmed they are asked verbally for their consent. Some patients were able to give informed consent at the time of filming and were asked each time the crew arrived for filming if they were happy to continue.  Written permission is then needed from patients before any material is broadcast. At no time will any footage be broadcast of identifiable patients who do not or cannot give informed, written consent.

Where there was any doubt a patient had capacity to give informed consent the producers were advised by the trust to ask a patient to undergo a capacity assessment given by an independent psychiatrist.

Communication

Throughout the 12 months of filming we asked to be involved in every correspondence, decision and discussion on filming with patients and staff. It meant a constant bombardment of emails but this enabled us to monitor and therefore manage what was going on in each area.

Before the producers even embarked on research for each film we ensured we were in close contact with all staff potentially involved.

We accompanied producers to initial meetings, explained our reason for wanting to make the documentaries and gave them the opportunity to ask questions or opt out of filming.

People who didn’t want to be filmed

Whenever a patient, relative, friend or member of staff said they did not want to be on camera, the producers did not film them.  Some opted not to be in the film at all. Others said if they appeared in a shot they were happy to be blurred out during the editing process.

What editorial control/viewing rights does SLaM have?

SLaM had the right to view the programmes before transmission to point out any inaccuracies and anything that they believed to be unfair but they did not have editorial control.

Appropriate clinicians also watched every episode to ensure that, on broadcast, the tone and content of the programmes would not be detrimental to the welfare of the patients.

Who is responsible for ensuring the patients' welfare?

The patients’ welfare was and continues to be paramount and clinical decisions made by SLaM always have precedence over any other considerations.

The Garden producers are in touch with all patients in the series and have been since filming ended.

We are now on the last hurdle and these certainly make for exciting times. It’s been a year of hard slog, a few doubtful moments but mainly an absolute pleasure to be part of. And knowing that every step of the way we collectively put the best interests of patients at heart has made it even more rewarding.

We will continue to communicate with staff and patients throughout the broadcast period. If there are any questions relating to any aspect of the programmes please contact us at communications@slam.nhs.uk

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