Greater Manchester Mental Health Trust has been criticised by investigators
‘It has not served you well to believe your own propaganda… [take some] time off from cup half full for a bit’. In the wake of claims of mental health patients being abused in hospital, Greater Manchester Mental Health Trust has been slammed as independent investigators pick the service apart.
Staff who were unequipped to be in senior management, a ‘combative management’ style, and a trust ‘believing its own propaganda’ were listed among reasons for shocking staff behaviour towards patients at the Edenfield Centre, ‘exposed’ by a BBC Panorama programme.
The Edenfield Centre is in the grounds of the former Prestwich Hospital and was the subject of a BBC Panorama programme that claims patients were abused. In the weeks following the episode, 30 staff were facing disciplinary action and a dozen were sacked soon after, the Manchester Evening News understands.
READ MORE: Independent review of troubled mental health trust launched following concerns for patient safety
Some staff were filmed by an undercover Panorama reporter embedded in the unit from March to June of last year. The footage in the one-hour programme, aired in September, captured apparent humiliation, verbal abuse, mocking and assault of patients – plus alleged falsification of medical paperwork.
A patient called Joanna was filmed apparently being pinched twice by a member of staff, and, against the rules, three male patients are found in one room watching porn, it is claimed. A member of staff was apparently filmed having a nap on a wall during her shift.
The trust commissioned the Good Governance Institute to conduct a review of systems and processes within the Edenfield Centre and across the trust in the wake of the Panorama programme, under the heading ‘why did we not know?’
“Edenfield became its own world,” investigators from the Good Governance Institute told leaders of Greater Manchester Mental Health Trust (GMMH) at a board meeting yesterday (March 27). Over a period of years, the centre became ‘closed to external influence’, breeding an ‘Edenfield management style’ that was ‘combative’ with other parts of the trust.
Inside the centre, ‘clinical leadership had become confused and dysfunctional’ prompting a rift between clinical staff and ‘management. Huge turnover among senior medics left a lack of authority and “staff who had stepped up to keep the service going were often too junior with little experience beyond Edenfield,” said Professor Andrew Corbett-Nolan, the Chief Executive of the Good Governance Institute, presenting his findings to the board.
“The poor physical environment and low staffing levels became normalised and accepted as ‘just the way things were.’”
The constant turnover over consultants ‘did not draw professional curiosity from trust leadership’, meaning ‘red flags’ were missed.
Beyond the troubled centre itself, the independent reviewers came up with a host of reasons why the centre had been allowed to decline so far despite being part of what was seen to be a successful organisation. Greater Manchester Mental Health Trust was receiving sustained positive feedback from health watchdogs, including the Care Quality Commission, and was put in a position of trust in the region.
However, the Good Governance Institute found that the trust prioritised growth and positive external judgements as signs of success, instead of being ‘spurred to be self-critical’. Matters were made worse by data being reported to executive board members in a ‘highly aggregated way’, meaning there was no indication of areas of concern and not enough detail needed to know where to change staffing levels, for example.
“There was a very clear desire to present a positive, optimistic image of the organisation which made dissent from this view difficult to surface,” added Professor Corbett-Nolan.
Concerns were also raised during the hours-long board session that the ‘Edenfield management style’ has ‘imprinted’ higher up in the trust as staff from the centre received promotions, one board member spoke of worries that those workers were still in positions of authority.
Unsafe levels of staffing is a hallmark of the trust, according to the Good Governance summary – and often went unchecked as ‘when standards of safe staffing became problematic, they were not appropriately monitored, allowing normalisation of lower than acceptable standards, placing undue pressure on staff and reliance on temporary fixes’.
“This was specifically prominent a feature within Edenfield,” said Professor Corbett-Nolan’s notes. “There is no escaping the fact that the staffing issues at Edenfield were critically low, exposing service users, staff and the trust to undue risk and this was not acted upon.”
The Good Governance discoveries came with a warning: “Sadly, this picture is not as exceptional as the public may think. This is a national issue and not unique to this trust.”
This is especially true for GMMH, said the presentation, as “the issues should not be surprising given the speed the trust had grown and the expectations placed on the leadership to sort out complex, long-standing issues in Greater Manchester.
“Services were bit by bit coming under significant pressures from multiple sources, e.g. national financial pressures and recruitment difficulties, the pandemic, etc.”
The findings come ahead of the more extensive Good Governance Institute report due to be published tomorrow. The report is one of a slew of measures which were taken to save the beleaguered mental health services following Panorama, including a police investigation which is ongoing.
The chair of the trust, Rupert Nichols, resigned in November after ‘inexcusable behaviour and examples of unacceptable care’ were ‘exposed’ at a mental health unit, he said. Later that month, the Manchester Evening News revealed that NHS England placed GMMH in the Recovery Support Programme, the ‘equivalent to the former special measures’, according to multiple senior NHS sources.
The presentation gave way to discussion of what the immediate steps are to change the trust, with a number of board members saying action needs to be happening faster, especially to boost staffing levels. Professor Corbett-Nolan told the board that it was heading ‘in the right direction’, but it should ‘get on with it’ and implement recommendations made by the institute now.
Source: Manchester Evening News, 28th March 2023