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Support after Shipman: the role of Victim Support and the Witness Service - Commentary and recommendations

The following commentary and recommendations have been written following discussions with the Preston Crown Court Witness Service, Tameside Victim Support, various others involved in the court procedures and a small number of family members concerned in the Shipman case.

Victim Support

The following are recommendations and points to address when Victim Support is involved in multiple homicide cases.

Leading factors

1. When an investigation concerns the working practice of a professional or other person who is trusted and has power regarding another's personal survival, it is likely that many lives will be touched. This will have implications for the number of contacts Victim Support might expect. While cases of multiple murder are rare, it is useful to have a backup position so that trained volunteers are available if necessary.

Families need prompt, skilled help. It is recommended that this help could come from regional teams drawn from local Schemes who can provide workers who are trained in helping those bereaved through homicide or multiple deaths. They could be brought together under a nominated co-ordinator when necessary but otherwise would normally operate within their own Schemes.

The teams would be 'floating' and could operate from the local Scheme headquarters. They would need special funding and regular training up-dates.

In fact, the period of time covered by this report has coincided with a period of structural change within Victim Support. Groups of Schemes have amalgamated their management across Areas (generally within counties) with a view to a more efficient delivery of services, more co-ordination and consolidated resources at a local level. Area management will enable the development of "floating teams" in a way which was not previously possible. (More information on Area management is given under no. 17).

Initial issues

2. National policy and local guidelines need to be clear regarding the services available from Victim Support for families bereaved through homicide.

It is recommended that policy statements and local guidelines should be made available to the senior investigation officer, coroner's and Crown Court clerks. They should include local contact names, addresses and telephone numbers. E-mail addresses are also useful.

3. Good lines of communication with the police about the investigation and its progress help co-ordinators to grasp the issues without being overwhelmed and to plan their work efficiently. Rules of confidentiality also need to be confirmed at an early stage.

It is recommended that contact with the police should be on a daily basis during the early part of the investigation so that the co-ordinator and volunteers are up-to-date with the progress of the investigation. Matters of confidentiality should also be clarified at the earliest possible stage.

Work processes

4. Working procedures around referral of families to Victim Support need early discussion with the police and legal advisers. The National Office should also be contacted and made aware of the situation.

It is recommended that a checklist of early contacts necessary to cope with the work should be drawn up locally and that the parameters of the role of Victim Support alongside others be flagged up.

5. Victim Support workers need information about the geographical area, any local practice agreements, and useful contact names and telephone numbers.

It is recommended that information packs should be available for the Victim Support workers involved with families. They should include maps of the area, Victim Support local agreements and policy statements, and brief details of the family with whom they are to work.

6. Family members who are geographically spread out may feel isolated and become further distressed and frustrated through lack of contact.

It is recommended that the Victim Support network should be used to make contact with families living out of the neighbourhood. Families could then be linked with the special Victim Support team assigned to the case.

7. Families may feel disappointment and anger in cases where the cause of death is established but where no trial will follow for legal reasons.

It is recommended that all families concerned should be offered help and the opportunity to discuss their feelings even where a trial will not take place. (This is in line with existing Victim Support practice that local Schemes should offer support to anyone affected by a crime, whether or not their case goes to court).

Support and supervision

8. Workers involved in complex and long-term cases need regular updating so that information is hopefully less overwhelming. Regular supervision helps support workers cope over longer spans of time. The co-ordinator would normally take on this role.

It is recommended that meetings to update should be arranged at least weekly with a daily review when circumstances demand, for example when crucial information is released, or during the trial.

Crown Court and beyond

9. Good working relationships are necessary between Victim Support and the Witness Service if families are to receive the best help and support throughout the period of the trial. Regular meetings normally facilitate this.

It is recommended that where a murder trial is to be held away from the normal operating area of Victim Support, early contact should be made with the Witness Service so that procedures, etiquette, legal issues and physical aspects can be discussed. (This is an existing requirement in the national Code of practice, section 1.5.4).

10. Familiarisation visits to court help families understand the layout of the court and surrounding facilities. They also clarify the roles of key figures who will take part in the trial, and provide an opportunity for the Witness Service co-ordinator to meet families and describe the support available for them during the trial.

