Mental health patient safety review launched in wake of abuse reports

The government has launched a rapid review into the safety of patients in mental health hospitals in the wake of a series of reports of abuse and poor care.

Mental health minister Maria Caulfield announced the short inquiry in a parliamentary statement yesterday.

“This review is an essential first step in improving safety in mental health inpatient settings,” she said. “It will focus on what data and evidence is currently available to healthcare services, including information provided by patients and families, and how we can use this data and evidence more effectively to identify patient safety risks and failures in care.”

The review will be led by former national clinical director for mental health at NHS England Dr Geraldine Strathdee, who is also chairing a parallel independent inquiry into mental health deaths in Essex over the past two decades.

Reports of abuse and poor care

The review follows a series of reports of abuse and poor care in inpatient settings including:

• Footage of staff assaulting, inappropriately restraining, secluding and verbally humiliating patients at the Edenfield Centre run by Greater Manchester Mental Health NHS Foundation Trust, screened by the BBC’s Panorama programme last year.
• A call from NHS England for mental health providers to root out “toxic and closed” working cultures in reviewing their safeguarding systems in the wake of the Edenfield Centre case.
• Patients reporting that a lack of activities was leading to increased violence on wards, with staff shortages undermining services’ ability to respond to this, according to the Care Quality Commission’s latest annual report on its monitoring of the Mental Health Act 1983.
• Findings that staff were failing to carry out basic health checks, patients were not treated for the side effects of antipsychotic medication and rapidly deteriorating health going unnoticed and untreated, according to an analysis of coroner reports over the past decade by The Independent.

The latter, published in December, led Labour to call for a rapid review of mental health settings.

Trusts’ urgently reviewing safety of care’

NHS leaders welcomed the government’s announcement.

NHS Providers’ director of policy, Miriam Deakin, said: “Trust leaders have been extremely concerned about the unacceptable reports of abuse and poor care in mental health services in recent months. Rightly, all trusts have been urgently reviewing their services as well as their approach to oversight and assurance of safety, quality of care and management of risk.

“We hope this rapid review will identify and support the immediate action that’s needed to improve patient safety and eliminate abuse in mental health services.”

She added: “We must listen to service users, their families and carers to make improvements, and we particularly welcome the review’s focus on using information provided by patients and families, as well as on other sources of evidence and data on mental health services.

‘Vital’ to increase mental health resources

“It’s vital that inadequate resourcing and structural challenges be tackled too. This requires long-term sustainable levels of investment in mental health services alongside other parts of the health, care and wider public sector, to ensure the needs of people with mental health conditions can be met compassionately and effectively as early as possible.”

Mind, which called for a public inquiry into the state of inpatient settings after the Edenfield abuse was reported in September, also welcomed the launch of the rapid review.

 “This announcement comes in the wake of deeply concerning reports over the last few months and indeed years from some patients and their loved ones about failings in mental health hospitals across the country,” said chief executive Sarah Hughes.

“It goes without saying that the voices of people with lived experience of this must be central to this review.”

She added: “This review needs to gather information on the much deeper-set systemic failings in mental health care, and establish what works in successful mental health settings that provide therapeutic and safe care.”

But, like Deakin, for NHS Providers, Hughes said the review on its own would not be sufficient to “fix the crisis in our mental health inpatient services”, with investment needed to “address the gaping holes in mental health care in England and Wales”.

For fellow charity the Centre for Mental Health, interim chief executive Andy Bell tweeted: “A rapid review won’t answer every question or concern but will be a start for what must be concerted and systemic reforms and improvements to inpatient services.”