Scottish MPs demand full report on ‘risky’ restraint cases

An internal inquiry into the Carseview Centre in Tayside found that “untrained staff were carrying out risky restraints on patients and that the number of restraints was high”, according to reports by the BBC.

“Restraint is supposed to be a last resort, but the sheer number of occurrences shows that it is anything but”

Willie Remie

The Carseview Centre, part of NHS Tayside, is a hospital which cares for patients with mental illness from depression and anxiety, to schizophrenia and psychosis.

An internal report into the service, which has not yet been made public, found that in a sample of 40 restraint cases, “more than half were patients being restrained face down on the floor for longer than 30 minutes”, the BBC reported. It said the longest restraint was one hour and 45 minutes.

In response to the revelations in the leaked report, Scottish Liberal Democrat leader, Willie Remie, called for the full report to be published as soon as possible.

He said: “These horrific reports suggest patients are being mistreated in a potentially life-threatening fashion.

“Restraint is supposed to be a last resort, but the sheer number of occurrences shows that it is anything but,” he added.

“Experts and whistle-blowers have raised serious concerns about this behaviour,” he said. “The health secretary must ensure that the complete report is published as soon as possible and that its recommendations are delivered in full.”

“These pictures and testimonies will be horrifying for people across Scotland, but they will be heart-breaking for local families”

Monica Lennon

In addition, Scottish Labour’s shadow cabinet secretary for health, Monica Lennon, also called for the full report.

She said: “These pictures and testimonies will be horrifying for people across Scotland, but they will be heart-breaking for local families who campaigned for answers about Carseview and appear to be having their worst fears confirmed.

“This report now needs to be published in full without delay,” she said. “Health Secretary Jeane Freeman needs to desperately get a grip of the problems at NHS Tayside, which are not limited to mental health services.”

The report was sparked by a BBC Scotland broadcast that focused on patient allegations in July last year. It exposed cases of bullying and patients being pinned to the floor unnecessarily.

NHS Tayside responded to the broadcast by commissioning an internal report into Carseview, to go alongside independent reports into mental health in Tayside.

In wake of the leaked report information, Scottish minister for mental health, Clare Haughey, said lessons learned from the ongoing inquiry into services across Tayside will be “shared widely”.

“Lessons learned from the ongoing independent inquiry into mental health services across Tayside will be shared widely”

Clare Haughey

She said: “The Scottish government is investing significantly into mental health services, and expect all services across Scotland to be delivered at the highest standards.

“Those who require it, should have the best quality of care and the lessons learned from the ongoing Independent Inquiry into mental health services across Tayside will be shared widely to help shape and deliver future services to ensure this,” she said.

Ms Haughey said that NHS Tayside had “indicated their determination to make improvements” to ensure it delivers the best possible mental health services.

She said: “NHS Tayside have acknowledged that a number of recommendations from this report were required to be progressed as part of their Mental Health Quality Improvement programme, and this is a matter for the NHS Tayside board to deal with at a local level.

Scottish National Party

Clare Haughey

Clare Haughey

“The Scottish government is keen to ensure the voices of people with lived experience are heard clearly, and the report by the Health and Social Care Alliance, based on evidence from people with lived experience of using services in Tayside, is a good example of taking an inclusive approach to this,” she added.

In response to today’s reports, Professor Peter Stonebridge, acting medical director for NHS Tayside said: “The concerns raised last year about the use of restraint in Carseview are a particular focus for our least restrictive care steering group who are working with staff, patients and carers to reduce the levels of restraint within our inpatient wards.

“We report our rates of violence and restraint to the Scottish Patient Safety Programme Mental Health and it is clear that our median rates of violence and restraint do not make us an outlier with other mental health services in Scotland,” he added.

“People have told us about the impact restraint has on their mental wellbeing and we will ensure that their stories drive forward the reductions we are determined to achieve,” he said.

Professor Stonebridge added: “We have confidence in the quality and commitment of our staff to ensure that patients and carers have the best care experience possible.”

Since the BBC programme aired in July 2018, NHS Tayside said it has identified mental health services as an organisational priority and ensured that there was an “unrelenting focus” on improving services across Tayside.

NHS Tayside explained that efforts were being led by a new leadership team which was appointed in October 2018, which includes a new associate medical director for mental health services.

Professor Stonebridge continued: “NHS Tayside’s new chief executive has made a personal commitment to driving improvements in mental health services to ensure people have access to high quality care and treatment.

“Last year, the board of NHS Tayside said it would be working closely with mental health services at Carseview and it would act where changes were necessary,” he said.

“We are acting on the recommendations in the internal assessment and are determined to make a difference and support our dedicated staff to deliver the best possible mental health services across Tayside,” he added.

According to NHS Tayside, adult mental health quality improvements are being delivered against five key areas:

  • Promotion of service user, carer and staff co-design of services
  • Data to measure clinical effectiveness across all systems of care and used to guide further service developments and monitor effectiveness of the current systems
  • Clinical pathways – evidenced based, reliable, consistent, safe with reduced variation and cost
  • A focus on least restrictive trauma informed care
  • Continual Professional Development of the workforce

They said that the involvement of patients, carers and staff and listening to the voices and lived experience of service users was key to informing how it changes and improves practice.

Staff are leading quality improvement within Carseview and currently there are in excess of 50 staff participating in improvement projects, NHS Tayside noted.