NHS trust apologises at mental health deaths inquiry as it acknowledges failings

A barrister offered an apology to bereaved families on behalf of a mental health trust at an inquiry into deaths of patients in Essex as she acknowledged a series of failings.

Eleanor Grey KC, for Essex Partnership University NHS Foundation Trust (EPUT), said there had been “serious issues raised about staff conduct including the neglect and abuse of patients, staff falling asleep on duty and inadequate patient observations”.

She said “low staffing levels including those below those authorised by the trust were reported on various wards”.

The barrister said “we acknowledge that there have been serious allegations of sexual assault of patients by staff and also of staff by other staff members”.

EPUT was formed in 2017 from a merger of the former North Essex Partnership University NHS Foundation Trust and the former South Essex Partnership University NHS Foundation Trust.

It provides mental health, community health and learning disability services.

Ms Grey said that in November 2020, EPUT pleaded guilty to a charge that during the period from October 2004 to the end of March 2015 it failed to manage the environmental risk from fixed ligature points within inpatient mental health wards, “exposing vulnerable patients in our care to the risk of harm”.

“During this period some 11 inpatients hanged themselves using ligature points,” she said.

“And in addition, others were harmed due to the failure of the trust to eliminate ligature points on our wards.”

She said the trust “accepted that lessons learned did not always result in the required or effective remedial action and we also know that further deaths involving fixed ligature points occurred after 2015”.

She said the trust board was “committed to engaging candidly with the inquiry”.

Earlier in the hearing, Ms Grey said: “I want to start with an apology.

“This opening statement is delivered at an early stage of the inquiry as part of the journey that we hope and anticipate will enable much learning and further change.”

She continued: “We do want to start by apologising on behalf of both EPUT and its predecessor organisations to everyone who has been failed – patients, family members and carers – by NHS mental health services in Essex.

“Patients, families and carers have a right to expect safe services and those were not always provided.”

Addressing inquiry chairwoman Baroness Kate Lampard at Wednesday’s hearing in Chelmsford, Ms Grey said: “EPUT’s board and its staff are committed to doing all that they can to support you, chair, and all the inquiry team to give patients, family and carers the answers they have been waiting for.”

She said there had been a “major recruitment drive” in 2023 with 1,700 new colleagues hired.

And she outlined a number of further steps already taken, including a review and more than £6 million spent on removing fixed ligature risks.

She said CCTV and bodycams are used, there is a “renewed focus on listening to families and carers” and she referred to a five-year programme of change called Time To Care.

“We know there’s more to do and much to learn from this inquiry and those who will share their experiences,” said Ms Grey.

The Lampard Inquiry will investigate the deaths of people who were receiving mental health inpatient care in Essex between 2000 and 2023.

Chairwoman Baroness Kate Lampard said the number of deaths within the scope of the inquiry will be “significantly in excess of the 2,000” previously thought.

This will include people who died within three months of discharge, and those who died as inpatients receiving NHS-funded care in the independent sector.

Valerie Charbit, representing North East London NHS Foundation Trust, said the trust wished to express “how sorry” it is and was “committed to assisting the inquiry in improving the outcome for Essex residents”.

Nicholas Griffin KC, counsel to the inquiry, said hearings will resume from 10am on Monday with commemorative and impact evidence.