A senior representative from Greater Manchester Mental Health Trust will attend to update the Committee on the Trust's response to the recent Panorama programme.  The Executive Director of Adult Social Services will provide additional information on the ongoing involvement of the Council's Social Work Safeguarding Team, working with other partners to support Manchester residents. Finally the Interim Deputy Place Based Lead (Manchester Locality) will provide an overview on how the local Manchester health and care system will interface with the Greater Manchester and regional systems and processes.

 

 

The Chair introduced this item of business by stating that following the recent Panorama programme, where an undercover reporter had filmed inside the hospital showing disturbing and upsetting scenes, a senior representative from the Greater Manchester Mental Health Trust had been invited to the meeting to address the Committee.

 

In addition, the Committee would hear from the Council’s Executive Director of Adult Social Services and Interim Deputy Place Based Lead, Manchester Locality.

 

The Chair further explained that the role of Health Scrutiny Committee was to consider how the Council and its partners in the NHS delivered health and social care services to improve the health and wellbeing of Manchester residents. The Committee could make recommendations about how they could improve these services.

 

The Chair advised that for anyone concerned about the care they were receiving or someone they cared for or has been affected by the issues raised in the BBC Panorama programme, they should not hesitate to contact the dedicated free helpline on 0808 175 3323. This was a confidential service staffed by trained and skilled practitioners who would be able to offer advice and support.

 

For completeness the statements are provided if full below:

 

Statement from the Deputy Chief Executive, Greater Manchester Mental Health Trust

 

Thank you for inviting me to speak to the Committee.

 

As you will no doubt be aware, the issues I’m about to speak to are extremely sensitive and are also subject to a number of ongoing investigations, including by Greater Manchester Police. As these proceedings are being live streamed and public, I therefore have to be cautious in what I can say to you today. I’m sure you will have questions and I will come on to how you can raise these formally, through our Programme Management Office, as I conclude.

 

By way of context

 

The Edenfield Centre is a secure hospital unit which provides inpatient treatment on our Prestwich site. Edenfield is approximately 1 mile away from the Trust HQ, situated near Phillips Park and Waterdale Meadow. The Centre has 12 wards within the secure perimeter, with around 160 inpatient beds and 600 staff.

 

On the afternoon of 8 September 2022, the BBC first informed us in writing that Panorama had conducted secret filming at Edenfield earlier this year (between March and June). They provided detailed information which listed a number of allegations about behaviours witnessed during their undercover filming – not of all which, we were told, would be broadcast. We formally requested to view the footage, but the BBC refused access to the programme in advance of broadcast.

 

However, we immediately notified Greater Manchester Police and Bury Safeguarding (who had also received a letter) and used the written allegations to take immediate action to protect patients.

 

At that point, it was clear that the BBC were alleging poor provision of services at the Edenfield Centre, including inappropriate or neglectful behaviour and a toxic staff culture. The information provided in advance by the BBC related to approximately 40 patients and approximately 25 staff.

 

We immediately recognised the seriousness of the allegations and set about taking immediate action. From a practical point of view, a Daily Executive Management Team was set up, chaired by Professor Craig Harris (deployed in from NHS Greater Manchester), who also took on the role of Programme Director for the newly created Programme Management Office. Our first and immediate priority was to ensure patient safety, so we acted quickly to:

 

·         Conduct detailed, senior clinical reviews of all the affected patients to ensure their safety

·         Put in place additional advocacy support for patients, their carers and their families

·         Deploy additional senior clinical and operational management to the Edenfield Centre to ensure that appropriate working practices are being followed – some of our most experienced and senior staff from other areas were redeployed to the centre itelf

·         Close the Edenfield Centre to new admissions and close a number of beds

·         We also suspended a significant number of staff, without prejudice, pending investigations – I’ll return to this point in a moment.

·         And we commissioned an independent clinical review of the Edenfield Centre, led by Dr David Fearnley (Chief Medical Officer at Lancashire & South Cumbria NHS Foundation Trust).

