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Content ArticleThe Northern Ireland Department of Health's Mental Health Strategy Delivery Plan for 2022/23 sets out the prioritised workstreams under the 2021-31 Mental Health Strategy, which was published in June 2021, alongside a ten-year Funding Plan. It outlines governance and monitoring arrangements, actions currently in progress and actions that will be delivered at a later date. The Delivery Plan is published alongside Mental Health Strategy Co-Production/Design Principles, designed to give structure and meaning to the Department’s desire to ensure continued co-production throughout the implementation of the ten-year Strategy.
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Content ArticlePeople with a learning disability and autistic people should have the right support in place to live an ordinary life and fulfil their aspirations, in their own home. This action plan from the Department of Health and Social Care (DHSC) aims to strengthen community support for people with a learning disability and autistic people, and reduce reliance on mental health inpatient care. This action plan outlines the government's policy to achieve this by: strengthening community support. reducing the overall reliance on specialist inpatient care in mental health hospitals. improving the experiences of people with a learning disability and autistic people across public services such as health, social care, education, employment, housing and justice. It brings together the commitments that have been made by different organisations to realise these aims, and aims to drive long-term change for people with a learning disability and autistic people.
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News Article
CQC prosecutes troubled provider over death of teenage girl
Patient Safety Learning posted a news article in News
A struggling mental health trust is being prosecuted over accusations it failed to protect a teenager at a children’s inpatient unit. Tees, Esk and Wear Valleys Foundation Trust ran the former West Lane Hospital in Middlesbrough until the Care Quality Commission (CQC) closed it in 2019. The CQC is now prosecuting the trust, alleging it breached the Health and Social Care Act 2008 in relation to the death of Christie Harnett, who took her own life at the facility in June 2019. In a statement, the regulator claimed TEWV “failed to provide safe care and treatment” by exposing the patient to a “significant risk of avoidable harm”. A CQC spokeswoman added: “Our main priority is always the safety of people using health and social care services, and if we have concerns we will not hesitate to take action in line with our regulatory powers. We will report further as soon as we are able to do so.” Read full story (paywalled) Source: HSJ, 30 June 2022 -
Content ArticleThe government has published a draft Mental Health Bill for pre-legislative scrutiny. The bill aims to modernise the Mental Health Act for the 21st century.
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Content ArticleThe poor treatment of autistic people and people with learning disabilities has been a long-standing problem for the NHS and care system. Although successive governments have focused on supporting autistic people and people with learning disabilities to live independent and fulfilled lives in the community, over 2,055 people remain in secure institutions where they are unable to live fulfilled lives and are often subject to unacceptable and inhumane treatment. This report by the Health and Social Care Select Committee chaired by Jeremy Hunt MP outlines the finding of the committee's Inquiry into the treatment of autistic people by health and care services.
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Content ArticleThe Quality Network for Inpatient Working Age Mental Health Services (QNWA) based within the Royal College of Psychiatrists' Centre for Quality Improvement are pleased to announce the publication of their 8th edition standards. Since the publication of the first edition standards in 2006, the Network has grown to include over 140 members from the NHS and private sector. This new edition of standards aims to reflect the changes in working practices and legislation over the last two years in addition to placing greater emphasis on equality, diversity and inclusion as well as sustainability in inpatient mental health services. The eighth edition standards have been drawn from key documents and expert consensus and have been subject to extensive consultation with professional groups involved in the provision of inpatient mental health services, and with people and carers who have used services in the past.
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Content ArticleThis Healthcare Safety Investigation Branch (HSIB) investigation explores medicines omission among patients with learning disabilities who are cared for in medium and low secure wards in mental health hospitals. A medicine omission is when a patient doesn't receive medicines that have been prescribed to them, and the investigation focused on a number of factors that could contribute to omission: the environment in which medicines administration takes place the availability and use of learning disability nurses in these environments the skills required for nurses to help patients with learning disabilities be involved in choices about their medicines. For it's reference event, the investigation looked at the case of Luke, who was detained in a medium secure ward of a mental health hospital. He spent 21 months on the ward before moving into a low secure ward at the same hospital, where he stayed for a further 11 months. Both wards were specifically designated for patients with learning disabilities. While at the hospital, there were a number of periods when Luke was not given the physical health medication he had been prescribed for his diabetes and high cholesterol. Although Luke’s medication record regularly noted that Luke refused the medication, Luke and his Mother disagreed with this version of events, stating that other factors led to Luke’s medicine omissions.
