Manchester leaders have again slammed the failing mental health trust after months of promised improvements – to little avail

Manchester Evening News, 21/12/2023

More than half of Manchester mental health patients are not being read their rights within two weeks of being sectioned. 

Just 47 per cent of patients in south Manchester and only 41 per cent of patients in north Manchester are being read their rights within the first two weeks of admission to hospital after being detained under the Mental Health Act, also known as being sectioned. The Manchester Evening News can reveal the shocking data after it was aired in a small council meeting to monitor Greater Manchester Mental Health Trust’s (GMMH) performance after more than a year of revelations about patient abuse, neglect and failure of patients. 

Councillors who have been scrutinising the troubled mental health trust’s improvement plan slammed the figures. Trust staff representing GMMH at the meeting responded by saying they did not exactly know why the numbers of patients being read their rights within two weeks was so low.

They added that they believed the rights might be being read in more cases than shown by the data, but staff may not be entering that information into the mental health trust’s system for care records.

The Manchester Evening News has spent months reporting on serious issues at GMMH, including harrowing treatment of vulnerable people at inpatient facilities caught on camera and staff in racism rows across the trust. One of GMMH’s in-patient facilities, the Edenfield Centre in Prestwich, became a focus for scrutiny after an explosive Panorama programme was aired.

Some staff were filmed by an undercover Panorama reporter embedded in the unit from March to June of 2022. The footage appeared to show patients being bullied, humiliated, swore at and taunted by some members of staff.

The trust was plunged into the highest levels of oversight by the NHS, and was told to improve by health watchdogs, the Care Quality Commission (CQC), and independent investigations alike. The overall rating for the trust itself now stands at ‘inadequate’, as of a new CQC report carried out in 2023. 

And more than a year of numerous pledges of progress, half the improvements the trust promised are ‘not progressing to plan’ and actually getting worse. At the trust’s latest board meeting at the end of November, papers revealed how key areas for improvement like ‘ligature risk management’, ‘safeguarding’, and ‘sexual safety’ have been classed as ‘deteriorating’.

Documents were published as part of the latest meeting of the Greater Manchester Mental Health NHS Foundation Trust: Improvement Plan Task and Finish Group, in which Manchester councillors were to probe the trust’s ongoing efforts to improve. The meeting held on Tuesday, December 19, at Manchester Town Hall revealed yet more concerns.

GMMH shared a presentation, but one slide detailing ‘improvements in patients’ rights being read within the first two weeks of admission for detained patients’ under the Mental Health Act left councillors reeling. Not only are the figures frighteningly low for such a basic action, said the councillors, the number are not increasingly nearly fast enough.

At the end of quarter one, a shocking 32 per cent of patients in south Manchester were being read their rights within the first two weeks of admission after being sectioned. That number improved to 47 per cent after three months, marking the end of quarter two.

For north Manchester, only 38 per cent of detained patients were being read their rights within two weeks after admission to hospital. That only rose to 41 per cent by the end of quarter two.

“This goes to the heart of what we’ve been talking about with the Edenfield Centre – these are issues with patients rights and treating people as humans,” said Councillor Joanne Green, the chair of Manchester City Council’s health scrutiny committee. “It’s not good enough that we don’t know whether it’s a data recording issue – and, regardless, it should be 100 per cent.

“Unless you can tell me a good reason why it isn’t 100 per cent? It would seem so basic and fundamental, I can’t understand it.”

Representatives of the trust told the meeting that they were not exactly sure why the figures were so low – with one suggestion being that GMMH staff do read rights in more cases than shown in the data, but do not record completing that action as they should on the trust’s system for care records, named Paris.

However, data issued by the trust claims that ‘Manchester systems and processes in place to ensure patients are aware of their rights and accurately recorded’, adding that ‘Mental Health Act training is now mandatory’ for staff. The trust says that the percentage of staff completing the mandatory training is high, quoting that 84 per cent of staff have completed training in the Mental Capacity Act and Mental Health Act, and 83 per cent are completed training in the Deprivation of Liberty Safeguards.

Trust targets, however, all stand at 85 per cent completion. 

The Mental Health Act is the law that mental health professionals use to detain people in hospital for assessment, treatment or both. If someone is detained under the act, it is sometimes known as being ‘sectioned’, referring to being detained under a particular section of the act depending on the circumstances of the person.

People should be given information about their rights under the Mental Health Act when they are first admitted to hospital, and regularly thereafter. 

John Foley, interim chief operating officer at GMMH, responded to the contents of the council meeting by saying: “Providing our patients detained under the Mental Health Act with clear, accurate and timely information about their rights is essential, and we are very sorry to those whose experience hasn’t reflected this. Improving this process, including clearly recording when these conversations have taken place so we can accurately monitor and report on it, is a key priority for GMMH, embedded in our improvement plan.

“Recently we have made some important changes, including investing in Quality Matron roles to enhance and ensure patient safety. Part of this role is to ensure that our staff are having the right conversations with patients at the right time, and are recording these conversations consistently. 

“There is a robust action plan underpinning this work, which includes weekly audits of patients’ rights being communicated, and targeted improvement work in the areas that need it.”