Investigation launched as patients ‘locked up’ at criticised NHS hospital

6 January 2014

Investigation launched as patients ‘locked up’ at criticised NHS hospital

Claims that vulnerable patients have been detained against their will at Dudley Group of Hospitals NHS Foundation Trust are being investigated on the  orders of the Department of Health after concerns were raised by a whistleblower.

John Marchant, the former head of security at Dudley Group of Hospitals NHS Foundation Trust was speaking with The Telegraph newspaper and stated that elderly children and children were amongst those who were locked up and restrained against their will at the Dudley Group of Hospitals, which is one of the country’s largest hospitals. Mr Marchant added that it was a matter of routine that vulnerable patients were forced to stay in their rooms and even confined forcibly to beds; even though they posed no risk or danger to anybody else.

Mr Marchant said that his security guards had raised the issue with bosses after becoming particularly concerned about having to restrain a child; they refused and informed their superiors the action was illegal. Further examples of restraint included forcing patients to stay in their rooms or to their beds when they simply wanted to walk around a ward or talk to other patients.

The health regulator, the Care Quality Commission (CQC), has been told to carry out an investigation by the Department of Health as a result of the claims.

"We are absolutely clear that physical restraint should only ever be used as a last resort and it should be used for the shortest time possible. There are strict conditions that must be met before any patient is restrained or detained.""These are very serious allegations and we have passed this information to the Care Quality Commission for further investigation," a spokesman said.

Sir Bruce Keogh, the NHS’s medical director; had initially highlighted the Dudley Group as a hospital of major concern amongst the 14 he identified earlier this year-particularly striking amongst its failings was the unusually high death rate. Keogh’s inspectors found insufficient numbers in qualified nursing staff, doctors absent during the night so leaving senior nurses in charge and significant bed shortages resulting in patients kept waiting on hours on trolleys and frequently moved from ward to ward.

The Dudley Group, although admitting security staff had raised concern about the issue, denied Mr Marchant’s claims instead insisting it always acted in the best interest of patients. Mr Marchant was in charge of security for over a decade until late 2012 and in his interview with The Telegraph stated that he was worried hospital managers were ignoring the welfare of patients in order to make life easier for nursing and medical staff.

"In many cases we are talking about patients known as ‘bed blockers’, elderly people unable to return home or with no residential care unit to go to," he said. "In these cases detention is being used simply because the patient [has] become so frustrated at not even being able to go out for a walk in the hospital grounds because there are no staff to accompany them.

"Some would go back to their rooms if you asked them, but others would have to be closed in and it would be very distressing for them."

The news has led to outrage amongst charities who are trying to raise awareness about care for vulnerable patients, whether they are infirm, elderly, children or those who lack mental health capacity.

Action On Elder Abuse campaigns on behalf of the elderly. Gary Fitzgerald, the charity’s chief executive, said: "It is shocking that older people should be treated so appallingly. They have the same rights as everyone else, and that includes the right to be treated within the law. These people are some of our most vulnerable, and this abuse makes a mockery of the NHS mantra to ‘do no harm’."

The issue of lack of care for vulnerable patients has come under increasing scrutiny in the last few years with a Commons health select committee warning in August 2013 that vulnerable patients were being left at risk of abuse due to "profoundly depressing and complacent" attitudes by staff at hospitals and care homes completely disregarding patient protection laws and who seemed to restrain patients for absolutely no reason.

Mr Marchant, who was made redundant from the Dudley Group in December 2012, stated that he became first aware in 2010 of the high volume of patient restraint requests by medical staff to his own security staff-often where no restraint was unmerited.

He said some of the methods used ranged from telling someone to go back to their bed, to pushing a patient back into their room or holding the door closed so they could not leave. He added: "In many of these cases medical staff had not carried out a proper assessment to determine if it was necessary for the patient to stay in hospital because they don’t have their full faculties."

"We were also called to restrain children. In one case it was a 14-year-old placed in the hospital by social services, in March 2012, who was awaiting transfer to another part of the country. She was not violent but became distraught at waiting to go into a care home. She started wrecking her cubicle so we pushed her into her room and kept her there for at least 72 hours."

His concerns also tally with ‘blanket restrictions’ on vulnerable staff that have been found after investigations at other hospitals, such as locking doors on wards and day rooms, for no reason other than to make life easier for staff.

The Dudley Group admitted that security concerns had been raised but that appropriate assessments of patients had always been taken beforehand, which Mr Marchant refutes.

Paula Clark, chief executive of the trust, said: "We emphatically refute the suggestion that we have ever unlawfully restrained patients at The Dudley Group. The health and wellbeing of our patients is our absolute priority and we always act in the best interests of our patients.

"It is our priority not to restrain patients. In the very small instances where this is necessary, it is to prevent patients harming themselves. Any kind of restraint is always reasonable and proportionate, and in line with our policy. Our policy has been held up as an example as good practice by our regional peer review of adult safeguarding."

Have you or a loved one experienced concerns regarding treatment at the Dudley Group of Hospitals NHS Trust or any other hospitals or trusts?  If so has a number of specialist teams who can provide you with advice, guidance and support about your rights and help you make a complaint or if what has happened is particularly serious, see whether or not you may be able to make a claim for possible medical negligence.