Forensic executive meeting - WEST LONDON MENTAL HEALTH NHS TRUST

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Forensic executive meeting - WEST LONDON MENTAL HEALTH NHS TRUST


    Paper WL897



    MONDAY 03 JANUARY 2006


    (Ratified 06 March 2006) Present:

    Tony Pearson, Non Executive Director [Chair]

    Sean Payne, Director of Forensic Services

    Angela Dolan, Service Director, DSPD

    Gemma Stanion, Head of Allied Health Professions

    Alan Brown, Director of ICT

    Sally Fraser, Directorate Accounts

    Dr. Kevin Cleary, Clinical Director, Adolescent Service, West London Forensic


    Jo Leech, Associate Director W. London Forensic Service

    Dr. Paul Gilluley, Clinical Director, Men‟s Central Directorate, West London Forensic


    Jimmy Noak, Deputy Director of Nursing

    David Cochrane, Service Head Social Work

    Dr. Kevin Murray, Associate Medical Director

    Alistair McNicol, Director of Security

    Dr. Ian Treasaden, Clinical Director, Men‟s West Directorate, West London Forensic Service

    Maggie Gairdner, Service Director, Men‟s South of England Directorate

    Debbie Richards, Service Director, Women‟s Services Directorate

    Liz Edghill, Planning & Performance Manager

In Attendance:

    Delore Jones, P.A. to Director of Forensic Services [Minute Secretary]


     Trudi Hilton, Chief Pharmacist

     Kate Lyons, Associate Director of Forensic Services (Modernisation & Performance


     Graham Crennell, Associate Director Environment, Strategic Service


     Prof. Derek Perkins, Head of Psychology, Forensic Division

     Nuala O‟Brien, Director of Communications

     Dr. Susan Iles, Clinical Director Women‟s Services Directorate

     Dr. Andrew Payne, Clinical Director, Men‟s London Directorate

     Dr. Morris Vinestock, Clinical Director, Men‟s South of England Directorate

     Professor Tony Maden, Clinical Director, D.S.P.D. Unit

Minutes of Meeting 2

    Forensic Executive Meeting 03 January 2006

     Andrew Weir, Service Director for Men‟s & Adolescent Services, W. London

    Forensic Services

     Celia McMahon, Executive Liaison Manager


     The Minutes of 7 November 2005 were agreed as a true record with minor



3.1. Absence Without Leave

     Sean Payne advised that data on AWOLs is being analysed and clinical

    commentaries will be added. Absences from WLMHT are principally from

    low secure wards and are generally when patients over-stay their agreed

    period of absence and in nearly all cases they return of their own volition.

     Dr. Paul Gilluley stated that there appears to be a few repetitive offenders

    and these cases need to be addressed from a clinical point of view.

     Liz Edghill advised that the final version of the London-side AWOL and

    Absconsion Data is due to be issued shortly for benchmarking. Dr. Gilluley

    pointed out that the data will be confined to medium secure patients because

    the definition of „low security‟ changes from borough to borough.

     The „AWOL‟ paper will be presented to the next Forensic Executive meeting.


4.1. Update of Developments in Women‟s Services

     The report from the Service Director gave the position at the end of

    November 2005. Sean Payne reported that the project is now progressing

    well. Physical build commences on 9 January for a 76 week programme

    with a target date for completion of June 2007. Design has been frozen for

    some time. Any proposed changes will be considered by Trust Capital


     Mr. Payne reported on an incident in December when a female patient on

    Leeds Ward was found in a collapsed state with a plastic bag over her head.

    The discovery was made by staff at 7.50 am on 9 December 2005. The

    patient had apparently died during the night. A critical incident review has

    been undertaken by the Clinical Team. Learning points from the review

    include the exclusion of plastic bags on the wards and changes regarding

    the expectation of night observations of patients sleeping. A root cause

    analysis review will be undertaken in the coming months.

Minutes of Meeting 3

    Forensic Executive Meeting 03 January 2006

     Mr. Payne advised that as patient numbers are decreasing in Women‟s

    Services, the Trust is working towards configuring the service over three

    wards in Broadmoor from February 2006. Dr. Susan Iles and Debbie

    Richards are leading on this change.

     With the increasing requirements of The Orchard project, Dr. Susan Iles will

    be transferring her clinical work and office base from Broadmoor to Ealing

    during the coming months.

