Psychiatric care 'collapsing' amid 'unsafe' mixed wards, bed shortages and poor safeguarding

By John Mercury February 21, 2024

The NHS England psychiatric care system is “collapsing” under the weight of “unsafe” mixed gender care spaces, inadequate safeguarding protections and bed shortages, according to former and current staff members who have spoken exclusively to Sky News.

The revelations follow the Sky News/Independent Patient 11 joint podcast investigation, which identified nearly 20,000 sexual abuse, harassment and rape complaints involving patients and staff in more than 30 NHS England trusts since 2019.

👉 Listen to episode one above – then tap here to follow the series wherever you get your podcasts 👈

Sparked by the testimony of former patient Alexis Quinn, the investigation has since triggered a slew of sexual assault and rape allegations from patients up and down the country.

Now, on the day the King’s Fund charity published a report that compounds care and safeguarding issues highlighted by the Sky News investigation, healthcare professionals have come forward to speak out.

“The mental health system is collapsing progressively as we’re speaking. It’s falling apart,” said Professor Jeremy Coid, a consultant forensic psychiatrist who, for a large part of his career, worked for NHS England.

“There is an acceptance that women can be very vulnerable, that some of the men are highly predatory and you cannot mix male and females [in non-segregated, male and female inpatient settings] in the context of severe mental illness. It’s ludicrous.”

In relation to the culture of dealing with inpatient sexual safety complaints, Sarah (not her real name), a ‘respect trainer’ who runs workshops with frontline carers in one NHS England trust, said: “Nobody wants to take responsibility for these things [sexual abuse complaints].

“It’s swept under the carpet. It doesn’t happen.

“We’ve got staff who aren’t trained properly. There’s no training that’s implemented within the NHS, co-produced by service users and staff regarding this stuff.”

In response, the NHS England mental health trust Sarah works for said any allegations of sexual safety were reviewed within four hours and that their guiding principle was “to believe any sexual safety reports from staff and service users”.

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‘I’m just being traumatised’ – former patient Alexis Quinn

Sophie’s experience chimes with that of one London-based locum psychiatrist who contacted Sky News saying they’d witnessed vulnerable female mental health patients being placed in “unsafe” non-segregated mixed gender care wards/shared spaces.

They said the process of logging sexual abuse complaints was often seen by staff as “an end in itself”.

A still-serving NHS nurse – who has also chosen to remain anonymous – has also come forward.

They allege they were told by a manager to “squash” a rape complaint made by a psychiatric inpatient against a doctor in a north of England trust because the complainant “was not to be taken seriously”.

In terms of the wider culture of safeguarding patients and staff against sexual attack, the Sky News podcast investigation initially found only six trusts from more than 50 contacted could demonstrate they’re applying government-backed sexual safeguarding protections – the 2020 Sexual Safety Collaborative – described as “vital” by the Royal College of Psychiatrists.

These latest individual testimonies speak directly to key findings in the King’s Fund healthcare charity report, which reveals:

  • 77% of NHS England mental health trusts require improvement or are rated inadequate for safety
  • That the current number of beds on mental health wards is at its lowest level since data collection began in 2010/11
  • And that there’s been a 24% increase in the number of people in mental health hospitals during the period April 2016 to November 2023

In response, NHS England said the pandemic resulted in an increased demand in beds “across the board” and that it’s making greater provision for home and community support.

(L-R) Stephanie Tutty, Alexis Quinn and Rivkah Grant say they were sexually assaulted while in NHS care
Stephanie Tutty, Alexis Quinn and Rivkah Grant previously told Sky News they were sexually assaulted in NHS care

‘Not enough beds to separate the sexes’

NHS England also cited its commitment to the NHS long-term workforce plan that aims to increase by 1000 the number of approved clinician roles across mental health services by 2036/37.

“There just aren’t enough beds,” added Professor Coid, who has in the past worked as an adviser to the Department of Health (DoH).

“So beds have been closed progressively and they continue to be closed. And you cannot separate the sexes,” he said.

“You’d have to create new wards and have more beds, which is desperately needed. But that’s not going to happen unless there’s a complete, total overhaul of mental health services.

Professor Jeremy Coid
Professor Coid says wards are understaffed, leaving patients vulnerable

“There was a reason that in the old mental hospitals, all the women would be kept separate,” said Professor Coid.

“At night, the nurses would set up like a barrier, sort of a counter within the corridor so that no male patients could get over to the female side because everybody knew what would happen.

“It’s very difficult [now] to provide the necessary oversight in a ward which has a 50:50 mix of male and female patients, said Professor Coid.

“You cannot provide oversight. That’s necessary. In addition to that, it’s compounded by the fact that wards are understaffed.”

In 2010, the DoH and NHS England committed to eliminating mixed male and female sleeping accommodation and shared common spaces.

Initially, breaches of the single-sex ward policy resulted in fines for individual trusts. This directive is no longer in place.

It remains a pledge enshrined in the constitution of NHS England that patients should not have to share sleeping accommodation, toilets or common spaces with patients of the opposite sex.

However, the Sky News Patient 11 podcast investigation discovered more than 500 allegations of rape and sexual assault in mixed, non-segregated psychiatric inpatient settings, across more than 20 trusts, since 2019.

NHS England currently has no mandatory enforcement of sexual safeguarding protections.

It says it’s asked trusts to appoint domestic abuse and sexual violence leads as part of a zero-tolerance approach to keep patients and staff safe from sexual misconduct and violence.

Yet former patients, staff and retired health professionals continue to come forward with fresh allegations.

‘Shocked how much it’s still going on’

Among them is former nurse Kathy Haq from Sunderland, who alleges that she was raped by a psychiatrist whilst working in a hospital in Yorkshire in 1969.

The psychiatrist was later charged but never prosecuted.

Later, Kathy was part of a victims’ group at the centre of the 2005 Kerr/Haslam Inquiry into the sexual abuse of patients in Yorkshire.

Kathy Haq
Former nurse Kathy Haq says she’s shocked by the scale of abuse still taking place

As a result of the inquiry, the government promised tough new measures to improve safeguarding and prevent the repetition of such abuses.

“Maybe I was naive to think that what we did would put a stop to these things,” Ms Haq told Sky News.

“I mean, I’ve worked in the NHS for 46 years. But I was quite shocked to see how many and how much it’s still going on.”

When Sky News first revealed the findings of its Patient 11 podcast investigation, NHS England said: “We are taking action to ensure the safety of patients and staff, including rolling out better reporting mechanisms, training and support as part of the NHS’s new Sexual Safety Charter.

“NHS England has advised all trusts and local health systems to appoint a domestic abuse and sexual violence lead to support patients and staff to report incidents and access support, with more than 300 now in place.”

A Department of Health spokesperson said: “Sexual violence or misconduct of any kind is unacceptable and NHS organisations have a responsibility to protect both staff and patients.

“The Department has zero tolerance and is clear that the NHS should work to stop sexual assaults happening in NHS services and premises.

“We have been clear patients should not have to share sleeping accommodation with others of the opposite sex and should have access to segregated bathroom and toilet facilities, and we expect NHS trusts to comply with these measures.

“We are working closely with the NHS to ensure anyone receiving treatment in a mental health facility receives safe, high-quality care, and is looked after with dignity and respect.”


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