…to not get these 24 hr in A& E ‘fly-on-the-wall’ documentaries?

[NellesVilla]

Good evening, all,

So I’m watching that 24 hours in A & E show and although I’m reasonably bright, I’m just wondering how they go about filming the separate stories?

Do they just shove a camera in the face of someone who’s just broken their back and neck in a road accident or would they speak to the family first if the victim is unconscious?

It’s not like they can go “Oh mate, I know you’ve crushed your pelvis and are in excruciating pain, but before we sedate you, could you sign this waiver for filming, please?” Or say to the family: “Yes, dad’s dying but could we do a few close ups, please?”..

I’m honestly interested and fascinated about this and ethically, how people feel about genuine victims/patients being filmed in the aftermath of a horrific crash?

Also- and yes I’ve had a drink as a non-drinking person so could be overthinking this- but do we really believe that they’re like that on the arrival of a new patient? When they stand to attention and listen reverently to the head surgeon give their orders on what to do with the patient? Is this staged? Bigged up for telly? Or is A & E really like this- a theatre in a theatre?

Also the 24 hours in police custody thing: are they allowed to film the suspect? If I were a possible murderer I know you’ve probably waived some rights such as privacy, but personally I’d hardly want to be filmed and perhaps wouldn’t answer the questions properly under that pressure.

I can’t answer the rest, but of course they bloody listen closely to their superior telling them how to treat a patient.

I can’t speak for the police, but in A&E, yes we all listen and only one person talks. Usually first the paramedic delivers the case, and then whoever is running the trauma will lead the exam and give out tasks. This could be the consultant, ENP, or a reg. We all stand still and we all listen because if we don’t pay attention and we don’t all work together then the patient could easily die because we missed something. In a lot of serious cases, you have what is called the golden hour, which is the tiny window you have to reverse or stem life threatening illness or injury. We can’t waste that by not paying attention or talking over each other.

In terms of the filming, I imagine they have fixed cameras dotted around and film basically everything and then cut down what they need subject to consent and storyline.

I've seen signs up in hospitals and other locations with some version of say "Filming is taking place in this location for X, if you have concerns speak to Y".

I've never actually had concerns (I'm not that interesting...), so I don't know what happens if you do!

Thanks, particularly @ElizabethBest- all really interesting.

In a resus- that's how it's done. Paramedics give the handover, Dr in charge then directs the resources both medical and nursing. Everyone has a defined role and knows what they are expected to do. People don't generally speak over each other as important information could be missed.

I know that when I was taken to A and E on blue lights it was exactly like that. The paramedics phoned ahead and put them on standby and when the ambulance doors opened hospital medical staff were waiting. They took me to resus and a team were waiting. The handover was just like on TV, one doctor led and each member of the team knew exactly what they were supposed to be doing. The paramedics stood out of the way at the edge of the room watching. It’s very reassuring to see how they focus and work together so well, all the while reassuring you.

The production team includes a bunch of people who go around getting consent from patients and next of kin. They can withdraw consent at any time though.

It’s called ‘fixed-rig documentary’, you can read about it here. rts.org.uk/article/how-fixed-rig-has-transformed-factual
It is complex ethically, only large production companies can deal with the complexity and have adequate technical, legal, ethical advice etc. in place.

I know a bit about this as they were setting up to film 24 hours in A&E in my department- I left before filming started but they had do trial runs and friends still worked there and told me about it.
Basically when patients arrive they are consented asap (as soon as practical) and asked if the cameras can just roll and capture the footage- they can withdraw consent at any time for this. Family are asked if patient can’t consent- they are reassured they can change their mind and will be able to review the footage before it’s on tv. When things have calmed down (eg patient been seen, know they’re not imminently going to die etc!) producers will then ask if they can clip a microphone on and ‘stage’ the area (ie ask relatives to not stand in the way of cameras etc). Obviously all the interviews are filmed way later.
And yes- the red phone rings like on tv and we get a summary. A group of staff are then ready to receive the patient and everyone is quiet for handover as it’s important. It’s decided before the patient arrives who will lead the admission- usually A&E consultant but sometimes anaesthetist if they need tubing etc. it’s generally calm as we are used to sick people!