It is recommended that, as far as possible, families and others who may be called as witnesses should be able to see the particular courtroom in which their case will be heard. Visits should be near enough to the trial date so that what is learned is still remembered when proceedings begin. (It is already a Code of practice requirement that court familiarisation visits should be offered to families and others who may be called as witnesses.)

11. Volunteers may arrange travel or accompany families to court. The trial judge, defence and prosecution barristers need to sanction this where more than one family travels together.

It is recommended that travel arrangements where Victim Support volunteer workers accompany more than one family to the court should be cleared and approved through the Witness Service co-ordinator with the trial judge, defence and prosecution barristers.

It is recommended that responsibility for reimbursement for travel and parking for the extra volunteers and families involved through multiple homicides should be clarified locally and nationally.

12. Having a Victim Support co-ordinator present at significant points in the trial, for example when the jury returns the verdict and when sentence is pronounced, can help families bridge the gap between court and the Scheme.

It is recommended that continual contact between the co-ordinators of Victim Support and the Witness Service should be maintained throughout the trial in order to maximise the help given to families and to establish when it would be helpful for the Victim Support co-ordinator to attend court.

Media contacts

13. Prior to and throughout the trial the media consistently approached the Victim Support co-ordinator for comment. Some help with the handling of high-profile cases, especially multiple homicides would be useful. While the National Office can and does help, media interest runs high locally and work with families needs careful handling.

It is recommended that, as co-ordinators need to be prepared for intense media interest where multiple homicides have been committed, training needs for dealing with multiple homicides be identified at local and national level, and appropriate training be devised.

14. Families were also approached by the media for comment.

It is recommended that families should be encouraged to seek help from the police press officer during the investigations, then from the court press officer during the trial.

The part played by others

15. Tameside Victim Support Scheme was called upon to assist families in this case. Their usual good practice meant that the Scheme supported the normal work and allowed the co-ordinator to concentrate on the particular work necessary to help a large number of families at the same time. This practice meant that the deputy co-ordinator and Scheme clerical assistant were able and trained to take over in the co-ordinator's absence. Their extra work was acknowledged through regular meetings with the co-ordinator who also kept them up-to-date on the progress of the case. High-profile cases can swamp normal work to the extent that workers feel undervalued. This did not happen in this case.

It is recommended that the local Victim Support Scheme staff should have regular contact with any co-workers assigned to special high-profile cases. Their support in bearing the extra burden of the normal workload for their colleagues should be acknowledged publicly and in any updates on the high-profile case.

16. The management committee became involved as soon as it was realised that this case would involve extra and high-profile work and quickly recognised the need for support of the co-ordinator, care of the volunteers and resource implications. Their continued interest and help was vital and appreciated.

It is recommended that that management committees should be informed as soon as the multiple nature of the case is known. They will have a variety of skills that can be used and play a vital role in helping the co-ordinator to maintain a balance between high-profile and normal Victim Support work.

17. The National Office engaged helpfully once the size of the task was appreciated. The presence of a National Office representative in the early stages would have been helpful to clarify the availability of financial and other help and to give encouragement in difficult work and commend good practice. Media issues could also have been discussed face-to-face early in the case.

As mentioned under note one, the period of time covered by this report coincided with a period of structural change and local Areas are now carrying out some of the functions that would in the past have been carried out by the National Office. Area managers would, for example, take on the role of conferring with the National Office and supporting local staff. However, in the Shipman case, there would still have been issues around communication and co-ordination to resolve as the local Scheme and Witness Service were in different Areas.

In addition, the National Office now has a Members' Helpdesk, which acts as a central contact point for members.

It is recommended that the respective roles of National Office and Area office staff with respect to co-ordination in cases of multiple homicide be clarified. A named member of staff should be nominated to provide a proper link for local co-ordinators when dealing with multiple homicides or other high-profile cases. An early visit from that staff member would be informative and helpful.

Lack of finances became a problem that was eventually worked out between the local Scheme and the National Office.

It is recommended that there be a named person at the National Office who can provide information about financial support in such cases. It is also recommended that clear guidelines be made available about financial support in cases of multiple homicide where the burden of extra work falls on the local Scheme, including information about contingency funds. [The National Association now has a contingency fund set aside for such emergencies].

