Wednesday, 6 December 2017

20 questions on clinical effectiveness at Stratheden Hospital 18 July 2012

I was raking back Emails yesterday and came upon this one from 18 July 2012, sent to Graham Buchanan, at that point Manager of Playfield Institute and Lead on Clinical Effectiveness at Stratheden Hospital, NHS Fife:

Strapline: 20 questions on clinical effectiveness at Stratheden Hospital 

"Dear Graham

As the lead on Clinical Effectiveness at Stratheden Hospital I have 20 questions about the effectiveness of clinical practice in wards at Stratheden Hospital that I would like you to consider and give a response to:

  1. How do you ensure that nurses take time to engage with patients, listen to them and establish relationships with them?  Please detail the procedures, training, systems.
  2. What processes are in place to measure the effectiveness of the nurse/patient relationship?  Please list the processes, how often they are implemented, outcomes.
  3. Have you asked patients/carers/family members for feedback on their experiences of inpatient care at Stratheden Hospital?  Please give statistics, outcomes.
  4. What is the best approach for a nurse to take when working with a patient experiencing mental distress?  Please explain and give reasons.
  5. Are there any alternatives to psychiatric drugs for patients in mental distress?  Please list alternatives.
  6. Do you have systems that give opportunities for patients/carers/family members to feedback on their experience of how patients were treated when in distress in acute wards?  Please send me the forms, procedures and outcomes.
  7. When is the use of force justified in the treatment of mentally distressed patients in Stratheden Hospital?  Please give details, examples, outcomes.
  8. When is it considered appropriate to bring in a police presence to psychiatric wards?  Please list the reasons.
  9. How do patients feel/react to police presence in psychiatric wards?  Please give feedback responses and statistical evidence.
  10. What are the reasons for patients absconding and the measures in place for limiting this?  Please detail reasons, procedures, outcomes.
  11. When is restraint used in the wards?  Please give details of situations, circumstances and any available statistics on use of restraint.
  12. How many patients have been injured by the use of restraint?  Please give statistics (I know there was one death in 1994, Shaun Martin).
  13. How do you ensure that the use of restraint is monitored closely and effectively?  Please give policies, procedures, training details.
  14. What feedback do you have from patients who have been restrained?  Please give information about this - how the patient felt, did it hinder their recovery or trust in staff etc.
  15. How do you ensure that bullying and intimidation does not happen in psychiatric wards, by staff to patients/carers, by patients to patients?  Please describe training, systems, procedures.
  16. How do you respond to allegations of bullying and intimidation, from patients or carers/family members?  Please give details, examples.
  17. What are the incidence rates of self harm by patients in wards and how do nurses minimise the risks of self harm?  Please give statistics, procedures, training details.
  18. Why have patients been driven to self harm while in wards?  Please give patient feedback details (I know of one patient breaking his own hand because he was intimidated, distressed and cornered by 3 male nurses in a room at the back of Lomond Ward)
  19. How many patients have attempted suicide while in the ward?  Please give details - by which means, which ward, outcome etc.
  20. How many patients on discharge have completed suicide?  Please give statistics (I know of one, Audrey Evans who was discharged on 31 March 2012)

I look forward to receiving a response to my questions. 

Regards, Chrys" 


Link to NHS Fife FOI Request Response which had very little information contained within. For example:

"We have no specific procedures or systems relating to this point"

"We have no specific processes in place that provide such a measure at this point in time."

"We have no collated feedback or statistical data relating to this point."


Following the abuse of my son in the locked seclusion room of Stratheden IPCU February 2012 and Scottish Government awarding £4.4million to NHS Fife to build a new IPCU, I believe that there have been improvements in the treatment of mentally distressed patients at Stratheden, in respect of safety and protection from physical, mental and sexual abuse, although I have no proof or evidence of this.  So I have written to Paul Gray, Director-General Health and Social Care/Chief Executive of the NHS, asking for evidence:

"Dear Mr Gray
Geoff Huggins, Scottish Parliament

Please find forwarded Email 6 June 2012, from Geoff Huggins, copied to others in Scottish Government, plus my previous responses.
Can you please let me know if "recording of use of seclusion, incidents etc. to track change over time in terms of the patient safety agenda" has happened since my son was abused in the locked seclusion room of Stratheden IPCU nearly 6 years ago? 

I would like details of this and the Scottish patient safety agenda, in respect of restraint, seclusion, abusive incidents, human rights issues of locked-in patients.  How this has improved since 2012, how patients and carers are being listened to now, we weren't back then.  And any other information that would help me to understand how things may have, hopefully have, improved for people experiencing mental distress or psychosis and entering Stratheden Hospital voluntarily as a patient, to be supported through psychosis and extreme emotional distress.

I would also like to know how unwaged Carers are being better supported than I was in 2012 after whistleblowing about the locked seclusion room's human rights abuses: no toilet, no light, no water, locked up for hours in the dark, unobserved.  Physical, mental and sexual abuse by Nurses, invading bodies, face down restraint in faeces and urine, as ways of "managing" locked-in seclusion room patients who have shouted for the toilet but not been heard because staff were down the corridor in their staff room, out of hearing and out of sight.  Resulting in glandular infections and series of verrucas, broken hand still needing treatment after psychiatric discharge.  I had to listen to the flashbacks from the abuse for years, my son lives with me.  We got no other support apart from occasional psychiatrist appointments.  Abandoned by community MH services, despite completing a Carer Assessment form.  Unpopular for speaking out about psychiatric abuse and neglect.

This is an FOI request.
Yours sincerely,

Chrys Muirhead (Mrs)"

Email from Geoff Huggins, Scottish Government, to me 6 June 2012, in response to an Email I sent him about the abuse of my son in Stratheden IPCU Feb12:

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