Vulnerable patients are fleeing secure hospitals because there are so few staff there, the regulator reveals

Mentally vulnerable patients in British hospitals are being traumatized, sexually abused and physically harmed – and have even managed to escape, the safety watchdog has warned in its first major nationwide investigation.

The Health Services Safety Investigation Body (HSSIB) report, subsequently released by former Health Secretary Steve Barclay The Independent exposes a series of failings in the sector and warns the government and healthcare leaders that cash-starved “oppressive” psychiatric hospitals are harming patients.

According to the HSSIB, inpatient mental health services across England are failing to protect particularly vulnerable patients and are even re-traumatizing them.

It highlights a raft of safety concerns, largely due to the national mental health workforce shortage, and warns that the ambitions of the flagship NHS long-term workforce plan may be “unachievable”.

Other deficiencies highlighted by the security watchdog include:

The report is the first in a series that the HSSIB will publish over the next year, which will also cover residential childcare. What follows is a series of exposés from The Independent and Sky News over “systemic” failings at a group of private children’s hospitals.

Dr. Sarah Hughes, chief executive of the charity Mind, said the report revealed the “brutal truth” about the state of mental hospitals.

She said: “What should be places of recovery have become places of pain and fear for too many people.” Therapeutic care is now the exception, not the norm.

“This is made even more difficult by outdated mental health law, which doesn’t give people nearly enough of a say in their care. No one under the care of the state should have their mental, physical or sexual safety at risk or lose their life due to a system failure.”

She said the lack of resources meant mental health care was “doomed” and called on the government to take action to improve inpatient mental health care.

Earlier this year, an investigation by The Independent and Sky News, quoted in the HSSIB report, revealed that thousands of sexual assault and harassment incidents were reported on NHS psychiatric wards. Following this revelation, the Department of Health and Human Services included sexual safety in the HSSIB investigation.

The investigation also found that hospitals are using mixed-gender wards despite NHS England guidance showing “zero tolerance” for this. At the time, Wes Streeting, the then shadow health secretary, called on the Conservative government to take action on the “rapidly increasing” number of mixed-gender wards.

According to the review, mental health managers warned that they did not have enough staff to observe patients or intervene when there was a risk of sexual harassment.

Inspectors also warned that patients who had previously suffered sexual trauma could be “retraumatised” on the wards and that managers were concerned that some staff had failed to act as they had “normalised” certain sexual acts by patients .

Staffing shortages were cited by HSSIB inspectors as the main cause of safety problems.

The watchdog gave examples of patients who were at risk of serious self-harm because overstretched staff were unable to observe them as required, and an example of a patient who was able to leave hospital unaccompanied.

Both patients and staff reported to HSSIB inspectors “fear for their own safety” as physical violence occurred on wards with a shortage of nursing staff.

HSSIB said it was “not unusual” on some wards for at least 50 per cent of staff to be temporary workers, while on some wards there were no permanent nursing staff.

In its report, the HSSIB noted that mental health staff were warned that they were not always equipped to deal with physical health problems. Examples found include a patient who died from a blood clot in the lungs after a hospital failed to risk assess the patient and follow the advice of a nutritionist. This patient had sat motionless the day before his death and had not drunk or eaten for two days.

The report also identified numerous concerns about the state of mental health buildings, which were described by some patients and staff as “dismal”, “oppressive” and “no longer fit for purpose”.

Due to a lack of capital resources, hospitals were unable to address security risks that resulted in patients breaking in through locked doors or attempting suicide.

A spokesperson for the Department of Health and Social Care did not comment directly on the recommendations or points about mixed-gender wards, but said: “Patient safety is paramount and everyone treated in an inpatient psychiatric facility deserves a safe, high-quality care.” are treated with dignity and respect. We are grateful to HSSIB for this report, which highlights important concerns that can help us improve inpatient mental health care.”

It highlighted plans to continue reforming mental health law and recruit 8,500 more mental health workers.

An NHS England spokesman said: “Mental health services are experiencing record demand, up almost two-fifths compared to before the pandemic, and we know there is much more to be done to provide better care for patients.”

“We are working to improve the quality and safety of all inpatient mental health, learning disability and autism services and plan to introduce hundreds of additional clinical roles across mental health services across the NHS.”