Operation Nexo – improving the reporting of crimes in hospitals

The aim of Operation Nexo is to:

• provide a victim-focused approach to improve the number of positive criminal justice outcomes at Heartlands Hospital
• deliver targeted engagement, early intervention, and strong partnership working between West Midlands Police (WMP) and UHB
• demonstrate effective problem-solving in a complex environment, while improving performance and confidence in WMP and UHB

The intended outcomes of Operation Nexo are to:

• increase victim satisfaction and confidence
• increase the number of positive outcomes through the proportionate use of out of court disposals (OoCDs) and prosecutions
• reduce victim disengagement and delays to investigations
• enhance the support for deterrence and offender management
• improve partnership working between WMP and UHB

The neighbourhood policing team identified that while there was a high volume of crime linked to Heartlands Hospital, positive outcomes were limited. WMP engaged with hospital staff, which highlighted that there was significant under-reporting, particularly among women and the Black community. The reason provided for under-reporting was low confidence in policing and the wider criminal justice system.

A neighbourhood officer recognised the need to address this issue by strengthening partnership working with UHB. The neighbourhood officer used the problem-solving scanning, analysis, response, assessment (SARA) model to:

• identify the problem – opportunities for early resolution, victim satisfaction, and positive police outcomes were sometimes missed
• understand the causes – analysing crime types within Heartlands Hospital and their outcomes
• actions taken and interventions – ensuring victims feel heard, supported, and empowered to make informed decisions
• measuring success and outcomes – assessing victim satisfaction rates and interactions with frontline hospital staff

The officer and their sergeant worked together to develop a dedicated hospital liaison officer role, to work with UHB supporting frontline staff. The purpose of this role is to:

• review and improve reporting processes
• increase staff confidence in engaging with police
• improve the quality of investigations and outcomes

Implementation

Implementing Operation Nexo involves close partnership working with hospital leadership, staff networks, and operational teams. A key focus has been managing expectations and building trust between policing supervisors, officers, and hospital staff. Engagement sessions have been held with staff groups and managers to secure organisational buy-in and deliver a suitable approach. 

The hospital liaison officer is responsible for:

• enhancing victim engagement – ensuring hospital staff are fully informed on all available actions such as OoCR, rather than defaulting to case closure or prosecution
• clear communication of legal processes – differentiating police actions from court proceedings, allowing victims to make informed decisions and improving sustained engagement
• early suspect contact – proactively engaging suspects who frequently provide accurate personal details, encouraging accountability and reducing repeat incidents
• conducting timely and robust investigations – rapid completion of investigative fundamentals and early securing of CCTV and body-won video (BWV) evidence through established UHB relationships
• crime oversight and victim support – reviewing all crime within Heartlands Hospital to ensure accurate recording, appropriate outcomes, and continued victim communication

As part of Operation Nexo, a hospital watch scheme has been launched to reinforce the message that offences committed on hospital grounds will be addressed by WMP and UHB. To support the implementation process, £2,000 was provided by the West Midlands Police and Crime Commissioner (PCC) to support the printing of promotional booklets and posters.

Initial buy-in was provided at neighbourhood level by the local inspector and sergeant. As Operation Nexo has progressed, it has gained wider support from senior leadership within WMP and UHB.

The intervention has had a positive impact on trust and confidence in policing among hospital staff. Early findings and observations show that incidents which were previously unreported are now being formally recorded and shared with the force. This increase in reported crime is believed to reflect improved confidence in reporting rather than an actual rise in offending.

There has also been a noticeable increase in intelligence reports submitted to police, particularly in relation to drug use and dealing on hospital grounds. This has improved situational awareness and enabled more targeted policing activity.

A key outcome of the partnership has been the ability to engage directly with the UHB’s senior leadership team (SLT). This has allowed policing representatives to help influence policies and procedures that support staff in reporting incidents and engaging with investigations.

As a result of the positive outcomes and learning from this approach, the initiative is now being rolled out widely across other hospitals within the UHB Trust, including the Queen Elizabeth Hospital and Good Hope Hospital.

Feedback from staff has been encouraging, with many report feeling safer and more confident in reporting incidents to WMP and UHB. Staff have also expressed a greater confidence in supporting criminal justice processes and engaging with investigations.

One of the key learning points from implementing this initiative is the importance of understanding and adapting to the organisational culture and processes of the NHS. By aligning with health services’ processes, the initiative becomes embedded within policy and procedure rather than remaining as a short-term engagement project. A genuinely collaborative approach between police and the NHS has been critical to building sustainable change.

A significant early challenge experienced by WMP was the level of distrust some staff held toward policing and the wider criminal justice system. Building trust and confidence therefore became the primary focus of the engagement. This required consistent visibility, listening to staff concerns, and investigating reports. Engaging with staff networks, ward teams and the SLT is important in addressing concerns and improving relationships.

Another challenge was the capacity of the hospital liaison officer. Initially, only one officer was able to dedicate time to developing the partnership between WMP and UHB. While this allowed the initiative to get off the ground, it limited the pace of development to engaging with one hospital at a time. Greater resourcing capacity would have likely enabled wider and faster implementation across UHB.

Despite these challenges, the initiative shows promise that meaningful engagement can improve confidence, increase reporting and strengthen partnership working.

For forces looking to implement a similar approach, it is important to secure early support from immediate supervisors and neighbourhood policing leadership. By having the backing of sergeants, inspectors and senior decision-makers, this provides the necessary support and legitimacy for partnership working at a strategic level.