Bedlam,’barbaric’ secure hospitals


via Bedlam¹,’barbaric’ secure hospitals, #rightfullives

37765453 - the bethlam royal hospital also known as bedlam

“At least 40 people with a profound learning disability or autism have died while admitted to “barbaric” secure hospitals the government has promised to close since 2015, a Sky News investigation has found.” Read full story here→

Most alarmingly, the number of cases of restraint in England rose from 16,660 in 2016 to 28,880 last year, a rise of 73%. NHS England alleges that the increase is explained by better reporting of incidents. [Oh really?] If we believe that, 12,220 cases of restraint went unrecorded in 2016 – 235 per week. Who’s being held to account for that?  

And the allegation that health services in Scotland, Wales and Northern Ireland were unable to provide figures is simply scary.

Sir Stephen Bubb² said that government’s failure to act was putting patients’ lives at risk:

“There are deaths of people in these institutions, some of them unexplained. We know there are significant problems and there will be at some stage another scandal, and yet we know what we need to do.

“The idea that in the 21st century you lock people up, you restrain them, you use prone restraint, you hold them down, I think is disgusting, it is barbaric and it is unacceptable, and it needs to be made unlawful.”

ignorance Plato


Adapting the words of Greek philosopher, Plato, in the context of mental health & LD:



¹ People with illnesses, which we now recognize as schizophrenia, depression, autism, and epilepsy, might all have found themselves in Bedlam.

² Sir Stephen Budd led the work, commissioned by NHS England, to support and enhance existing activity, to ensure thousands of people with a learning disability, who are still stuck in Assessment and Treatment Units, are supported to move back to their local community. The press release about the work with links to the full report is here→

The ‘Do nothing’ Advice


“Do nothing … if you can, take the rest of the day off.”

5892231 - crying crocodile


via Crocodile tears and the ‘do nothing’ advice




As usual, inciteful and poignant observations by Dr Sara Ryan, this time on attitudes to complaints and complainants within the NHS. It follows an article by Clare Gerada, Lady Wessely, an ex-chair of the Royal College of GPs and member of the Council of the British Medical Association. She is a Fellow of the Royal College of Psychiatrists too.

On receipt of a complaint, Gerada advises doctors to:

“Do nothing … if you can, take the rest of the day off.”

That’s not a luxury available to bereaved families or those suffering harm as a result of clinical negligence.

Extracts from Gerada’s twitter account (#FBPE @ClareGerada) also posted at Crocodile tears and the ‘do nothing’ advice include the following gems:

“It’s easy to complain. No risk to complainant. Sadly they kill doctors.¹”

And after a reply pointing out that it’s not always easy to complain, Gerada responds:

“It should be difficult. And patients should think very carefully. Complaints kill.¹”

So now folks, we (complainants) kill doctors!

And yes, there is a risk to complainants, who often suffer symptoms of stress in ‘taking on’ the (already far too ‘difficult’) NHS complaints system. We know one complainant, who suffered PTSD as a result of complaining about clinicians, and others whose mental health has been harmed.  One would expect a reasonably skilled Fellow of the Royal College of Psychiatrists to appreciate the risk of psychological harm to complainants.

What are the chances of transforming the NHS if Gerada’s ‘old-school’, defensive attitude prevails? Contrast this with the patient-centered culture of Virginia Mason Medical Centre, the world’s leading authority on Total Quality Management in healthcare:

“Stories have a profound impact on medicine – patient perspectives have the power to inspire an organization and strengthen the commitment to improving the quality, safety and delivery of health care.

“Capturing the patient voice opens the floodgates to know when the patient is feeling more vulnerable, lonely, worried, empowered or happy along each point of their care journey. Their experience can help inform where improvements can be made along the way.

“Through empowerment and solicitation of patient input, the patient experience can be fine-tuned, even perfected.”

Perhaps Gerada could attend ‘Eliminating Preventable Patient Harm‘ – a two-day course at The Virginia Mason Institute™ (please, not at taxpayers’ expense) or watch the webinar: Capturing Value in Patient Voices and Perspectives‘.

Very sad for a leading GP not to understand that, if the NHS is to become a safer place, complaints should be encouraged, investigated diligently and lessons learnt. Gerada’s attitude reminds us of the, “Patronising disposition of unaccountable power!” 

We are all for taking a break from the stresses of working life but the recipient of a complaint should (and must) ‘Stop the Line‘; report the incident; and ensure it is investigated immediately, especially if it represents a serious risk of harm if repeated.

Indeed, an inciteful clinician, who makes a mistake, should not be surprised by a complaint – he/she should have self-disclosed it already and have an answer before the complaint is received.

The goal should always be to achieve a zero defect healthcare system, in which customers always come first. 

And after the problem is solved and the risk eliminated, then take the whole of the next day off, relax and do something different (preferably with exercise), confident in the knowledge that the incident will not recur.

For example: take an alpaca for a walk²!

¹  We do not trivialise situations in which anyone has died, including clinicians: all deaths (or harm), suspected of being preventable, should be investigated with the same speed and vigour, regardless of the patient’s profession.

²  Petlake Alpacas of the New Forest  [Image © CRASH]  

Alpaca Walking Experience RECOMMENDED   Gold Star Minute   Gold Star Minute   Gold Star Minute  Gold Star Minute  Gold Star Minute    or Gifts

Reminder to self: if relocating to London do not register at a Hurley Group Medical Centre – of which there are many – your GP might have taken “The rest of the day off.”