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News Article
Inquiry opens into alleged patient abuse at Muckamore Abbey
Patient Safety Learning posted a news article in News
A public inquiry has opened into allegations of extensive and repeated abuse of patients at Muckamore Abbey, a hospital for vulnerable adults in Northern Ireland. The inquiry’s chair, Tom Kark, said at the first hearing on Monday that the allegations of abuse and neglect at the psychiatric facility outside Belfast, in County Antrim, brought the medical, nursing and care professions into disrepute. “Many of the parents and relatives and carers who trusted the hospital have been let down and they are understandably furious and some feel guilty,” he said. Kark, a QC, said a civilised society had a duty to care for people with learning disabilities and mental illness. Police have arrested 34 people and more than 70 staff have been suspended as a precaution since the alleged abuse came to light in 2017. The police investigation will proceed in parallel to the inquiry. Detectives have viewed about 300,000 hours of CCTV footage from the hospital. Relatives of patients hope the inquiry will shed light on accounts of mental and physical abuse and neglect at what used to be considered one of the best facilities of its kind in Northern Ireland. The hospital currently has about 60 patients, down from about 1,500 in the 1980s. “Without pre-determining any issues, it’s quite obvious that bad practices were allowed to persist at the hospital to the terrible detriment to a number of patients,” Kark told the inquiry. Read full story Source: The Guardian, 6 June 2022 -
Content ArticleThis report published by the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) looked to identify and explore remediable factors in the clinical and organisation of the physical healthcare provided to adult patients admitted to a mental health inpatient setting. The report suggests that a physical healthcare plan should be developed when patients are admitted to a mental health inpatient setting. Other key messages aimed at improving care include calls to: formalise clinical networks/pathways between mental health and physical health care; involve patients and their carers in their physical health care, and use admission as an opportunity to assess and involve patients in their general health, and include mental health and physical health conditions on electronic patient records.
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News Article
Urgent patient safety warning at hospital facing police probe
Patient Safety Learning posted a news article in News
A private hospital facing a police investigation following a patient’s death has been given an urgent warning by the care regulator due to concerns over patient safety. The Huntercombe Hospital in Maidenhead, which treats children with mental health needs, was told it must urgently address safety issues found by the Care Quality Commission (CQC) following an inspection in March. The CQC handed the hospital a formal warning due to concerns over failures in the way staff were carrying out observations of vulnerable patients. The move comes as The Independent revealed police are investigating the hospital in relation to the death of a young girl earlier this year. In a report published last week, the care watchdog said it had received “mainly negative” feedback from young people at the hospital’s Thames ward, a psychiatric intensive care unit which treats acutely unwell children. Commenting on the hospital overall, the report said: “Young people told us that staff did not follow the care plans in relation to their level of observations. They told us that if there was an incident the staff stopped doing intermittent observations. Staff in charge of shifts on wards asked new staff members to do observations before they understood how to do it. Staff had to ask the young person how to carry out their observations as they did not always understand what was expected of them in carrying out different levels of observations.” Read full story Source: The Independent, 19 May 2022 -
News Article
Death toll of autism and learning disability patients revealed
Patient Safety Learning posted a news article in News
