PSYCHIATRIC patients in Yorkshire were potentially unlawfully detained under the Mental Health Act because of “fundamentally defective or unsafe” documentation, an investigation has found.
The manner of the closure prompted widescale criticism of the organisation and standard of treatment offered to vulnerable patients, many of whom had to be relocated, virtually overnight, to another hospital in Middlesbrough.
It has now emerged that legally-required records to support detention of patients in both York and neighbouring Leeds were incomplete or lacked necessary verification in at least 25 cases, with an ongoing audit likely to find further failings.
All 25 patients had to be formally discharged from care as a result with some ultimately found not to be required to be subject to any form of detention under the Mental Health Act.
Some of the gaps in the records, held by Leeds and York Partnership NHS Foundation Trust (LYPFT), dated back several years which meant patients had potentially been unlawfully detained for lengthy periods of time.
Leading mental health campaign groups have criticised the failures with Mind stating there are “no excuses for not doing this properly when this is a decision which can have such a massive impact on someone’s life.”
Detention under the Mental Health Act, which is often referred to as being ‘sectioned’, usually requires the approval of two doctors and a mental health specialist. It should be subject to tightly governed checks and balances, including the maintenance of full and accurate records, to ensure a patient’s liberty is being limited on a lawful basis.
LYPFT, which is no longer responsible for the majority of mental health patients in the York area, has apologised for the failings and said it had increased resources for records management in response.
Initially it was discovered that 11 patients had been unlawfully detained by the trust’s services in the York area. Those cases were found after services were transferred, in October, from LYPFT to a new provider, Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV), who carried out their own audit into their newly acquired patient records.
As a result, LYPFT decided to carry out checks on records for its remaining services largely in the Leeds area and has so far found another 14 incomplete records. Further shortcomings are likely to be uncovered as the trust is continuing to check documentation for Community Treatment Orders (CTOs), which require patients to comply with a course of treatment outside of hospital detention.
LYPFT said: “The audit discovered 12 inpatients and 2 patients subject to a Community Treatment Order who had previously been inpatients where the documentation for their detention was considered fundamentally defective or unsafe.”
The two patients subjected to CTOs and one inpatient have been discharged entirely.
Eight patients were re-detained following a fresh assessment with the remaining three agree to remain as informal patients.
TEWV said four people who were subject to community treatment orders were discharged entirely and one was made subject to a fresh application under the Act.
Six inpatients were re-assessed with five re-detained and one person agreeing to stay as an informal patient.