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Sexual safety an issue for mental health wards, review finds

Staff must be given appropriate training, and incidents taken more seriously, insists regulator

Caroline White

Wednesday, 12 September 2018

Sexual safety is an issue for patients and staff on mental health wards, a review* of nearly 60,000 patient safety incidents reported by mental health trusts, has found.

The review, which was carried out by health and social care services regulator, the Care Quality Commission (CQC), shows that over 1000 of these were sexual, involving patients, staff, and visitors. More than a third could be categorised as sexual assault or harassment of patients or staff.

Prompted by concerns about the safety of patients and staff working on mental health wards, following an inspection of a mental health trust last year, the CQC reviewed nearly 60,00 reports on patient safety incidents that staff had submitted through the NHS National Reporting and Learning System between April and June 2017.

Many reports described sexual safety incidents: 1120 involving patients, staff, visitors and others were described in 919 reports – some of which included multiple incidents.

More than a third of these (457) fell into the categories of sexual assault or sexual harassment of patients or staff.

Providers and service users told the regulator that people who use services don’t always feel that they are kept safe from unwanted sexual behaviour, and clinical leaders don’t always know what’s good practice in promoting the sexual safety of people using the service and of their staff.

Many staff said they don’t have the skills to promote sexual safety or to respond appropriately to incidents, while the ward environment doesn’t always promote sexual safety either.

Staff may under-report incidents, and reports may not reflect the true impact on the person who is affected, says the CQC, while joint working with other agencies, such as the police, doesn’t always work well in practice either.

People need to be kept safe and their privacy and dignity should be maintained at a time that, for many, is the most vulnerable point in their lives, says the regulator, which has pledged to work with all the relevant parties to improve the sexual safety of people who use mental health services.

Health and social care services must work with patients to produce guidance to enable everyone who delivers mental health services to do the right thing about sexual safety, it says.

Staff should be given the right training to enable them to put in place new national guidance for managing sexual safety incidents, and leaders must also encourage staff to have open conversations about sexual safety with people who use services, insists the CQC.

Providers, stakeholders, staff, people who use services, the police and safeguarding teams should work together on the approach to sexual safety incidents to make sure that disclosures are taken seriously and given the attention and sensitivity they deserve, it says.

NHS Providers deputy director of policy and strategy, Miriam Deakin, said that the safety and dignity of people who need care, and of the staff who deliver it, “is an absolute priority for NHS trusts.”

She added: "This report provides valuable insight into how very serious incidents such as these are captured, reported and addressed - as well as the steps trusts can take to prevent them.

"In particular we agree that providers should work collaboratively with stakeholders, including patients, the police and safeguarding teams, to ensure that sexual safety incidents are taken seriously and addressed appropriately, and the process for reporting and learning from sexual incidents should be strengthened.”

She continued: "The review findings reinforce the importance of ensuring that funding earmarked for mental health gets through to frontline services to enable trusts to manage rising pressures on local services. Within this workforce shortages must be addressed as a matter of the utmost urgency."

*Sexual safety on mental health wards. A report prepared by the Care Quality Commission, September 2018.

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