Agenda item

This item will be considered jointly with the Public Protection and Safety PDS Committee.

The object of the report is to advise and re-assure the PDS and residents of Bromley of South London and Maudsley Trust’s (SLaM) awareness of the risk of patients on leave becoming absconders and the actions that have been put into place to address these risks.

On 30^th November 2009,  Prof, Hilary  McCallion – Dir. Nursing and Education, Patrick Gillespie, Service Director and  Prof. Tom Fahy – Clinical Director of the Service from SLaM attended a joint meeting of the PP+S and A+C PDS to respond to the concerns following the absconding of a patient over the weekend of 13^th November 2009.

The Joint PDS were advised that a) an investigation was underway around the circumstances of the incident and b) that a review of patient leave from the Medium Secure Unit was also underway.

Representatives of the SLaM Trust agreed to return to the PDS on 17^th March 2010 to report on progress with that Review. Members requested that the Chief Executive and Chairman of the SLaM Trust attend the meeting.

In the meantime, it was noted that the Director of Adult and Community Services would be invited by SLaM Trust to review the outcome of the investigation of the incident on a confidential basis.

Members received a report from SLaM and an updated copy was circulated at the meeting.  SLaM was brought with them Sara Murray whose company “Buddi” had provided the trust with a “tagging” system.  Unlike like the ones used by the probation service  the Buddi tags had a GPS tracking device and so the trust were able to track patients on leave.  In the event that a patient absconded, went more than 25 miles from the hospital or failed to return at the correct time the hospital would be alerted and immediate action would be taken.  In addition the tag could have an alarm programmed so that it vibrated to remind patients when to return.  Patients themselves had requested this feature.  It could be set to a desired time, for example 30 minutes before leave was due to end so that patients know when to return.  The device itself was tamper proof, if a patient did try to tamper with it an alert would be sent to the hospital.  Patients had to agree to wear a tag if they wanted to go on leave.

Members had concerns that tracking patients was a breach of their human rights. The company explained that the device only alerted the hospital if the patient breached their leave conditions it did not record what patients were doing, it was purely for tracking purposes.  Members were also concerned that they were kept informed. 

Members then debated the SLaM report. The Chief Executive explained that they recognised that things went wrong and had changed their policies and procedures in light of this.  Whilst they could not entirely eliminate it occurring they would now have systems which would mean they could respond more rapidly to recover the patient. 

Councillor Nicholas Bennett requested that all Ward Members of the 3 surrounding wards were kept informed of abscontions and not just Kelsey and

Eden Park wards. The trust agreed that as soon as they alerted the Police they would also alert the Chairmen of the Public Protection and Safety Policy Development and Scrutiny Committee and the ACS Policy Development and Scrutiny Committee as well as ward members of the 3 surrounding wards, one of which was a Croydon ward. 

Members welcomed the 10 point action plan. They queried why a GRAB plan had not been used in the past.  SLaM representatives explained that it had but had now been updated and included more information. 

The Trust answered a number of questions from the Portfolio Holder for Public Protection and Safety relating to patient profiles and medication. 

The Portfolio Holder for ACS questioned that assessment process which determined whether patients were suitable for leave. The Trust explained that before agreeing to leave clinicians assessed each patient using a very detailed process.  These assessments were then sent to the Ministry of Justice who approved the leave.

The trust also confirmed that only low risk patients were allowed unescorted leave.  High risk patients were always escorted and only went out for emergency apportionments or court appearances.

They acknowledged that mistakes had been made but were confident, with the new systems in place.  They also explained that they were also subject to auditing by the Royal College of Psychiatry and were 86% compliant with the performance outcomes.

Members welcomed the recommendations and requested an update in a year’s time.

The chairman thanked the SLAM team, they had taken Members concerns very seriously and he was delighted to see the progress made.  He also thanked the Portfolio Holder and Members for their persistence in getting this matter reviewed.

Resolved that the report is noted.