Records of patients at a mental health trust were falsified to meet performance targets, claims a report triggered by allegations raised by whistleblowing social workers.
An independent investigation found that records of some patients at Avon and Wiltshire Partnership NHS Trust (AWP) had “undoubtedly” been falsified. The report, written in 2012, was released under the Freedom of Information Act after a request submitted by a user of the ‘What do they know?’ website.
The investigation was commissioned in May 2012 by NHS South of England, one of the regional strategic health authorities disbanded when the government’s health reforms came into place in April this year.
“The falsification of records has undoubtedly occurred in Wiltshire. We believe that the majority of records altered were linked to unrealistic, unnecessary and non-evidence based local targets and/or thresholds,” the report concluded.
Staff had falsified records due to “a zero tolerance approach” to breaching performance targets, the report found. Patient care was not affected and there was “no evidence” that senior managers had told staff to manipulate data but the trust’s culture meant “middle managers felt unsupported, and had to use increasingly creative measures to survive,” it added.
AWP said it investigated the allegations but found no proof that records had been falsified.
“When the issue of alleged falsifying of data was first brought to our attention approximately 18 months ago, we carried out a full investigation,” a statement from the trust said.
“Neither that investigation, nor subsequent investigations by independent parties found any evidence to support the claims and the matter is now officially closed.”
The report was written by three NHS staff and two independent consultants, one a psychiatrist and one a head of safeguarding at another mental health trust. The investigation was launched after 30 social workers employed by Wiltshire Council used whistleblowing procedures to raise concerns in March last year.
The report said an analysis of 17 patient records backed up the social workers’ claims and “exposed a lack of consistency, omissions and false reporting” in records. The records contained events that did not happen, including face-to-face contacts, and incorrect patient outcomes, the report found.
The problems identified probably represented a “significant symptom of a system under stress”, it added.
“This is a systemic issue. The majority of the staff appeared as hard working and caring clinicians who were under significant duress,” the investigation said.
The report focused on Wiltshire, one of several local authority areas covered by Avon and Wiltshire Partnership NHS Trust, but concluded that the “systemic cause” of the findings meant it was “probable that the issues run wider than Wiltshire”.
Investigators concluded that AWP needed to urgently change its management from one that was “punitive and threatening” to one that was “honest, constructive and supportive”.
The trust underwent a senior management change in October 2012. An independent report published this year noted a “significant change in organisational culture” at AWP with less of a “relentless drive to achieve targets”.
Andy McNicoll is Community Care’s community editor