July 17, 2016

Heavily pregnant mental health patient 'pinned to the floor' in NHS Trust

Multiple mainstream media outlets including BBC News, Daily Mail and Metro have this week reported that Central and North West London NHS Trust has launched an investigation after an eight month pregnant patient was allegedly dragged from a seat and pinned to the floor by staff.

According to a witness, on 10th July 2016 the woman was "knocked face down to the floor" by a male nurse in a psychiatric hospital and was subsequently held there by three members of staff.


"I know safe restraint, and this wasn't it."

The alleged incident occurred on a night that a former adviser to the health secretary on patient safety, Alison Cameron, was an inpatient at the unit. Ms Cameron reported that the woman was eight and a half months pregnant and whislt she was being verbally aggressive, "she hadn't made any physical threats". 

"A male nurse came marching over from the treatment room to the dayroom," said Ms Cameron.

"He was threatening the woman saying 'If I hear your voice again, I will, I will...' and without finishing his sentence, he physically manhandled the woman from her seat to the floor. Three other members of staff then pinned her down."

Ms Cameron, who has been a patient advocate for years, said the use of force was wholly unnecessary. "I know safe restraint, and this wasn't it."

Following the incident Ms Cameron posted several tweets about the incident:

"I have just witnessed the most horrific display of violence by staff. Pregnant patient wrestled to ground. Horrible horrible horrible. Scary". 

"Nurse in charge was not even in the room when the incident kicked off. He rushed straight in, threatened the patient & dragged her to the ground".

"Pregnant woman is going to report last night's incident to the matron. She was checked by duty doctor who expressed concern at her bruises".

Ms Cameron, an associate at the King's Fund and an expert on patient safety, told the BBC that her experience of spending two nights at the unit last weekend was appalling.

She suffers from PTSD and needed treatment after feeling suicidal.

"It was far from therapeutic. I noted from the outset a lot of what I would describe as manhandling of patients which appeared to me to be the accepted culture on the ward," she said.

"The ward was short-staffed, with lots of bank and agency nurses", said Ms Cameron.

People were expected to sleep in dormitories, but because of the noise that some very sick patients were making, rest was impossible and she said some patients felt unsafe.

"There was constant shouting and swearing, everyone was tense and tired, there was potential aggression from patients, and the staff were very demoralised. I needed peace and quiet, and rest, to help me recover and I could see that wasn't possible."

She has reported her concerns to the Care Quality Commission (CQC).


CQC Report

The CQC has not commented on this recent incident and it is not known if the staff members involved had completed any physical intervention training. Page 32 of the latest report on the trust by the CQC, published June 2015, stated: 

"Between 1 May 2014 and 31 Oct 2014 restraint was used on 773 occasions. Restraint was being used mostly on the mental health psychiatric intensive care units, acute and forensic inpatient wards. In 284 (36.7%) of these 773 incidents, patients were restrained in the prone position. In 319 (41.3%) of the 773 incidents of restraint rapid tranquilisation was administered.

"The number of prone restraints was being closely monitored by the trust through a restrictive interventions group. However at the end of the last quarter (December 2014) the numbers of prone restraints remained at around 75 a month which is a high figure."

"Physical intervention training was delivered by an in-house tutor team and the model used was the general services association. The training focused on verbal de-escalation techniques but also teaches techniques to safely restrain patients."


CNWL: "We want to know why restraint was necessary"

In a statement to the BBC, the Central and North West London NHS trust said it acted as soon as it learned of the allegation.

"The chief executive immediately asked for an investigation which is well underway; witnesses (staff and patients) are being interviewed to find out what happened. We want to know why restraint was necessary, because it is always an extreme event, even when occasionally needed.

"After the incident a doctor examined the woman in question and she was fine. We are working with her and her family about the incident and helping her from here.

"We're keeping the CQC informed. Until the investigation is completed, the member of staff involved has been taken off clinical duties which is a normal - and neutral - step following this type of allegation."


The trust has apparently asked the media "not to name the hospital to protect the identity of the patient, who remains in the unit".