Patient And Staff Safety Within The Mental Health Setting

• Published date: 23 June 2023
• Subject Matter: Food, Drugs, Healthcare, Life Sciences
• Law Firm: Weightmans
• Author: Jasmine Armstrong

How can healthcare providers nurture a positive learning culture to improve staff and patient safety?

Organisations providing mental health services have to navigate some of the most challenging regulatory, legal and statutory risks. In that context, how can those providers nurture a positive learning culture to improve staff and patient safety?

Fundamentally, healthcare providers strive to give the safest care, because a consequence of falling short is injury or fatality. To the people delivering care, the regulatory, legal, statutory threats/sanctions are not a key motivating factor. Nevertheless, the consequence of harm to patients and staff remains a huge burden:

• Patient harm: in one year the cost of claims linked to poor mental health care was just less than '20m. As well as the costs in damages these claims are likely to have involved exacerbation of ill health and increased care needs.
• Patient death: in 2022, 193 deaths occurred whilst the deceased was detained under the Mental Health Act.
• Staff harm: staff in mental health trusts are approximately seven and a half times more likely to be attacked than staff in other NHS trusts. Over 5 years NHS Resolution received 1,791 claims associated with assaults in a mental health setting. The costs associated with assaults on NHS professionals during this period was '26.2m (damages). We do not have data on how many of those people returned to work or the medium-long term implications of the assault upon their well-being.
• Prosecution by CQC: breach of regulation 12 (Safe care and treatment) nearly always involves failure to safeguard patients who are vulnerable and/or lacking capacity.
• Prevention of Future Death reports: in 2021-22, 40% of PFD reports concerned healthcare providers.
• Individual and organisational reputation: in 2021, more than 15,000 written complaints concerned Mental Health services (10% of written complaints).

Other consequences which are not so measurable involve local communities' lost confidence in their healthcare providers, healthcare practitioners leaving the profession and/or facing GMC/NMC investigation.

Nurturing a learning culture

"Being Fair, promoting a person-centred workplace that is compassionate, safe and fair" demonstrates the importance of a nurturing, learning culture. Similarly, the Patient Safety Incident Response Framework (PSIRF) is designed to facilitate proportionate, compassionate investigations and a learning culture: moving away from blame. However, the...