• HSE assessing how health and care providers are managing risks to employees
  • Three health workers in the last five years have died after being assaulted by patients

Safety inspections have been carried out at 20 health and care providers, in response to a high level of assaults, including three staff killed by patients in the last five years.

The Health and Safety Executive has inspected how well the providers are managing risks to their staff from violence and aggression, as well as looking into musculoskeletal disorders.

HSE has identified that physical assaults and musculoskeletal disorders are more prevalent among health and social care staff than in other sectors, and has already told at least one NHS trust it is breaking health and safety law.

The inspections come after HSE noted that three of the six fatal incidents involving staff in health and social care in the last five years were caused by physical assault. These involved:

  • Healthcare assistant Sharon Wall, who was stabbed in the NHS Wotton Lawn Hospital in Gloucester in 2014 by patient Ryan Matthews. Mr Matthews was later given a whole life order. HSE found 2gether Foundation Trust, which ran the hospital, did not breach any health and safety guidelines;
  • Volunteer nurse Patrick Clarke, who was stabbed in privately-run Southleigh Community Hospital, South Croydon, in 2016 by patient Jimi Jedson. Mr Jedson was sentenced to a hospital order with no end date after being found guilty of manslaughter with diminished responsibility; and
  • Care worker Jenny Foote, who was hit with a fire extinguisher in 2015 by mental health patient Michael Meanza at Collette House hostel in Acton. Mr Meanza, who had been conditionally discharged from NHS-run Ealing Hospital, was sentenced to life imprisonment. An independent review commissioned by West London Mental Health Trust said it needed to improve the way it monitored risk assessments.

HSE has said it inspected “a mixture of acute and mental health care providers” in the first half of 2019-20.

It added that around 22 per cent of non-fatal incidents reported to HSE between 2015 and 2018 in health and social care were attributed to acts of violence, “which is three times as high as in all industries”.

Leeds Community Healthcare Trust has disclosed the HSE’s findings on its visit to them, and its response, in its board papers (see below). 

HSJ asked the HSE to identify the other 19 care providers which were included in this inspection programme and for the findings of those it has carried out, but it has not yet provided these.

Leeds Community Healthcare Trust

The trust has disclosed in its board papers that HSE inspectors told it they had “observed significant contraventions of the law” during an audit in August and September.

The HSE’s inspection found “evidence to indicate the trust is not doing all that is reasonably practicable” to manage violence and aggression and musculoskeletal disorders, which breached two sections of the Health and Safety at Work Act 1974.

The inspection also found:

  • The trust’s policies for violence and aggression, lone workers and safe moving and handling “do not identify high risk locations, tasks or roles”;
  • There was “no indication” in the violence and aggression policy “of what type of risk assessment must be produced and when”;
  • Evidence that security or environmental risk assessments “are not consistently carried out”;
  • Procedures for responding to panic alarms are “inconsistent” and there was “no evidence to confirm any procedures are routinely tested to ensure they work”; and

Inspectors also found the trust had three breaches of the Management of Health and Safety at Work Regulations 1999, which require employers to have sufficient risk assessments in place and take “all reasonable steps” to comply with the law.

In her report to the trust’s board in December, Leeds Community Healthcare FT chief executive Thea Stein said “a full action plan” is being developed to address the contraventions.

She added: “The HSE recognised the great culture in the organisation and the positive commitment and attitude they encountered from everyone they met.

“They concluded in their report, however, that whilst our culture was good, the trust could do more to systematically manage these types of risks and to ensure that we have all the right procedures in place.”

The trust said that, while it has been sent a notification of contraventions letter, it has not been served with an improvement notice or prohibition notice.

A trust spokeswoman added: “HSE is conducting an inspection programme to assess how NHS organisations are identifying and managing the risks posed to employees by violence and aggression, as well as musculoskeletal disorders.

“Leeds Community Healthcare NHS Trust was included in this inspection programme between August and September 2019.

“The HSE letter instructs the trust to produce and send a written action plan to address the points raised by end of March 2020. The trust will ensure it complies with this instruction. The HSE has not indicated that a follow-up inspection is required.”

Commenting on the Leeds inspection, an HSE spokesman said: “This document is a notification of contravention following proactive HSE work that looked at violence, aggression and manual handling relating to staff. As this is an ongoing intervention, it would be inappropriate to comment further at this stage.”