 

We anticipate that this review will present its findings to the Trust Board at the end of this month.

 

On the day of broadcast, 28 September, we opened a new, confidential freephone helpline for people who were affected by the issues raised in Panorama or those who wanted to report anything that they thought would be relevant to the investigations. Details of this, and other sources of support and routes for reporting crimes were published on the GMMH website – and publicised by partner organisations including Greater Manchester Police.

 

Partnership working has been absolutely central to our response. Straight away we established close, regular contact with local and national partner organisations including NHS England, the Ministry of Justice, NHS Greater Manchester (the Integrated Care Board), neighbouring mental health Trusts (such as Pennine Care) and the Bury Safeguarding Unit – all of this to ensure the safety of our services.

 

The CQC – who also received a letter from the BBC on 8 September and whose response was included alongside our own in the broadcast – have also been in contact frequently. You might have seen that the CQC have also been criticised in recent media reports on this matter.  Last week, the BBC reported that the CQC noted “strong” leadership at the Edenfield Centre and only suspended its “good” rating of the Centre in September, after the BBC had given the CQC information arising from its secret filming.

 

Separately, Greater Manchester Police began an investigation into the allegations contained in the BBC programme. This is ongoing. We are working with GMP to see if further footage can be obtained from the BBC to ensure that we have covered every base in ensuring patient safety and taking forward the necessary remedial, including disciplinary, action that may be required. Between gathering the secret footage in March through June 2022, the BBC only first notified us two-to-three months later - on 8 September - of their findings and allegations.

 

The police assured us last week that there was no reason why their own investigation should prevent us from making progress with our internal disciplinary processes.  I am sure you will understand that I cannot say much more than has already been published in partner briefings with regards to disciplinary processes at the present time - because I do not want to prejudice them in any way. We expect to have some more news on this matter very soon. Suffice to say, disciplinary procedures began immediately on receipt of the Panorama letter a month ago, and we are making rapid progress in this respect.

 

You will also no doubt appreciate that we have rightly been inundated with requests for information and assurance from multiple sources. Because of the nature of how the Edenfield Centre is commissioned, our patients come from across the Greater Manchester region and beyond. As such there are various routes of governance and assurance, and we are doing everything we can to ensure that all interested parties receive updates and information when we can share them.

 

This incident has, as you can imagine, put even more pressure on our limited capacity and resources – both from an operational and management perspective – but it’s safe to say that we have all been working tirelessly to do what is necessary to ensure our patients are safe and to put things right.

 

At this point, I should add a personal reflection. So let me be very clear: what we all saw on Panorama was utterly appalling and shocking. It was extremely uncomfortable to watch.

 

It’s fair to say that this has been, without a doubt, the most challenging period in the Trust’s history to date. Everyone has been shocked by the allegations and our colleagues were as horrified as everyone to view the programme. You only need a cursory glance at social media to see the kind of reaction from the public – and, unfortunately, some of our staff have been subject to a high level of abuse, which makes the duty of protecting our services and service users even more pressing. We have a responsibility to all our staff and service users to ensure a safe and proper working and therapeutic environment.

 

And it’s important to recognise that, whilst Edenfield is part of GMMH, the Trust is extremely large, with over 6000 staff and serving 60,000 patients across multiple boroughs and many geographical sites. You may be aware of other challenges we are facing in our other services, not least in Manchester on which you were briefed by my colleagues at your last meeting. Arguably this speaks to the wider picture of the pressures on the NHS in general, and on mental health services in particular which has been widely reported in recent months, and in the aftermath of the pandemic. We are focused on improvement and recovery.

 

We do not believe that the behaviours depicted at the Edenfield Centre on BBC Panorama are reflective of the vast majority of our services, or our staff. But of course we are not complacent about this and we are all working extremely hard to ensure that no one ever experiences this kind of poor care within our services.

