The NHS has a large number of contracts with private providers of mental health services, both residential and in the community. In many cases these private providers have failed to provide the standard of care required under the contracts, instead providing inadequate and often unsafe care.
In November 2017, the Care Quality Commission (CQC) reported that people with drug and alcohol addiction are being put at risk of harm at many independent residential rehabilitation units. The CQC report found that nearly three-quarters of private clinics were failing to hit regulatory standards of care. The report was based on inspections of 68 independent services providing residential detoxification services over the last two years. The CQC required 49 providers (72%) to make improvements because they had breached regulations of the Health and Social Care Act 2012 and failed to meet fundamental standards of care. The CQC took enforcement action against eight providers.
Private companies that have been reported in the media are The Huntercombe Group, Cygnet Healthcare and The Priory Group.
The Huntercombe Group
Hospitals run by the Huntercombe Group have received particularly critical reports after inspections by the CQC. In 2016, its hospital in Stafford was placed in special measures and told to urgently improve in 24 areas.
In September 2017, Watcombe Hall, was closed indefinitely after the local NHS hospital raised concerns about the number of young patients being admitted from the unit suffering from malnutrition and dehydration.
In December 2018, an inspection by the CQC of the company’s hospital in Norwich found serious concerns. The CQC took immediate action to protect those using the service, including enforcement action to remove the registration for the hospital. The Huntercombe Group then closed the service and the children and adolescents had to be found places elsewhere.
Hospitals run by Cygnet Healthcare have also been criticised.
The CQC inspected the Knole Ward at the Cygnet Hospital at Godden Green, in Kent, in July and August 2017 after it was informed of concerns about the safe care and treatment of young people.
As a result of the visits restrictions on the provider’s registration were imposed by the CQC, saying it could not admit any young person to the ward without prior agreement with the CQC. This remained in place for a month.
In June 2019, HSJ reported that multi-agency investigation had been launched into Cygnet’s 65-bed hospital in Maidstone, whose 15-bed male psychiatric unit had had a “disproportionate” number of safeguarding alerts for patient-on-patient attacks.
The Priory Group
The Priory has been the subject of several reports of failures in care in recent years, including patient deaths.
In 2016, an inquest ruled that the death of a 14 year old Amy El-Keria at a Priory hospital in 2012 was as a result of months of serious failings at the hospital, including staff failing to pass on the fact that she had spoken of wanting to end her life. The inquest also ruled that staff failed to dial 999 quickly enough and failed to call a doctor promptly. Staff were also not trained in cardiopulmonary resuscitation (CPR). Staffing levels were also found to be inadequate and a lack of one-to-one time caused or contributed to Amy’s death in a “significant” way.
Following the death of Amy, the Health and Safety Executive brought a case against The Priory Group under the Health and Safety at Work Act. In January 2019, The Priory Group pleaded guilty; reports state the fine could be unlimited, but the prosecutor suggested it would be at least £2.4 million. Eventually the company was fined only £300,000 in April 2019; the judge reportedly took into account that the firm pleaded guilty to criminal charges and reported that its 2017 turnover was £133 million with an operating profit of £2 million.
Early in 2016, the the family of 17-year-old Sara Green, who died in the Priory Royal in Cheadle in 2014, called for the company to have its NHS contract cancelled. In March 2016, the Priory and Solent NHS Trust admitted liability for the death of 15-year-old George Werb, who had been a patient at the Priory Hospital Southampton.
More recently in July 2018, the company’s hospital in Southgate, North London, was rated “requires improvement” overall by the Care Quality Commission, following an unannounced inspection. However, the CQC rated it as “inadequate” for safety and noted several concerns across its child and adolescent mental health services, acute adult wards and substance misuse services. In February 2018, the company’s hospital in Roehampton was rated “required improvement” overall.
More recently in February 2019, the Priory’s hospital for children with learning disabilities in High Wycombe was closed, following a CQC report that gave the unit an overall rating of ‘inadequate’. The CQC found the hospital “not adequately equipped to care for young people with complex needs”. The hospital had only opened in April 2018 and catered for children aged 13 to 17 with learning disabilities and/or autism.
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