Hospital negligence at a "scandal" level - what to do?

[Highgatehospital]

I will try to keep this brief but want to give as much information as possible. I have name changed but a long time mumsnet user.

My brother was sectioned under the mental health act and taken to a mental health hospital in North London.

My brother was a flight risk having already escaped once and attempted to escape another - not at the same hospital.

The north London hospital was made aware of this by myself and my mother but should be able to access this on his notes too.

This is a high security hospital where many patients are extremely unwell, vulnerable and a threat to themselves and others.

On day 2 of being hospitalized he was walked to the front door accompanied by 2 nurses/ members of staff. One told my brother that many people escape this hospital and never come back. He then walked him over to the door and turned around allowing my brother to run off.

My brother had no reason to be near the front door. His ward was nowhere near here and he has internal courtyards for fresh air / smoking if needed.

The staff claim he was signed off to go outside to the front to smoke by the hospital consultant.

Why taking someone to a front / unsecured carpark to smoke as opposed to the internal secured courtyard they have use of, is the preference, I have yet to understand.

Now here is where the large-scale negligence comes in.

Because my brother escaped, we contacted the police missing persons unit and reported him as missing.

We had the most amazing PC call us back and after me expressing my concerns regarding his escape the police officer mentioned that this is a DAILY occurrence!

They get calls almost daily regarding this hospital and patients escaping. Always in the same way.

The consultant signs the patients off to smoke at the front and patients are allowed to WALK off. Not run, WALK. No one intervenes. No one stops them.

When the police request CCTV footage. The cameras either weren't working or show absolute negligence where patients simply walk off with either no staff standing next to them or no one bothering to stop them. No staff follow them or attempt to stop them from leaving. This specific officer has been raising concerns with this hospital for over 2 YEARS.

Because the officer has to go via the official channels all that ever happens is a liaison person / team acting as an intermediary between the police and the hospital recommending changes to be made which never come to fruition.

She also mentioned that they take seriously unwell patients (think dangerously ill where they could pose a threat to society/ attack someone) on day trips outside and again, allow them to walk off. When asked by police why they don't attempt to stop / retain them the excuse is always that they are dangerous individuals and they don't want to risk being attacked.

To add to this, after a patient escapes, they also never follow any of the procedures they are supposed to follow, such as filling in a 137 form to allow the police to arrest the patient and bring them back to the hospital. Without this the police can't help should the patient return home.

Now AIBU to suggest this is absolute negligence on a mass scale and that the consultant and nurses involved should be stricken off!?

I have made an official complaint but any advice as so where else to take this would be much appreciated!

I will be speaking to the local MPs too but this cannot be allowed to continue.

The police officer I spoke to, who is sick of how these vulnerable people are being treated recommended I request a freedom of information act to show many patients have escaped over the last year, which I've done.

Some patients in this hospital are so unwell that they would not be able to advocate for themselves. I think this is why they have been getting away with gross negligence for such a long time.

To add to this, my brother claims his room was filthy. Bed sheets couldn't have been changed from the last patient as they had BLOOD on them!?

"In which case, simply don't allow them to smoke"

You'd have so many angrier patients withdrawing from one of the most addictive drugs there are. It would be literally dangerous. Read a bit about the link between mental health and smoking habits.

I don't really understand what your issue is? NHS Trusts are none smoking, either you give your brother vapes when he's in there, or you accept he has to give up smoking. If he's coherent enough to understand what happened, then there's no reason to not understand that he cannot smoke whilst he's in there and ask for a nicotine patch.

It's is an NHS England directive that all hospitals are smoke free, they cannot just allocate one space for smokers - that's what the directive has smoked.

Also you seem to think people can just freely be in a yard together and there won't be any incidents. I was on a female only ward and there were around ten fights each day - it was horrible, chaotic, and always at times when staff numbers were lower (which the patients figure out very quickly). I was the only patient in there for a reason other than "had stopped taking medication suddenly". I think there were maybe 30 patients in there, and all the rest of them had chosen to stop there medication and ended up spiralling. They were all shouting about "capacity" and "rights (to smoke)" but most of them couldn't even figure out what they wanted for meal times.

Wards become more dangerous when staff are constantly ferrying people outside to smoke. I am insanely grateful the ward I was in had such a strict policy on this (ie. no smoking at all, vapes and patches were offered + visitors could bring them in).

I felt so sorry for the staff, particularly when patient families would come in and start berating them on how "there little darling would have never done that" when there little darling was doing it multiple times a day.

If someone is sectioned, they have very limited rights - I remember a psychiatrist apologising to me for removing all my rights, and he said it's the worse part of his job particularly knowing the circumstances that I ended up in there for.

Staff constantly put themselves at risk on wards, the very nature of their job makes it risky - they do so to protect patients from themselves and from others. There has to be limitations on this for staff safety though.

Is he now under the HTT/CRT?