18. Adjoining Victim Support Schemes were, in this case, extremely helpful. In essence they provided a special team of volunteer workers who worked exclusively on this case.

It is recommended that a regionally based, rapid response specialist team should be considered. This team could be on call for Victim Support Schemes faced with a sudden volume of work.

It is recommended that such teams be financed by the local Schemes and through National Office funding and be given appropriate national training in high-profile situations and multiple homicide work. The development of regionally-based teams might be aligned with the new Area structure.

19. The Witness Service came together with Victim Support and produced working guidelines, information packs and training in order to cope with this high-volume and high-profile situation. There were no rivalries and they "shared" families and acted within the parameters of agreed work so that families were given the best possible support and help.

It is recommended that help and support for families should be the focus of all work so that best practice is achieved through co-operation and properly discussed agreements on practice. (This is existing Victim Support practice and is in accordance with our commitment to providing a "seamless service" - see Code of practice, section 1.5.3).

20. Police and other officials exchanged information, were willing to discuss any issues that would help families, and were willing to change some local procedures to these ends. Good relationships, which had been established and nurtured over a period of time, provided a firm grounding in this special situation. Victim Support worked in co-operation through frank discussion without compromising its independence.

It is recommended that good working agreements should be in place but if not, cases similar to Shipman may provide the opportunity to establish good contacts, especially as help for the families is central to the work of all.

Continuation

21. The case continues and it is producing more families and more work for Victim Support. Extra staff are now in place and the co-ordinator has returned to normal duties, handing over the Shipman work to another member of staff whilst retaining overall managerial responsibility. This work is likely to last a further two years and will incorporate the public inquiry.

It is recommended that where there is a continuation of work beyond the trial. Another member of staff should take on the responsibility for that work. The risk of fatigue is greater once the flow of adrenalin associated with the trial and sentence is over.

Witness Service

The following are recommendations and points to address when the Witness Service is involved in multiple homicide cases.

Initial issues

22. The actual amount of work necessary to sustain families during the trial may be difficult to gauge and the number of Witness Service volunteers necessary to support the work may be larger than that available. In the circumstances, the volunteers may need to have repeated involvement.

It is recommended that the agreed practice between judge, barristers, CPS and the Witness Service about involvement of volunteers more than once, mentioned above, should be followed.

23. The Court Users Group also needs alerting to the extra dimensions of multiple homicide cases.

It is recommended that an early meeting of the Court Users Group be convened so that issues can be discussed and protocols agreed. This will save time and effort later.

It is recommended that, where a Court Users Group does not meet regularly, a meeting between the key people involved should take place.

24. As multiple cases will be heard over a longer period of time, and for greater efficiency of work, there should be two senior Witness Service workers assigned to co-ordinate the work.

It is recommended that a total-team approach, with the co-ordinators as leaders, should be used. Meetings should not only include matters regarding the use of the specific skills of those specially assigned to the high-profile case team, they should also allow for the sharing of knowledge and creation of room for breaks in the work. A team approach also allows the co-ordinator(s) to take overall charge, still properly supporting the other team members and involving them in the decision-making. This means it is less likely that alienation occurs between the specially allocated workers and the rest of their colleagues.

25. Early face-to-face meetings between co-ordinators in the Witness Service and Victim Support involved with families are important.

It is recommended that meetings between Witness Service and Victim Support co-ordinators be arranged as soon as possible after the decision is made about the venue of the trial.

It is recommended that where possible, face-to-face meetings should happen throughout the case. Where this is difficult for reasons of geography, it is helpful to arrange at least one face-to-face meeting so that each co-ordinator has a visual and more personal image of the other, that can be shared with the families involved.

26. The parameters of each role: the Witness Service and Victim Support.

It is recommended that work agreements be written down clearly and for distribution to all interested parties, including the families, where relevant. They need to be clear about who is responsible for what and the tasks each individual or group will undertake. The tasks for the Shipman trial have been defined earlier in the text and comments made on best practice, but there may be different tasks which arise and need discussion about the support of families, depending on the local circumstances.

