Three patients die on psychiatric ward

Three patients have died within 12 months on the same ward following warnings from unions about budget cuts

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• Mark Gould
• guardian.co.uk, Tuesday 12 April 2011 13.10 BST
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Unison warned that budget cuts would compromise staff and patient safety. Photograph: Garo/Phanie/Rex Features
Three patients have died within the last 12 months on the same locked psychiatric ward, following repeated warnings from unions that budget cuts would put staff and patients at risk. In April last year, Prodip Debnath died after suffering multiple stab injuries to his face, head, chest and stomach in the Tower Hamlets Centre for Mental Health, in Stepney, east London. A fellow patient, Kamran Uzzaman, was found guilty of his murder. After Debnath's murder, the East London NHS Foundation Trust, which runs the hospital, instigated a raft of cuts to save up to £20m over three years. At the time, staff belonging to the health union Unison warned that the cuts – including reducing nursing cover by the equivalent of two nurses per ward – could put patients at risk. They also warned that new rotas would reduce the crucial handover period between shifts to just one hour, which could jeopardise the vital exchange of information on patients with complex needs, and would also oblige nurses to cover six shifts instead of five. Since then a second patient has died on the same ward – Roman ward – after placing a plastic bag over his head and suffocating. A mental-health worker who did not want to be named said: "The patient found the bag in a wastepaper bin. Anti-suicide guidelines say plastic bags should not be left on locked psychiatric wards because of the risk they present." In a statement to the Guardian, the trust said that, following the second death, an internal report recommended increased staffing levels on all acute wards, additional training and support for staff, and improvements to the physical environment. However, Roman ward saw the death of a third patient, a woman, in February this year. An inquest has been ordered, but has yet to be held. "There are concerns that the patient was not properly supervised … three deaths on one ward within less than 10 months does seem extreme," the health worker said. Tower Hamlets Centre for Mental Health is a £35m, purpose-built, 119-bed unit for seriously ill psychiatric patients. The building is only four years old, yet before it was opened Unison warned that the design would require extra nursing staff to ensure safety, as every patient has their own room. In January 2007, in a letter to the trust, Unison branch chair John Peers said: "The design of that building makes acute mental-health care very difficult and will require an increase of nursing staff in order to ensure the wellbeing of service users and staff, especially at night time." After the first two deaths, the trust undertook further redesign works, but Unison says its staff have no confidence that the work will make the building any safer. The NHS standards watchdog, the Care Quality Commission (CQC), made an unannounced visit to Roman ward in November as part of its routine schedule of inspection of the trust. It is due to report soon. A spokeswoman said: "CQC is aware of the death of a female service-user on the Roman ward. We will be working with the trust as it investigates this incident to determine whether a regulatory response is required." The CQC also visited the hospital in December. Dianne Barham, the director of patients' watchdog Tower Hamlets Local Involvement Network, said: "There are concerns because this is three deaths on one ward from patients and people in the Bangladeshi community. Staff morale is also a concern, as it's a pretty stressful business working in mental health." In a statement, the trust declined to comment on the details of the three deaths, but said that increased costs and a rise in the number of people being treated meant it would need to make further savings. It promised to do this in consultation with staff and patients. The statement added: "The trust is exploring a range of options to achieve savings without compromising the quality of care. We can confirm that we have enough staff on our wards to make our patients safe."