The Government report and action on patient safety is a welcome start – but root and branch reform is needed

30 June 2023
By Andy Bell

The UK Government’s rapid review into patient safety in mental health inpatient services underlines why root and branch reform is urgently needed to ensure people are treated safely, compassionately and effectively in hospitals.

The review’s findings tell us that providers and commissioners of mental health inpatient services do not have the right information to know if the wards they are responsible for are safe or providing high quality care. This has profound implications for service users, carers and families, and especially for people who are in closed institutions where the safety risks are highest.

We welcome the Government’s plan to set up a new national investigation into safety in mental health inpatient services, and its inclusion of a focus on children and young people’s wards. This must not, however, delay action on the Rapid Review’s recommendations.

We also welcome the Government’s decision to place the inquiry into deaths in inpatient services in Essex on a statutory footing to ensure that it receives the evidence it needs to complete its vital work.

But we need a lot more action to promote safety for everyone who needs mental health inpatient care. Nationally, the Government must commit to its manifesto promise of modernising the Mental Health Act during this Parliament. This will ensure people who are subject to the Act have more protection and better safeguards for their safety and dignity.

We also need government to invest in updating mental health hospitals that are no longer fit for purpose, where the buildings put people’s safety at risk. This must include investing in community services so that fewer people need hospital beds, and services close to home so that people are not needlessly sent miles from their local area. It is also vital that we invest in the mental health workforce, creating good jobs in healthy environments, tackling the current high vacancy and sickness rates in inpatient services.

Equality must also be at the heart of safety in mental health services. We know that Black people are less safe in mental health services, and racism continues to prevent people getting the right care. We know that too many autistic people are detained in mental health services because there isn’t the right help in their community. And too many LGBTQ+ people feel unsafe in mental health inpatient care that fails to meet their needs. So every effort must be made to ensure that safer services are more equitable services that are culturally competent, gender-responsive and affirming, and adequately adapted to people’s needs.

The Rapid Review is clear that leadership is needed at every level to make services safer. This is urgent, and action is needed now in every integrated care system and every service provider to make every ward as safe as it can be. It also requires reform and redesign, to reduce reliance on inpatient services wherever possible and make sure local areas have the right levels of provision to meet people’s needs where they live.

People deserve safe, effective and compassionate mental health services. No one should be in a ward where their safety and dignity are compromised. The Rapid Review must be the start of a process of both immediate action and longer term reform that makes the necessary changes to these essential services.

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