Fourteen patients with autism or learning disabilities have died since 2015 while detained in psychiatric facilities in Scotland, figures reveal. The statistics were released for the first time by Public Health Scotland (PHS) following a parliamentary question by Scottish Conservative MSP Alexander Burnett, who has campaigned to end the “national scandal” of otherwise healthy people being locked up for months or years due to a lack of community-based support. The PHS report does not detail the causes of death, but does show that seven of the deaths occurred in patients who had been resident at an inpatient psychiatric facility for between 91 and 365 days, with six (43%) in patients whose stay had exceeded at least one year. Rob Holland, acting director of the National Autistic Society Scotland, said the data was a “step forward in understanding the experience of autistic people and people with a learning disability within inpatient psychiatric facilities”. He added: “While it does not shine a light on the reasons for the deaths it does highlight how almost all of those that died had been within institutional care for more than 30 days with 6 people having been there for more than a year. “Hospitals are not homes and it adds further impetus to the Scottish Government’s ‘Coming Home’ strategy to reduce delayed discharge and support people to live in homes of their own choosing.” Read full story Source: The Herald, 18 May 2022 -
News Article
Ukraine refugees in UK face waits of up to two years for war trauma therapy
Patient Safety Learning posted a news article in News
Traumatised Ukrainian refugees who have sought sanctuary in the UK may have to wait two years before they can get specialised therapy to help them heal from the horrors of war, according to experts. Therapists who specialise in treating war trauma say they have seen NHS waiting lists of two years before refugees can access the specialist treatment they need. Services across the UK are patchy with some areas “treatment deserts when it comes to trauma”, according to Emily Palmer-White, a psychotherapist and community manager at the charity Room to Heal, which provides support for people who have fled persecution. “There are often extremely long waiting lists. I have been told two years. You can’t separate the psychological from the practical – it’s more difficult to help people if they’re preoccupied with survival,” said Palmer-White. A spokesperson for the Department of Health and Social Care said officials recognised the trauma Ukrainians were facing and stood shoulder-to-shoulder with them. However, beyond having access to NHS care officials did not cite any specific provision to provide newly arrived refugees with trauma support. Prof Cornelius Catona, of the Royal College of Psychiatrists, said the visa delays of several weeks would likely exacerbate mental illness for those already struggling and that the refugee schemes should have included a mechanism for spotting signs of trauma early. Viktoriia Liamets, a Ukrainian child and family therapist who recently arrived in the UK after fleeing the war, said Ukrainians arriving in Britain had multiple and complex traumas to contend with. Read full story Source: The Guardian, 9 May 2022 -
Content ArticleAn investigation started on 9 October 2020 into the death of Matthew Alexander Caseby. Following his admission and subsequent absconsion from the Priory Hospital in Edgbaston, Matthew stepped in front of a train on the 8 September 2020 and was fatally injured. At the time, Matthew was suffering from disorder thinking and did not have the capacity to form any intention to end his life. Matthew absconded from Beech ward over a fence in the courtyard area and at the time of his absconsion Matthew was unattended. It was inappropriate for Matthew to be left unattended in the courtyard. There were concerns regarding Matthew absconding but the recording processes on Beech ward were inadequate which resulted in the communication to staff involved in Matthew's care being lacking. As a result of risks not being fully recorded, Matthew's risk assessment was not adequate as it was not based on all of the available information. Overall, the inadequate risk assessment for Matthew, the inadequate documentation records, the lack of a risk assessment for the courtyard area and the absence of a policy regarding observations levels in the courtyard means that the courtyard was not safe for Matthew to use unattended. His death was contributed to by neglect on the part of the treating hospital.
