The director of nursing at South London and Maudsley NHS Trust says the problems on its acute wards are ‘absolutely unacceptable’, but that in some cases the only other option would have been to turn patients away.
As the News reported last week, the Care Quality Commission’s report found ‘breaches of fundamental standards of care’ in acute wards, leading them to be rated ‘inadequate’.
These included over 30 patients left sleeping on sofas and in temporary rooms last year, wards being completely full, health checks not taking place after tranquilisation, and staff failing to take accurate records of when and why physical restraints had been used.
Speaking to the News, Beverley Murphy said of the bed crisis: “It is absolutely unacceptable and crosses a red line,” she said, “Everyone should be treated with privacy and dignity.
“What they did in those thirty-six cases is the best they could do at the time.
“It is not right but I cannot support staff turning away patients.
“We are really sorry that that been put in that position.
“It is not their responsibility to manage the flow of patients, it is our responsibility as leaders to manage it better.”
She says the hospital is aiming to keep its acute wards at around 85 per cent occupancy to avoid this in future, but this is difficult when some patients are unable to leave as they have no suitable housing to go to.
There were also incidents involving physical restraining – including the ‘prone’ restraint, where patients are effectively held face-down with pressure – which were not being recorded.
“If you are held face down on a floor, you would not feel very safe, or very valued, and it does put a patient at risk of asphyxia. Any restraint is risky,” she said.
“We know that in some of our wards we are making real progress on reducing that.”
Overall the NHS Trust, which includes the Denmark Hill-based Maudsley hospital and Bethlem Royal Hospital in Beckenham, was awarded a ‘good’ rating in last month’s report, with most of its work found to be ‘good’ or ‘outstanding’.
In particular, the care and compassion shown by staff across the Trust was praised by inspectors.
Ms Murphy believes by supporting staff to develop resilience and look after their own mental health, especially after serious incidents, they can stop nurses from ‘triggering’ and use restraints when a situation can be calmed down without.
She describes the overall picture for mental health services as one of ‘high need, low investment’, and is pushing for ‘parity of esteem’ between mental health and physical health services.
“It was hard getting the rating, but this is an opportunity for us,” she said. “I think our commissioners are sitting up and taking notice.
“People with a mental health problem deserve the same services. Mental health is no less important, but the funding is so much less”.