If you want to take it further it's like body cam will have been worn, as your brother has capacity he can request this under an SAR (I'd suggest just asking for that day otherwise it will come back as an unreasonable request).

Then going through the hospital complaint procedure, and if that isn't resolved to your liking then go to the Health ombudsman.

I hope your brother gets the support he needs, it's a horrible place to be in, but equally you can't have everything you want when you are on a section... it's not how it works, and it's not how it's meant to work.

Just also to say - I disagree your brother wont be considered a valid narrator - I was considered to be one and there was a huge stink kicked up because of what I was saying, every single person sat in my MDT and listened to me and raised the issues, and supported me to raise the issues as well including providing clear guidance on the process.

I actually think their raison d'être is literally just to keep patients from harming themselves or others

This is actually the legal stance of some sections (not all, but some).

I second this, and your MP and maybe the MP for where the hospital is,if they're different.

This will all depend massively which section he is being held under. Section 3, which is the most common, is basically a section for treatment. You will be held in a secure facility, but staff are not allowed, legally, to physically prevent you leaving if you find a way. Only Section 5 provides holding power, and even then, it is limited.

The NHS tried very hard to get allowances for sectioned patients to be able to smoke in a section of garden. The government ignored this and forced it through. Try imagine being staff trying to manage patients who are very unwell AND withdrawing from nicotine. It is also dangerous to quit smoking abruptly when on certain drugs used in severe mental health (one example is Clozapine - there is a significant issue with patients who stop smoking in hospital requiring their clozapine to be significantly reduced, then they leave hospital, start smoking again which means their current level of clozapine isn't effective, and causes a serious relapse and return to hospital).

The above all presumes this is a non forensic section. If he is on a forensic hold, or court ordered, then that is different.

So, unfortunately, physically restraining him to prevent him leaving, or allowing smoking in the internal courtyards, is illegal. Whether right or not.

Please listen to the podcast investigating Essex. Dying to be saved. Trigger warning it's very very upsetting and harrowing. The reason I say this is because I'm pretty sure there is an ongoing investigation for hospitals in Essex but also wider areas. Lots of failing. It might be that you can contact them for support/info

It's the Lampard Inquiry

This is going to sound completely off topic but hearing these types of stories is why I would NEVER vote for assisted suicide in this country. The various NHS departments and governing bodies which FAIL massively on a daily basis - how could we expect them to add deciding if an individuals assisted suicide case was to be allowed.

It does sound like poor care and you are right to pursue it and speak to the local MP etc.

What is worth knowing is that all the organisations concerned (health are, police, MP's office, lawyers with experience of mental health settings) will already be aware that such incidents are commonplace. You are shocked, which is natural, but nobody else will be, as you have already learned from the police.

I am not saying this to discourage you, only to explain that it will not be a case of you revealing shocking information which will swiftly acted on.

This. It’s bad enough being literally mental let alone withdrawing from nicotine.

I quit recently for 6 weeks. It wasn’t even the first few days which were difficult. It was regulating my mood and mental state weeks 2-6 which were the hardest. And ultimately the reason I started again. I literally had an irrational anger for a week. Finally caved ; One cigarette and it went. I was back to normal.

Im well aware it’s bad and will probably kill me. Smoking is actually the number 1 killer of people with my suspected condition.

I appreciate this but if we are being told that the NHS isn't allowing patients to smoke in internal gardens what is the solution?

Allowing patients to walk off daily? Some of these dangerous?

I have also mentioned higher up in my responses that my brother isn't a regular smoker. He used this as an excuse to escape.

Thank you to all that took the time to reply.

Some very helpful suggestions here and I will take note.

Well technically they aren’t allowed to do any of these.

So I think it should be a courtyard.

Why did you call the police if he went to your DMs house ‘as you assumed he would’?

So they could take him back...he is under section and supposed to be in hospital for 28 days. He escaped on day 2.

This is one of those situations where a range of legislation and rights clash and it's impossible to uphold all. This is not the fault of local staff or even local NHS trusts.

It happens in health and safety where it is impossible to comply with h&s legislation, fire safety, equalities, human rights etc all the the time in every situation.

I think your concerns are totally legitimate but tbh I don't know how staff in those hospitals manage to turn up for work day in and day out. Being the person administering a completely broken system does something to your brain - it breaks you. I've seen it - people being casually cruel without realising it because they are so frustrated and basically hate themselves for being part of such a horrible, pointless system.

People who are under section need very high-quality care, the same as people who have been diagnosed with stage 4 cancer. But in the eyes of the NHS (and society at large to a great extent) cancer patients are worthy of all the support they can get while those with mental illness are not. Secure hospitals become holding pens. It is horrible being one of the keepers (and I use keeper in the zoo sense of the word).

Something fundamental has to change in how people with mental illness are viewed before anything is likely to get better.

It’s UP TO 28 days by the way… and the legislation is designed that people are home / out of hospital at the quickest possibility and have their rights returned following assessment or a further section is put in place