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News ArticleThe death of a young woman a day after she was discharged from a mental health facility has sparked renewed calls for a public inquiry into a scandal-hit trust. Abbigail Smith, 26, who had autism and learning difficulties, was found dead in a park in Essex in February, 24 hours after she was allowed to leave the Linden Centre run by the Essex Partnership University Hospitals Foundation Trust (EPUT). The trust has launched an investigation into the care she received before she died, according to a letter seen by The Independent, and Essex Coroner’s Court will examine her death. The Independent can reveal 97 patient deaths have been declared by the trust between February 2021 and February 2022 under the national patient safety alert system. The trust is already facing an independent inquiry into 1,500 patient deaths between 2000 and 2020. Deaths after December 2020 will not be looked at by that inquiry. At least 68 families have called for a public inquiry into mental health services in Essex, led by Melanie Leahy, whose son Matthew died at the Linden Centre in 2012. Nina Ali, a solicitor at Hodge Jones & Allen, which is supporting the Wolffs and other families, told The Independent: “It is worrying that the government has and continues to completely ignore the call led by Melanie Leahy, now supported by some 68 families and individuals, for the current independent inquiry to be converted to a full statutory inquiry on the basis that the current inquiry – which lacks the statutory power to compel relevant documentary evidence to be obtained and to compel witnesses to attend and give their evidence under oath – will ultimately prove to be a complete waste of time and money.” Read full story Source: The Independent, 25 April 2022
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News Article
Children’s services rated ‘inadequate’ as trust remains ‘outstanding’
Patient Safety Learning posted a news article in News
The children’s inpatient unit at an ‘outstanding’ mental health trust has been downgraded to ‘inadequate’ by the Care Quality Commission (CQC), amid a surge in demand for its services. The CQC previously rated child and adolescent mental health wards at Hertfordshire Partnership University Foundation Trust as “outstanding” in May 2019. But after an inspection in November and December 2021, these services were downgraded to “inadequate” overall and for the key categories of safety and leadership. Although inspecting a core service, the CQC said its visit was “not wide-ranging enough” to update overall trust ratings, so HPFT remains “outstanding” overall. Teenagers aged from 13 to 18 and admitted to Forest House, a 16-bed unit in Radlett providing HPFT’s only inpatient service for children and adolescents, told CQC inspectors they felt “unsafe”, dissatisfied with their care, and had experienced bullying by fellow patients. Leadership in the service had “significantly deteriorated” since previous inspections, CQC chiefs wrote in a report published today, and this was having a “knock-on effect in all areas of care being provided”. Staff morale was low and access to clinical psychologists limited, with a reduced ability to provide therapeutic interventions, inspectors added. Read full story (paywalled) Source: HSJ, 30 March 2022 -
News Article
1,500 deaths to be investigated at scandal-hit mental health trust
Patient Safety Learning posted a news article in News
More than 1,500 patient deaths are to be investigated in the largest-ever independent inquiry into “unacceptable” mental health care. A probe into the deaths of patients who were cared for by NHS mental health services across Essex has revealed its investigation will cover deaths from 2000 to 2020. All 1,500 people died while they were a patient on a mental health ward in Essex, or within three months of being discharged from one. In 2001, following an investigation into 25 deaths, police criticised the trust for “clear and basic” failings but did not pursue a corporate manslaughter prosecution. And in 2021, the Health and Safety Executive fined the trust £1.5m due to failures linked to the deaths of 11 patients. The regulator said the trust did not manage the risks of ligature points for a period of more than 10 years. In January 2021, following pressures, former patient safety minister Nadine Dorries commissioned former NHS England mental health director Dr Geraldine Strathdee to chair an independent inquiry. While it is not known yet how many of the 1,500 deaths were caused by neglect, Dr Strathdee said evidence had so far shown some “unacceptable” and “dispassionate” care. Melanie Leahy, who has campaigned for change within Essex mental health services since her son died in 2012, has been leading the call for it to become a public inquiry on behalf of the families. Her son, Matthew Leahy, died as an inpatient at the Linden Centre, following multiple failings in his care. A 2018 parliamentary health service ombudsman report on his death, and that of another young man called Richard Wade, identified “systemic” failings on behalf of the trust. These included the failure to manage his risk level, to look after his physical health and to take action when he reported being raped in the unit. Read full story Source: The Independent, 28 March 2022 -
News Article
Women died after ‘gross failings’ by scandal hit mental health trust
Patient Safety Learning posted a news article in News
A young woman died following “gross failings” and “neglect” by a mental health hospital in Essex which is also facing a major independent inquiry into patient deaths. Bethany Lilley, 28, died on 16 January whilst she was an inpatient at Basildon Mental Health unit, run by Essex Partnership University Hospitals. The inquest examined the circumstances of her death this week and concluded that her death was contributed by neglect due to a “plethora of failings by Essex University Partnership Trust”. Following the three week inquest, heard before coroner Sean Horstead, a jury found “neglect” contributed to Ms Lilley’s death and identified “gross failures” on behalf of the trust. The jury identified a number of failings in her care including evidence that cocaine had made its way onto a ward where she was an inpatient. There was evidence of “very considerable problems in the record-keeping at EPUT psychiatric units.” It was also concluded staff failed to carry out a risk assessment of Ms Lilley in the days leading up to her death, and failed to carry out observations. Ms Lilley’s death is one of a series of patients who have died under the care of mental health services in Essex, which have been brought into the light following the campaigning of bereaved families. Read full story Source: The Independent, 19 March 2022 -
Content ArticleBenjamin Lee Stroud died on the 19 March 2021 at home. He lived alone but had a partner who saw him regularly. He had a previous medical history of recreational drugs, including steroids and cannabis; he was recently diagnosed as insulin dependent diabetic and had undergone a kidney transplant. He fell and injured his back at work, and developed a dependence on pain medication, some of which were purchased on the internet. His mental health issues increased as a result of his psychical health problems. A post mortem was undertaken and the cause of death was multiple drug toxicity.