 

With that in mind, I must emphasise that we are in constant contact with partners across the system. And we are very grateful for the support, the challenge and the guidance we are receiving from local, regional and national stakeholders – including some in this room today.

 

Let me end by saying that we are wholeheartedly committed to doing whatever it takes to put right these wrongs – and to preventing them from happening again. Our Chief Executive, Neil Thwaite, has promised honesty, candour and transparency as we go forward. And through our relationships, with your Chair and with other colleagues across the council, we will continue to keep you updated on progress.

 

I unfortunately can’t take questions. But if you do have any further questions please contact the Programme Management Office at progofficeEC@gmmh.nhs.uk

 

Thank you.

 

Statement from the Executive Director of Adult Social Services, Manchester City Council

 

Due to the significant serious nature of the concerns raised this incident is categorised as a safeguarding enquiry; this involves a coordinated response across GM Local Authorities. This is being led by the Director of Adult Social Services – Bury Council and the Bury Safeguarding Partnership with support from Manchester City Council and other local authorities. An ongoing series of weekly directors' strategy meetings is taking place to monitor and coordinate interventions and work with partner agencies to ensure the safety of patients on the wards.

 

We have mobilised a team of Senior Social Workers who are in the process of undertaking multidisciplinary care and wellbeing reviews with patients. We have a small number of Manchester patients identified at present, but we are expecting this number to increase in the coming weeks and months.

 

We have provided guidance to our workforce including contact centre staff and front-line practitioners across our teams, to ensure that we can give information and advice to patients and families who may require our support. We have established systems and processes to capture all relevant incoming information that is relevant to the enquiry. 

 

Statement from the Interim Deputy Place Based Lead, Manchester Locality

 

Edenfield was discussed at the meeting of the Manchester Partnership Board on Friday 7^th October and the Chief Executive of Greater Manchester Mental Health Trust provided the Board with an update.  NHS and social care partner organisations in Manchester are supporting the work to ensure that patient safety is prioritised in partnership with the NHS Greater Manchester Integrated Care Board.

 

Finally a copy of these statements will be circulated to members of the Committee after the meeting

 

Some of the key points that arose from the Committee’s discussions were: -

 

·         The Committee unanimously condemned the appalling treatment and abuse of vulnerable patients entrusted to the care of the Trust;

·         The Panorama programme demonstrated a systemic failure at the Trust;

·         The Committee could not be confident that these failings were isolated to the Edenfield Centre;

·         The senior leadership at the Trust were ultimately accountable for the failings witnessed, describing what was reported as a catastrophic failure on behalf of the Trust;

·         Noting that when the Trust had previously presented to the Committee they had portrayed themselves as making significant improvements in the care of patients, the Committee were of the opinion that this was evidently not correct and trust and confidence between the Committee and the Trust had been lost;

·         The Trust needed to engage with and meet all patient groups, community activists, families and carers, and local Councillors to hear and respond to all concerns raised in regard to the care of patients; 

·         Members questioned the efficacy of the Trust’s Whistleblowing Policy and the Trust needed to review these cases to consider any patterns that should have alerted management to issues within the organisation; and

·         The Committee unanimously called for a Public Inquiry to consider the issues at Trust.

 

The Deputy Chief Executive, Greater Manchester Mental Health Trust replied by stating that the Trust and its Board accepted that they were ultimately responsible for the quality of service. He stated that he had listened to the views of the Committee and these, along with those of all stakeholders would be reflected upon and included in the improvement plan. He advised that the Committee would be kept informed of this work.

 

The Executive Member for Healthy Manchester and Adult Social Care stated that there was a duty to support all the victims and their families who had experienced abuse and neglect. He advised that he would be lobbying the Secretary of State for Health and Social Care to launch a Public Inquiry to consider the issues raised in the BBC programme.

 

Decision

 

The Committee recommend that the Executive Member for Healthy Manchester and Adult Social Care write to the Secretary of State for Health and Social Care to ask that a Public Inquiry is launched to examine the issues raised in the BBC programme.