4.2. The Paddock Unit

     Angela Dolan stated that the official opening of The Paddock Centre by

    Rosie Winterton MP on 13 December was very successful.

     There are currently fifteen patients in the unit, with a further two admissions

    scheduled for January. There are five patients on the waiting list and

    fourteen referrals in the process of assessment.

     Three patients have been temporarily transferred to Broadmoor from

    Rampton Hospital. Sean Payne and Angela Dolan will be discussing

    operational issues with staff from Rampton.

     The next two wards are scheduled to open in June 2006.

     There are currently seven vacancies in the unit. Interviews for two

    Consultant Psychiatrists will take place in February with interviews for a

    Nurse Consultant scheduled for March.

     Mr. Pearson expressed thanks to all the team involved in the official opening

    of the Paddock for their hard work in making it a very successful day. He

    asked Ms. Dolan to pass on congratulations and appreciation to the rest of

    the team.

     Action Angela Dolan

4.3. The Wells Unit

     Dr. Kevin Cleary reported on progress on the Wells project.

     There is currently a two weeks‟ slippage and the opening is now scheduled

    for May 2006.

     Staff recruitment is going well. Interviews for a Ward Manager will be taking

    place on 4 January.

     Funding for education has now been agreed with NSCAG and a

    procurement process will be commenced to secure an education service to

    the unit.

Minutes of Meeting 4

    Forensic Executive Meeting 03 January 2006

4.4. Foundation Trust

     Sean Payne reported that the Trust Board is currently considering applying

    for Foundation Trust status from May of this year. If successful, the process

    will be completed by July 2007. Copies of slides were included in the FEM

    papers outlining the proposed strategy and the timeframe. Lesley Stephen,

    Director of Strategy and Performance will be asked to share the information

    after the January Board meeting.

     The rationale at this point is that all Trusts will need to move to foundation

    status by 2008. WLMHT is not the first mental health Trust to apply for

    Foundation Trust status and a number of mental health Trusts are currently

    in the application process.


5.1. London Forensic Services SMG

     Jo Leech advised that the meeting structure for London Forensic Services

    has been changed. There will now be a Senior Managers Group [SMG]

    meeting which replaces the Business and Communications meeting. The

    new meeting will have a more strategic and decision-making agenda. Terms

    of Reference have been drawn up and will be circulated in advance of the

    next meeting.

5.2. Business Planning

     Sean Payne reminded the meeting that the business planning deadline is 21

    January. The intention this year is to move to one business plan for London

    Forensic Service and one for Broadmoor Hospital. Guidance notes were

    sent out some weeks ago by Lesley Stephen. If there are any problems,

    they should initially be referred to Sean Payne.


6.1. C18B Child Visitors to Inpatient Wards

     This policy is out for consultation. Comments should be submitted to Trevor

    Farmer, Associate Director and Chair of the Safeguarding Children Sub

    Group, by Monday 9 January 2006.


7.1. Finance Report

    o The Trust‟s financial position improved in November, but this was due

    mainly to non recurring items.

    o The Forensic Division showed an overspend of ?23K in November.

    Overtime costs on one of the London Directorate Wards was the main

Minutes of Meeting 5

    Forensic Executive Meeting 03 January 2006

    reason. This brought the cumulative overspend for the Forensic

    Division to ?424K.

    o The Director of Forensic Services budget was underspent by ?2K in

    November, which reduced the cumulative over spend to ?137K.

     Sean Payne reported on a meeting held on 22 November 2005 with the

    Commissioners to discuss the independent sector placements. Issues

    remain on agreeing a risk share regarding independent sector placements.

    The Consortium will meet again on 12 January. This is the second year that

    the independent sector budget has been under pressure. The PCT has

    acknowledged there is a need to move to a risk share and the Trust has

    made the PCT aware that if we are not able to reach agreement on this

    matter, then the Trust will have difficulty in retaining the placements budget.

     Dr. Kevin Murray informed the meeting of a judicial review currently being

    pursued involving a patient from Broadmoor Hospital and his placement in

    the independent sector.


     Alistair McNicol tabled details of security issues during the period 1

    November to 29 December 2005.

8.1. Broadmoor

    o There were 137 security related incidents during this period, compared

    with 110 during the same period last year.

    o The lowest number of positive drug indications were obtained, i.e. one

    indication from 128 visitors.

