Trust's mental health services are threadbare, says CHI
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《英国医生杂志》
Mental health services run by a Welsh NHS trust are threadbare and often cannot help patients with urgent needs, an investigation by the Commission for Health Improvement (CHI) has concluded.
Staff shortages have led to heavy dependency on locums and bank staff, and there have been times when patients who needed to be detained or sectioned had been left in the community overnight.
The commission's investigators also found evidence of nurses working 24 hour shifts (by being both permanent and bank nurses), signs of staff burnout, considerable levels of sickness absence, high staff turnover, and concerns about the level of supervision for professional staff.
"Chronic staff shortages, lack of action on known risks, and confused lines of accountability, were all contributing to a failing mental health service at the trust," the commission says.
The investigation was triggered during a routine review of acute and mental health services of Pembrokeshire and Derwen NHS Trust when a number of concerns were identified, including little evidence of action being taken after previous incidents.
The commission says that the trust failed to implement changes after internal and external reviews following two serious incidents in 2001, including the death of a 20 year old woman after which the coroner recorded a verdict of suicide aggravated by neglect. The commission says that the trust's failure to act was also demonstrated by another major self harm incident in 2003.
At the time of the investigation the commission found that some ligature points, from which people could hang themselves, still existed on one of the inpatient wards.
"At present, the mental health service of Pembrokeshire and Derwen NHS Trust does not command the trust of the community. It urgently needs to demonstrate that it can provide good care when it is needed and particularly in an emergency. The trust provides a service in a challenging environment, but it needs to respond to incidents with appropriate thoroughness and address the staffing problems more innovatively and with more imagination," said Jocelyn Cornwell, the commission's acting chief executive.
The trust's chief executive, Frank O'Sullivan, said: "We are in no way complacent and will be working very hard to respond positively to the recommendations in the report. However, it is a pity that CHI have given such a negative report on certain aspects of our mental health services at the expense of excellent practice in other areas of our mental health, learning disabilities, acute hospital, and community services."
Welsh Assembly health minister Jane Hutt said that the issues raised must be tackled effectively and quickly: "Both the Welsh Assembly and the trust are fully committed to ensuring that the best possible healthcare is available, and it is absolutely vital that the issues identified in the review and recommendations from other work to be undertaken by the Assembly and Audit Commission are addressed as quickly as possible," she said.
She added, "I have asked that a review of priority risk areas for mental health services in Wales be undertaken. The review will look at variations across Wales in the practice and delivery of mental health services."(Abergavenny Roger Dobson)
Staff shortages have led to heavy dependency on locums and bank staff, and there have been times when patients who needed to be detained or sectioned had been left in the community overnight.
The commission's investigators also found evidence of nurses working 24 hour shifts (by being both permanent and bank nurses), signs of staff burnout, considerable levels of sickness absence, high staff turnover, and concerns about the level of supervision for professional staff.
"Chronic staff shortages, lack of action on known risks, and confused lines of accountability, were all contributing to a failing mental health service at the trust," the commission says.
The investigation was triggered during a routine review of acute and mental health services of Pembrokeshire and Derwen NHS Trust when a number of concerns were identified, including little evidence of action being taken after previous incidents.
The commission says that the trust failed to implement changes after internal and external reviews following two serious incidents in 2001, including the death of a 20 year old woman after which the coroner recorded a verdict of suicide aggravated by neglect. The commission says that the trust's failure to act was also demonstrated by another major self harm incident in 2003.
At the time of the investigation the commission found that some ligature points, from which people could hang themselves, still existed on one of the inpatient wards.
"At present, the mental health service of Pembrokeshire and Derwen NHS Trust does not command the trust of the community. It urgently needs to demonstrate that it can provide good care when it is needed and particularly in an emergency. The trust provides a service in a challenging environment, but it needs to respond to incidents with appropriate thoroughness and address the staffing problems more innovatively and with more imagination," said Jocelyn Cornwell, the commission's acting chief executive.
The trust's chief executive, Frank O'Sullivan, said: "We are in no way complacent and will be working very hard to respond positively to the recommendations in the report. However, it is a pity that CHI have given such a negative report on certain aspects of our mental health services at the expense of excellent practice in other areas of our mental health, learning disabilities, acute hospital, and community services."
Welsh Assembly health minister Jane Hutt said that the issues raised must be tackled effectively and quickly: "Both the Welsh Assembly and the trust are fully committed to ensuring that the best possible healthcare is available, and it is absolutely vital that the issues identified in the review and recommendations from other work to be undertaken by the Assembly and Audit Commission are addressed as quickly as possible," she said.
She added, "I have asked that a review of priority risk areas for mental health services in Wales be undertaken. The review will look at variations across Wales in the practice and delivery of mental health services."(Abergavenny Roger Dobson)