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The Royal College of Psychiatrists’ request back in May for government to hold a public inquiry into failings at Whorlton Hall has now hit national news. The calls resurfaced following a scathing Care Quality Commission report last month into a learning disabilities unit, called Newbus Grange, which is run by the same provider.

Both Whorlton Hall and Newbus Grange – along with two inpatient units called Thors Park and Chesterholme – were previously operated by the Danshell Group before it was bought out by Cygnet Healthcare last year.

Abuse and failings at Whorlton Hall have now been well publicised, and CQC reports into the three others have now all raised serious concerns over patients’ “unexplained injuries” and high levels of restraint.

Despite the mounting evidence it seems unlikely the current government, in this political climate, would launch a public inquiry into failings largely on its own watch. 

On the other hand, if a general election puts Labour into government, a public inquiry would be a realistic possibility.

Yet an inquiry focused solely on Whorlton Hall – or even the group of units – would surely miss much wider problems.

There’s growing evidence of systemic poor care in the ex-Danshell inpatient units – but also in other privately-run inpatient mental health and learning disability units.

And there is no lack of examples of poor care in NHS run units over the last few years either.

A recent NHS example came in August, when the CQC closed down several child and adolescent mental health units in Middlesbrough, run by Tees, Esk and Wear Valley Foundation Trust. The service was rated “inadequate” and criticised for “substantial and frequent” staff shortages; staff not adequately assessing, monitoring or managing risks to patients; and insufficient staffing levels and skill mix. Two teenage girls had died there in June and August, and admissions had earlier been suspended by the CQC in June.

And the series of failures at North Essex University Partnership FT’s inpatient units have already been the subject of a police investigation, and are now being examined by multiple independent reviews.

Calls for a public inquiry about this trust, in relation to the death of a young boy, were recently backed by MPs across the three main parties: Norman Lamb, Barbara Keeley and home secretary Priti Patel. Ms Patel has also written directly to Matt Hancock about it.

So it appears the health secretary has had two letters across his desk just this year – from a royal college and a fellow cabinet member – calling for public inquiries into two separate mental health and LD providers. 

These cases appear to be the tip of an iceberg, and it is clearly an issue of widespread and growing concern.

If Mr Hancock or any of his successors did look at launching a full-blown public inquiry, they would have to plump for one or another individual failing.

That’s not to say, of course, it would prevent system-wide evidence coming forward, or system-wide learning. The Francis inquiry on Mid Staffs – the freshest in the NHS mind – led to a range of national policy change, and to increases in acute nurse staffing nationally. It also fuelled a thorough debate about whether those failings should be considered a one off, or not.

Regardless of the public inquiry issue, the safety of inpatient MH and LD units, both private and NHS, is yet to be properly examined by national NHS bodies. NHS England and NHS Improvement might want to address this by commissioning their own independent review.

Mental Health Matters is written by HSJ’s mental health correspondent Rebecca Thomas. Tell her what you think, or suggest issues she could cover, by emailing her in confidence at rebecca.thomas@wilmingtonhealthcare.com or by sending a direct message on Twitter.

Join us at the HSJ Transforming Mental Health Summit (28-29 November 2019, Hilton Leeds) as senior peers from across the NHS, local authority and wider mental health service delivery landscape discuss the remaining challenges as we reach the end of the Five Year Forward View. Register your interest here: http://bit.ly/2KbYAzJ