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News Article
Man's partner 'begged' for help before his death
Patient Safety Learning posted a news article in News
A man who died from a mixed medication overdose might still be alive if the help his partner was "begging" for had been provided, a coroner said. Mental health patient Benjamin Stroud, 42, had been under the care of Essex Partnership University NHS Trust (EPUT) in the weeks before his death in March. Essex coroner Michelle Brown said in a post-inquest report that, despite "escalating psychosis", his care co-ordinator did not flag the case. Following an overdose of medication in February, his partner, a nurse, called for psychiatric intervention and despite "begging" for help, Mr Stroud's care co-ordinator did not make a referral to the multi-disciplinary team (MDT). Mr Stroud died at home on 19 March and was found surrounded by empty insulin pens and pain medication. In her prevention of future deaths report, the coroner said: "It was clear from [his partner's] account that she had been begging the care co-ordinator for Mr Stroud to have an appointment with the psychiatrist, which did not occur and, from the evidence of EPUT, it was clear that Mr Stroud's care co-ordinator did not make any referral to the MDT, despite his escalating psychosis." The coroner added that the issue of care co-ordinators failing to document their reasons for not referring cases to the MDT had been raised at other inquests. "If these practices continue there is a real risk of future deaths occurring," Ms Brown warned. Paul Scott, chief executive at the trust, said: "We will continue to view all safety-related incidents as an opportunity to learn and make sure lessons are shared across the trust." Read full story Source: BBC News, 16 February 2022 -
News Article
Mothers beg for their sons to be released from locked hospital units
Patient Safety Learning posted a news article in News
Three mothers whose sons have been locked in hospital psychiatric units in Scotland for years have spoken to the BBC because they’re desperate to get them out. The three young men did not break the law but have autism and learning disabilities. Jamie has autism and was sectioned after becoming distressed at 19. Although he was free to go after 3 months there was no where for him to go so he has lived in hospital units since then. He is now 24. The Scottish government said it was unacceptable to hold people with complex needs in hospital when they could be cared for in the community. "He's left to rot", says his mother. Watch video Source: BBC News, 9 February 2022 -
Content ArticleIn this study, 156 participants were recruited and randomised to placebo (n=83) or ketamine (n=73), stratified by centre and diagnosis: bipolar, depressive, or other disorders. Two 40-minute intravenous infusions of ketamine (0.5 mg/kg) or placebo (saline) were administered at baseline and 24 hours, in addition to usual treatment. The primary outcome was the rate of patients in full suicidal remission at day 3, according to the scale for suicidal ideation total score ≤3. Analyses were conducted on an intention-to-treat basis. The findings indicate that ketamine is rapid, safe in the short term, and has persistent benefits for acute care in suicidal patients. Comorbid mental disorders appear to be important moderators. An analgesic effect on mental pain might explain the anti-suicidal effects of ketamine. There are also some useful and thought-provoking comments on this research, and a helpful visual aid.
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Content ArticleThis resource by the mental health charity Mind is for people who want to change the practice of restraint in mental health services and end reliance on force, particularly on adult mental health wards. It is mainly aimed at people who use mental health services, carers, advocates and campaigners. It provides information about restraint, people’s experiences, official guidance, good practice and campaigners’ stories.
