Security guards without medical training caring for Walsall mental health patients

A litany of safeguarding issues and risks concerning mental health patients across Walsall Healthcare Trust facilities and Manor Hospital can be revealed by the Express & Star.

A massive shortfall in mental health nurses meant security guards cared for vulnerable patients with complex mental health needs for 8,000 hours in 2020/2021. The hours were filed under the term Patient Watch.

Mental Health charity Mind outlined the dangers of the trust's Patient Watch policy.

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 unwell, and need to receive compassionate support and treatment from trained professionals in a safe therapeutic environment.

"Having staff such as security guards monitor patients in place of mental health professionals is unlikely to be safe, as untrained staff are unlikely to have the skills to support someone experiencing a complex mental health crisis. This is a problem in hospitals across the country, one that can only be fixed if the UK government invest properly in our mental health workforce.”

Incidents involving mental health patients using weapons, drugs and alcohol got worse during the pandemic forcing a review of procedures at the trust.

The trust has also been forced to build a secure unit, surrounded by security cameras, to stop staff and patients stealing laughing gas (nitrous dioxide) and liquid oxygen.

Another major issue facing the trust was the mishandling medicine by staff, leading to patients getting the wrong doses at the wrong time, if at all.

The findings of a security report ordered by Walsall Healthcare Trust's health and safety committee led to a raft of recommendations which the trust is working through to dig itself out of the crisis.

Walsall's dire state of provision for mental health patients is replicated across the NHS. Last month Greater Manchester Mental Healthcare Trust sacked several employees after an undercover BBC Panorama reporter filmed shocking abuse of patients.The investigation revealed care assistants, on minimum pay and without medical training, were often left to supervise patients with severe mental health issues.

In Walsall, as a desperate measure, nurses can apply for a few hours of Patient Watch during which security guards supervise patients. However, instead of a process of last resort, Patient Watch has become a default method of care.

An audit report stated this summer: "The Health and Safety Committee [noted] the concern around patient watch requests from nursing staff, as security staff may not be the most appropriate people to sit with a patient. The Health and Safety Committee will be undertaking a review of the criteria around patient watch, the financial element involved and appropriate processes for these patients.

"A total of 8,000 hours was recorded for patient watch during 2020/21, it was noted that these patients often have complex mental health needs and there is no appropriate risk assessment undertaken."

"There is concern around Patient Watch requests from nursing staff, as security staff may not be the most appropriate people to sit with a patient."

Kevin Bostock, director of assurance, said: "The situation deteriorated during the pandemic, the Trust does not have the infrastructure to deal with mental health patients apart from short term assessments, which has had a huge impact on the number of Patient Watches."

Children and young people with mental health problems have also been let down this year.

The Walsall Healthcare Risk Register report warned in June: "Walsall Healthcare Trust ability to support and manage any child or young person awaiting a tier four admission. An increase in children and young people in crisis within paediatrics which results in a failure to process and manage patient safety through the patient journey.

"There is no provision of mental health training to ward staff but a misplaced conception that the staff at 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 out of hours. There is no access to Paediatric psychiatry out of hours."

A series of conflicts of interests were also found in the audit reports including staff signing off their own hours and incredibly 1,600 staff members who cannot be contacted by email because they "do not have an account".

The report states: "The committee were advised that around 1,600 staff do not have an email addresses. This makes communication more complex and carrying out the staff survey problematic."

Walsall Healthcare Trust has been approached for comment.