Coroner calls for action on mental health funding Lack of cash is ‘ongoing risk’ to patients
BIRMINGHAM’S Coroner has demanded an investigation into mental health funding in the city after the death of a man days after he was discharged from hospital.
Coroner Louise Hunt has taken the unusual step of writing a formal letter to NHS bosses before an inquest is held, expressing concern at the underfunding of mental health provision.
It follows the case of Michael Wheeler, who died two days after being sent home from Edgbaston’s Queen Elizabeth Hospital after suffering a mental health episode. Mrs Hunt said it was the seventh case of its kind she was aware of.
In an unusual move, she has made a Report to Prevent Further Deaths and sent it to the various NHS bodies in charge of mental health services in Birmingham and Solihull.
Normally these reports are only sent to organisations following an inquest.
Her actions followed the death of 57-year-old Mr Wheeler from Edgbaston in July.
A pre-inquest hearing will be held on October 29, while the full inquest will be on December 7.
His family claim he was let down by the NHS and that he took his own life during an attack of paranoia.
In a letter to Mr Wheeler’s family, the Coroner’s office told them: “The Coroner has become concerned that this case demonstrates an ongoing risk to patients receiving mental health treatment within the Birmingham and Solihull area from under-funding of mental health services.
“Therefore the Coroner has made a report to prevent future deaths to NHS England and the Birmingham and Solihull Care Commissioning Group setting out the concerns and asking that the funding situation is reviewed.”
The letter goes on to reveal that alongside Mr Wheeler’s death, there have been six other cases that raise similar concerns.
In the report, which is by Mrs Hunt’s deputy, Emma Brown, Area Coroner for Birmingham and Solihull, details are given of Mr Wheeler’s death.
He died in a fall from his fourth-floor flat two days after attending the QE while displaying symptoms of extreme paranoia.
At the hospital he was seen by a member of Birmingham and Solihul’s RAID (rapid, assessment, interface and discharge) Team. The medic concluded he could be discharged that day but needed to be seen urgently and referred him to the Home Treatment Team (HTT) for a review the following day.
This visit took place and it was identified that he needed a medical review the following day, July 27 – the day he died.
Ms Brown said during her investigation that matters were revealed which gave her “cause for concern”. These included: He was not reviewed by a psychiatrist at the QE and given a diagnosis and treatment plan.
Inpatient beds within the Birmingham and Solihull Mental Health Foundation Trust (BSMHFT) are currently operating at 109 per cent capacity and are often not available.
The situation is made worse by the fact that the cases of psychosis in Birmingham and Solihull is more than three times higher than the national average.
But a reply to the Coroner by Dr Hilary Grant, executive medical director of the Birmingham and Solihull Mental Health Trust, refutes any suggestion that lack of money is to blame.
Dr Grant writes: “We are working very hard internally, with relevant stakeholders, commissioners and across the public and third sector providers to attempt to address issues of capacity and demand in order to improve access and clinical outcomes for our service users and their families.
“We scrutinise serious incidents and mortality case notes reviews to identify themes and with regard to the latter, also undertake human factor analysis.
“We have not identified the theme of under-resourcing as a current factor in deaths.”