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News Article
HSIB launches investigation into community mental health care
Patient Safety Learning posted a news article in News
The Healthcare Safety Investigation Branch (HSIB) has launched an investigation into community mental health care following the death of a 56-year-old woman. HSIB has begun examining how patients in crisis with severe mental health needs are assessed by NHS services. The investigation came after warnings from multiple coroners over the poor assessment of suicide risk in people in mental health crisis in the last year and followed the death of Frances Wellburn, who took her own life in August 2020 while under the care of Tees, Esk and Wear Valleys Foundation NHS Trust (TEWV). Wellburn had long-term mental health problems but suffered a crisis and was admitted to hospital in September 2019. Following discharge, she was not referred to a specialist NHS service for people experiencing psychosis because clinicians incorrectly believed she was too old for the service, according to a TEWV investigation report seen by The Independent. Despite being assessed as a “medium risk”, Wellburn was not contacted by mental health teams for three months. In June 2020, she was admitted to an inpatient unit for three weeks, but her health deteriorated, and she later took her own life. Separately, coroner warnings in three prevention of future deaths reports published last year found mental health staff failing to risk assess people who later took their own lives. HSIB’s investigation will look into how patients’ risk is assessed when receiving care in the community and how services interact with families and other health services. It will also examine how mental health services consider menopause when assessing women’s mental health and referrals to early intervention psychosis services. Read full story Source: The Independent, 27 January 2022 -
News ArticleThere are serious concerns over the standards of specialist care being provided to patients with the most complex mental health needs, a BBC investigation has found. Patients sent by the NHS to stay in mental health rehabilitation units say they have been placed in unsafe environments, often far from home, with untrained staff. Experts say not enough is being done to regulate the sector, which costs the NHS half a billion pounds a year. Lissa had spent years struggling with her mental health, having experienced traumatic life events. She was diagnosed with mixed personality disorder, depression and high-functioning Asperger's. So when the NHS sent her to a unit in Coventry run by Cygnet Health Care for a specialist talking therapy, she agreed. The hospital, however, was in special measures. There had been two deaths in the previous 20 months. In both cases there was found to be a failure to follow the patient's care plan and carry out observations correctly. Lissa says staff failed to treat her with dignity and respect. The system in England is regulated by the Care Quality Commission, (CQC). Some rehabilitation wards haven't been inspected for four or more years. John Chacksfield, who was a CQC inspector until late 2020, says greater scrutiny is needed. "Sometimes the private sector provides really excellent service, but there are certain units that really do need regular inspections just to make sure staff are being trained enough, or are having enough clinical supervision. It does worry me," he says. Read full story Source: BBC News, 18 January 2022
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News Article“Unacceptable” failures by a mental health hospital to manage the physical healthcare of a woman detained under the mental health act contributed to her starving to death, The Independent has learned. A second inquest into the death of a 45-year-old woman, Jennifer Lewis, has found that the mental health hospital to which she was admitted “failed to manage her declining physical health” as she suffered from the effects of malnutrition. Ms Lewis had a long-term diagnosis of schizophrenia. Her family described how she had lived a full life, completed a degree, and given lectures about living with mental illness. However, after undergoing bariatric surgery, against the wishes of her family, her mental state declined and she was admitted to the Bracton Centre, run by Oxleas, in 2014. In an interview with The independent, her sister, Angela, described how, in the year before her death, Ms Lewis lost her hair, suffered from diarrhoea, and developed sores on her legs as she effectively “starved to death” from malnutrition. Ms Lewis’s sister told The Independent that in the year leading up to her death, when the family warned doctors she was “starving to death”, their concerns were dismissed and they were told that the hospital “will not let it come to that”. Mental health charity Rethink has called for improvements to physical healthcare for patients with severe mental illness, whose physical needs they say are “all too often ignored”, while experts at think tank the Centre for Mental Health have warned that patients with mental illness are dying too young as the system “still separates mental and physical health”. Read full story Source: The Independent, January 2022