27. Visit to the incident room to meet the Chief Investigation Officer (CIO) and Family Liaison Officers.

These meetings for the senior Witness Service workers responsible may seem superfluous but they aid understanding of the working practices and can preempt problems. They also put faces to the names of the CIO, and his/her investigation team and aid recognition during the trial when it can be difficult to find relevant people quickly.

It is recommended that visits to the police incident room be encouraged.

Physical issues

28. Availability of rooms for families during and after the trial, and for any emergencies that might occur needs to be clarified. Even if Witness Service work is to take place within the normal court buildings, there may be a need for extra accommodation, over and above that recommended in existing guidance. Families will need to be separated for legal reasons - non-contamination of evidence - at various stages of the trial eg, having given evidence, the witness can remain in the court and must not mix with those witnesses who have not given evidence. Also, if half way through giving evidence there is a break, those witnesses need to be isolated from others.

It is recommended that a sufficient number of rooms that provide a warm, safe setting be allocated to the Witness Service for families at various stages of the trial. NB Smokers will also need a safe and private place or may need to be accompanied if they go outside the court buildings).

29. The availability of a private room with a telephone line for Witness Service workers needs to be clarified. While most calls could be made with a mobile phone, there will be occasions when a longer or more confidential call needs to be made. In most cases this facility will be available in the normal Witness Service office, but if the court is sitting in a different place than normal, this facility needs to be agreed.

It is recommended that a private room with a telephone line is made available to the Witness Service for confidential calls.

30. Safe places for handbags and coats.

It is recommended that space be provided for coats and handbags in a secure place where access is supervised. This will remove a burden from the family when in the courtroom.

31. Private access to food and drink and private access to toilets.

While eating and drinking may be difficult for families, if facilities can be offered so that families can be away from the public gaze it may encourage them to eat and drink, and is also a demonstration of caring. Some negotiation may be necessary if private access to toilets is a problem.

It is recommended that, wherever possible, private access to areas for food and drink and toilets be negotiated with the court manager.

Familiarisation with court buildings and procedures

32. This was logistically difficult but a schedule was worked out that could take place mainly during the summer recess. Families need to be familiar with court buildings, where people concerned in the trial sit, and their roles. Pre-trial visits to court are therefore invaluable and a concrete way of supporting them. The number of times any one family can be accommodated may need discussion and the outcome will depend on individual circumstances. It may be helpful to consider the timing of the visit in relation to the part of the trial that is most relevant to the family, and the best time for them to absorb the information. Families may need more than one visit.

There is also the question of visits by "other" families whose deceased relative may not be the subject of the case in hand, but whose death may be suspicious - as in the Shipman case, where only a handful of deaths were the subject of the court case, but many more were investigated.

It is recommended that pre-trial visits to court should be offered to families concerned with the trial. It is also recommended that visits by those other than directly involved families are discussed with a view to providing familiarisation visits, as it may be the only time such families will have their day in court. (It is Victim Support practice to offer support to victims and their families and friends when they attend court, whether or not they have been called as witnesses).

33. It may also be that others involved, eg, police officers and specialist witnesses, may also appreciate such visits being arranged for them separately.

It is recommended that familiarisation visits should be offered, wherever possible, to police officers, specialist witnesses and witnesses not connected as family.

Seating in court

34. This was naturally a concern for families and it was dealt with through early negotiations between the co-ordinator and court manager. Separate seating for families is not normally a problem, but in cases of multiple homicide a larger number of families may wish to be accommodated at any one time.

It is recommended that a larger number of seats be negotiated for families of multiple homicide victims.

Separate entrance/exit points

35. Separate court entrance and exit points give families a choice regarding whether or not they wish their comings and goings to be private. They will need to be negotiated with court officials, but use of a fire door may be permitted if a rear or side exit is not available.

It is recommended that separate entrance and exit points be negotiated for families.

Place for media interviews

36. A proper place for media interviews rather than a free-for-all outside court provides a dignified arena for what might be very painful interviews for families.

It is recommended that somewhere where families can be interviewed, other than on the pavement, is identified. It may be that the police press officer, or a court official will arrange such interviews rather than the Witness Service but the facility may need to be negotiated on behalf of others.

Witness Service work during court hearing

Work during the Shipman trial involved the normal methods of supporting families throughout a trial but in this case some different methods were necessary due to the number of families being supported.