So interesting, @NameChangeLifeChange, but that annoying phone noise. I’m always like: “ANSWER THAT BLOODY PHONE!”…

@NellesVilla if I remember correctly you had to answer it within 3 rings or ‘something happened’ (eg your superiors were informed of staff not being quick enough). Not sure if that was actually the case but it remember sprinting across the department for it if I was the only one around on a night shift. Good times!

The noise of that bloody phone still haunts me, why can't it be something distinct but not soul tearing?

@Hillrunning You kind of want it to be something that makes your adrenaline jolt a bit though tbh.

I don't think they should be allowed to film and ask for consent later. They still have the footage!

It's unethical.

The footage is taken and often would be taken for safety reasons anyway, just like police or debt bailiffs who wear body cams. Or CCTV in lots of places. Or even people cycling on the street with helmet cams or drivers with dash cams. Or even that sodding security camera inside Matt Hancock's office...

On telly, A lot of background people get faces fuzzed out so obviously never gave consent.

I luffs 24 hrs in A&E. It's well produced.

Really? Hospitals often film people in cubicles and record their private conversions without consent for safety reasons?

There is CCTV in ambulances. It says that on some announcement thing when you get in them,

CONVERSATIONS, not conversions!

I have a friend who was on 999: What's Your Emergency. It was a recording of the phone call of her contacting the police. She gave consent for it to be in the final program, as the person she was reporting appeared in it anyway. She asked for her voice to be distorted. The program was aired, and they did not distort her voice. She had loads of people contacting her asking about it as they recognised her.

A few series have been filmed in my hometown, and at the time, I was having a lot of MH crisis. I somehow avoided being filmed, but the prospect of it scared me to death. The cops said the film crew were a drag and made things difficult. They also said that if I was filmed and did not give consent, I could still be in the series anyway but blurred out. I hope that is a load of shit tbh..

@NellesVilla
at a trauma call or an arrest there’s someone who leads who stands at the foot of the bed and oversees.
If it is a patient who is peri-arrest/really unwell requiring stabilising then you might have an a&e senior overseeing while other team members get IV access/give drugs/do assessments

I imagine they have signs up, and then seek proper permission afterwards when they decide which stories to show. They must film lots of stuff that doesn't get shown. If you notice, some people have faces blurred out, I assume they're the ones who hadn't given permission.

I love those documentaries, I think they show how superb and how caring the staff are. Doctors/nurses/paramedics, the staff in ambulance call centres, they are amazing. Saving Lives at Sea too, those RNLI volunteers omg.

My current favourite is Ambulance, the one with the call centre and the paramedics. There was an absolutely amazing young lady a couple of weeks ago who was on the initial 999 call and spent ages calming down a caller who was going to stab a load of police officers. She talked to him for like 2 hours and got everyone out of the situation safely and got the bloke to walk calmly into an ambulance and go for psychiatric treatment. She was only about 22, really something.

I got filmed for helicopter heroes years ago when I worked in A&E in Leeds.
The camera crew just turned unannounced with the patient in resus. We just carried on working like they weren't there and they didn't get in the way.
The patient was a 4 week old baby so I don't know if they ever spoke to the parents about permission to film etc but they definitely didn't ask us if we we're happy being filmed at work.
It never made it onto TV and I don't know if that was down to parents refusing permission (I can't imagine they would have agreed given the circumstances) or whether it was because there wasn't much to see and film. We had the baby on a resuscitaire with 4 staff members around it so we would have pretty much blocked their view.

I imagine they have signs up, and then seek proper permission afterwards when they decide which stories to show. They must film lots of stuff that doesn't get shown. If you notice, some people have faces blurred out, I assume they're the ones who hadn't given permission

Yes, that was what I was told by the police. That if you did not give consent (or even know) then they would just blur your face out.
I really hope it is not true, and that consent was sought multiple times before even considering it for airing on TV. If my face had been blurred, I would still have been recognised by my friends/family as I dressed very distinctively.

I love 24 hours in A & E, especially when Consultant Will McGuiness is on, he has such a nice calm voice.