A range of protection issues and risks for mental health patients across Walsall Healthcare Trust facilities and Manor Hospital can be exposed by Express & Star.
The massive shortage of mental health nurses has resulted in security guards caring for vulnerable patients with complex mental health needs for 8,000 hours in 2020/2021. Hours were filed under the patient observation term.
Mental Health charity Mind has identified the risks of its patient monitoring policy for trust.
Paul Spencer, Head of Health, Policy and Campaigns at Mind, said: “When you are admitted to hospital for your mental health, you are at your most extreme, and you need to receive support and treatment from trained professionals in a safe therapeutic environment.
“Having staff such as security guards monitor patients rather than mental health professionals is not likely to be safe, as untrained staff are less likely to have the skills to support someone experiencing a complex mental health crisis. This is a problem in hospitals across the country, one It can only be fixed if the UK government invests properly in our mental health workforce.”
Incidents involving mental health patients using weapons, drugs and alcohol have worsened during the pandemic forcing them to review procedures at the secretariat.
The Secretariat was also forced to build a secure unit, surrounded by security cameras, to prevent staff and patients from stealing laughing gas (nitrous dioxide) and liquid oxygen.
Another major problem facing the trust was the mishandling of medications by staff, which resulted in patients getting the wrong doses at the wrong time, if they got them at all.
The findings of a security report ordered by the Walsall Healthcare Trust’s Health and Safety Committee have led to a set of recommendations by which the trust is working to extricate itself from the crisis.
Walsall’s dire state of providing for mental health patients is being repeated across the NHS. Last month, the Greater Manchester Mental Health Care Trust sacked several staff after an undercover BBC Panorama reporter filmed horrific patient abuse, and the investigation revealed that care assistants, who are paid minimum wages and without medical training, are often left to oversee patients who have serious mental health problems.
In Walsall, as a measure of desperation, nurses could apply for a few hours of patient watch during which security guards would supervise patients. However, rather than an operation of last resort, Patient Watch has become a default method of care.
An audit report this summer read: “Health and Safety Committee [noted] Attention to patient monitoring requests from nursing staff, as security staff may not be the most appropriate people to sit with the patient. The Health and Safety Committee will conduct a review of the standards relating to patient monitoring, the financial component involved and the appropriate processes for these patients.
“A total of 8,000 hours of patient monitoring were recorded during 2020/21, and it has been observed that these patients often have complex mental health needs and an appropriate risk assessment is not being undertaken.”
“There is concern about patient monitoring requests from nursing staff, as security personnel may not be the most appropriate people to sit with the patient.”
“The situation has deteriorated during the pandemic, the fund does not have the infrastructure to deal with mental health patients except for short-term evaluations, which has had a significant impact on the number of patients monitored,” said Kevin Bostock, insurance director.
Children and young adults with mental health issues have been let down this year, too.
A Walsall Healthcare Risk Register report in June warned: “The Walsall Healthcare Trust’s ability to support and manage any child or young person awaiting Level 4 admission. Increase in children and young people experiencing crisis within pediatrics resulting in failure to address and manage patient safety throughout the patient journey.”
“There is no mental health training for ward staff, but there is a misplaced perception that staff in the trust are trained to meet the needs of children and young people in crisis.”
And worryingly: “There is no access to mental health support or advice outside of working hours. There is no access to child psychiatry outside of working hours.”
A series of conflicts of interest were also found in the audit reports including employees signing off on their own hours and an incredible 1,600 employees who could not be contacted by email because they “don’t have an account”.
“The committee was informed that approximately 1,600 employees do not have email addresses. This makes communication more complex and conducting an employee survey problematic,” the report reads.
Walsall Healthcare Trust has been contacted for comment.