37. Code of practice and new protocols

Each court will have its own local practices and protocols that will need to be discussed as they will normally expand or change. A recommendation made earlier in the text regarding the involvement of the Court Users Group covers the above.

A recommendation is also made earlier in the text regarding a protocol for use when volunteers are used more than once to support a witness in court during a multiple homicide case. Such a protocol needs to be agreed by prosecution and defence barristers, and approved by the trial judge.

38. Forward planning for the end of the trial

End-of-trial media interest can be distressing for families if they are unprepared. Help in making statements to the press is useful and this can be done through the court manager or Lord Chancellor's Department press office.

It is recommended that the court manager and Lord Chancellor's Department press office be contacted for help in media matters for families.

Supervision and support

Supervision and support for volunteers and co-ordinator(s) are essential if they are to be helped with both management of the logistics and the distress of families.

39. Co-ordinator supervision and support

In accordance with the Code of practice and Supervision model, all co-ordinators should have regular supervision from their line manager or from a suitably qualified member of the management committee. If no-one on the management committee has the appropriate skills and it isn't possible to recruit a suitable person onto the committee, a supervisor can be appointed from outside the committee. In high-profile cases like this, supervision should be on a weekly basis.

It is recommended that regular weekly supervision sessions with a properly qualified person take place. They are essential for co-ordinators who will in turn supervise the volunteers.

40. Regular supervision and day review sessions for volunteers

It is recommended that review sessions with volunteers be held on a daily basis, but extra time be made for reflection and to raise current issues so that they can be resolved with the minimum difficulty. This will reflect in the quality of support given to families.

It is recommended that, during a long trial, volunteers should have a meaningful daily contact with the co-ordinator. This can be informal, or more structured, depending on the needs of both individuals, but should include discussion of factual issues as well as feelings regarding the evidence being given in court and the effects on the families.

The role of the management committee

41. The active involvement of the management committee was very important as it was through their concerns that issues were addressed and outside support for the co-ordinator was arranged so that she in turn could support the volunteer workers.

It is recommended that the management committee take an active part in events by keeping in touch with the co-ordinator through their line manager regarding the progress of work. Through this the co-ordinator will have support and the confidence to discuss issues as they arise. Some members may have specific skills that could be helpful in management of a long-term and high-profile case.

It is recommended that regular meetings between the co-ordinator and/or their line manager and the management committee should be planned in the work diaries of both as soon as a case of this magnitude is identified.

Jury deliberation and verdict

This brings a mixture of emotions for all involved and no-one should be left to simply go home having completed a long and difficult period of support for families.

42. Immediately post trial

It is recommended that review sessions be held with volunteers and that they be thanked for their efforts.

It is recommended that the Witness Service co-ordinator should have a session with his or her personal supervisor as soon as possible following the trial, and preferably on the same day. A further opportunity to talk through the whole case and mark up strengths in the work completed as well as points for development should be booked. The co-ordinator may need supporting emotionally following the natural sense of deflation after a high-profile and lengthy trial. Points that will be helpful in future situations can be lost if not recorded fairly soon after the event.

The media and the Witness Service

43. Contacts with the media need to be considered when planning meetings take place. As noted, families may need help with preparing statements and meeting the media representatives.

It is recommended that in a high-profile multiple homicide case, both Victim Support and Witness Service co-ordinators plan local strategies for dealing with the media and prepare local guidelines for the future.

General comments

Juries

44. One other issue arose through this case. It was observed that the jury involved had listened to a trial which had many painful and difficult aspects not only for the bereaved families, but also for other former patients of Harold Shipman. The case touched the wider public of Hyde and had implications regarding the trust placed in doctors generally. While at the end of this case the judge's comments to the jury acknowledged their difficult work, the possibility of Witness Service support for juries is something that needs wider discussion.

While it was not in the briefing of this research, the needs of juries who sit on these difficult cases should not be ignored. Indeed, the help they might need should be assessed properly and the means found to assist them.

It is recommended that support for juries be explored by Victim Support National Office.

The co-ordinator's deputy

45. It is recommended that the co-ordinator keeps the deputy up-to-date on the progress of the case on a daily basis and ensures other work problems are discussed. The meeting is also an opportunity to show appreciation for and value of the normal work being done.


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