Mental health practices under watchdog scrutiny
Tayside amongst worst areas‘boarding out’patients to wards
A mental health watchdog says NHS Tayside was among the worst areas in Scotland for‘boarding out’acute adult patients to other wards.
Along with health boards in Lothian and Greater Glasgow, a total of 86 patients were found to have been shifted to wards not meant for their treatment because of a lack of beds.
But inspectors from the Mental Welfare Commission for Scotland also reported positive comments regarding staff and care at Perth’s Murray Royal Hospital.
NHS Tayside says the commission’s report is based on inspections from a number of years ago. They were carried out in 2012.
The commission’s inspectors looked at 47 mental health units and wards across Scotland in the assessment, where more than 1000 hospital beds are available.
Their report carried two complimentary mentions from a patient and a visitor at the Perth hospital. The patient commented on the nursing care and their recovery action plan said they felt “comforted”.
The commission’s snapshot of this area of care across Scotland also looked at the suitability of the surrounds for patients and moves to bolster their physical health and well-being – not just their mental health – through activities.
Concerns were raised about mixed gender wards and that some patients were feared for their welfare.
The new replacement Murray Royal Hospital officially opened in 2013. The Moredun ward was chosen for the inspection, while the Mulberry Unit in Angus was also visited.
Inspectors considered issues such as patient involvement with their care in terms of advance statements. These are used to help shape patient care and could be used if patient notes are not immediately available, such as in out of hours care.
NHS Tayside confirmed that it had adopted this approach.
Dr Neil Prentice, Associate Medical Director for Mental Health, on behalf of the Perth and Kinross Health and Social Care Partnership – which is responsible for delivering mental health services across Tayside – said: “NHS Tayside is keen to support patient involvement in their care. The use of Advanced Statements is beneficial for patients with significant and recurrent mental health problems and our staff do encourage patients to consider this. Our staff are fully trained in supporting a patient in this respect, however, we are not in a position to instruct patients to undertake this as it is a personal choice for individuals.”
The PA also asked about other care factors which were mentioned. These included carers, in many cases relatives of the patient, who felt they were not Murray Royal Hospital
properly updated on patient treatments.
Dr Prentice added: “There is clear guidance in relation to the responsibilities and the role of the named person in relation to the Mental Health Act. Our Mental Health Services do support this approach and in addition encourage named persons, carers and other relevant parties to become involved in the care of our patients where appropriate.
“The Carers Charter and Triangle of Care are key elements to support this approach.”
Inspectors also found at some sites there was no suitable provision for patients and visitors to speak in private.
Dr Prentice responded: “Murray Royal Hospital is a purpose-built psychiatric facility with a focus on positive patient experience and a support therapeutic environment. We have clearly identified individual private space which can be used by patients and their families.”
However, since the publication of the commission report last Thursday, a former patient at Murray Royal Hospital confirmed that while there designated space for patients and their families, it is often not available.
The service user, who wished to remain anonymous, said: “The new Murrays (Murray Royal Hospital) is an excellent facility, but during my stays when I have family or friends in I often had to meet them in my bedroom. That’s not great because one of of you has to sit on the bed while the other uses the available chair.
“The visitor spaces are often taken up and other rooms were being used by staff or for consultation.”
NHS Tayside said it would be looking at MWCS’ report and “develop a specific response and action plan to this report following its publication”.