8.2. Ealing

    o There are concerns at the number of cigarette lighters being found

    during searches on the Ealing site, which will need to be addressed.

    o Mr. McNicol pointed out that only data from the medium secure wards

    has been used in the Security Report when reporting on absences

    without leave.

    o The number of indication during searches by the drugs dogs was high;

    totalling thirty six indications from two searches.

    o Sixteen members of staff completed the Intensive Search Techniques

    Course on 6 & 7 December.

    o The personal protection and panic alarm system is currently being

    commissioned in the RSU and should be operational from 10 January.

     The meeting was made aware by Alan Brown that a reasonably detailed

    aeriel photograph is available of the Broadmoor site on the internet through

    „Google Earth‟.

Minutes of Meeting 6

    Forensic Executive Meeting 03 January 2006


9.1. Mental Health Act Commission Annual Report

     This report has been circulated previously and the Trust is in the process of

    preparing its response. Sean Payne reminded the meeting that Celia

    McMahon has been chasing responses to this report, which now covers the

    whole Forensic Division, i.e. both the Ealing and Broadmoor sites.

     Sean Payne drew attention to Section 2.3.14 relating to alleged existence of

    hospital sub-cultures. Mr. Payne stated that this had been a criticism of

    secure hospitals in the past and he asked that if staff are raising these

    issues, he would like to hear about them. Also, if anyone is aware of any

    areas of concern they should make them known. Debbie Richards stated

    that it is helpful to have these issues pointed out, but the Commission should

    be requested to provide details if known. Tony Pearson confirmed that

    Simon Armson from the Mental Health Act Commission was asked about

    this issue during a Trust Board presentation, but he was unable to provide

    any specific information. Mr. Pearson suggested that if there are new

    concerns, they will need to be resolved, but some of the issues may be

    historical. Sean Payne agreed to take up this matter with Simon Armson.

9.2. Transfer of Prisoners to Hospital Under the MHA

     This paper was tabled for information. Sean Payne advised that a seminar

    is being organised by the N.W. London Strategic Health Authority on 27

    January to consider this issue. Sean Payne would welcome hearing from

    anyone interested in attending.

     Dr. Paul Gilluley reported that this issue had raised concerns at the recent

    London MH Development and Strategy meeting.

     Dr. Kevin Murray advised that the statements made in Section 6 of the paper

    were of concern and could have a big impact on services and the

    responsibilities of PCTs. Dr. Gilluley confirmed that these concerns have

    already been picked up and clarification is awaited from the Home Office.

     Debbie Richards advised that Rampton Hospital staff will need to be

    involved in this Seminar as the only reference for high security for women is

    through the national high secure service at Rampton.

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    Forensic Executive Meeting 03 January 2006


     The following documents were tabled for information only:

10.1. Trust Board Agenda November 2005

10.2. Executive Team Meeting Minutes:

     21 October 2005

     04 November 2005

     18 November 2005

     02 December 2005

10.3. Information Strategy & Steering Group Minutes

     25 November 2005

10.4. Information Planning & Coordination Group Minutes

     26 October 2005

     23 November 2005


11.1. Redevelopment of Broadmoor Hospital

     The meeting was informed that ?190 million has now been allocated by the

    Government for the redevelopment of Broadmoor Hospital.

     Sean Payne advised that the Trust will be advertising for a Programme

    Director. Interviews will be held during late February. In the interim period

    Sean Payne will lead on the project. Arrangements regarding local

    management of the Hospital are being discussed with the Chief Executive

    and Mr. Payne will keep relevant personnel fully informed.

     Mr. Pearson advised that meeting that a DVD of the BBC Radio 4

    programme “All in the Mind”, which discussed the redevelopment of

    Broadmoor Hospital, is now available from the Trust‟s PR office. Dr. Kevin

    Murray participated in the programme.

11.2. Inquiries into the Incident on Luton Ward in April 2004

     11.2.1. Independent Inquiry:

     Sean Payne advised the meeting that the Inquiry Panel will be sitting

    again during week commencing 16 January. The Inquiry Team are

    aiming to present its report to the Strategic Health Authority in

    November 2006.

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    Forensic Executive Meeting 03 January 2006

     11.2.2. Internal Inquiry:

     Sean Payne reported that the internal inquiry is in its final stage and

    hopefully will be submitting the report to the January Trust Board.

    Sean Payne will clarify this with the Inquiry Chair, Professor Kennard.

     Action Sean Payne

     File Ref. (Delore Jones) H:\My Documents\DMJ\FEM\2006\March\FEM Minutes 3 January 2006.doc

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