Decision report 201104822

Summary

The hospital introduced a new clinical model in September 2011, setting up new hub and cluster units. Each of the four hubs supports a cluster of three

12-bedded wards, with various therapeutic, physical, creative and social activities taking place in the hub. There is also a central unit where more formal therapies and educational activies are held.

Mr C, who is a patient in the hospital, complained that when the new model was introduced he was unreasonably pressurised to attend activities in the hub area even though he did not like it there. He described it as little more than a corridor, and found it cold and uncomfortable. The board acknowledged that there were teething problems in the early days of the new model while both staff and patients got used to the new regime. This sometimes meant that wards were closed, or patients relocated to other wards, to allow staff to be suitably deployed while ensuring patient and staff safety.

Our investigation found that since Mr C made his original complaint to the board - which they upheld - matters had improved. The board had addressed staff recruitment and training issues and reviewed some policies to allow a more flexible use of resources. This had allowed them to keep more wards open while still staffing the hubs, and they confirmed that in the last few months Mr C's ward had not been relocated. Mr C said that he considered that this had only happened because he had complained. However, we explained that the purpose of the complaints system is for issues to be raised and addressed and for solutions to be found.

We did not uphold Mr C's complaint. Although work is still on-going to fully implement the new clinical model, the independent advice received from our adviser was that good and positive progress had been made. We found no evidence that Mr C had been forced or unreasonably pressurised to attend the hub. Our adviser said that staff often have to find a balance between encouraging patients to engage with therapies and activities and making them feel pressurised. However, our adviser said that staff would be failing in their duty of care if they did not try to encourage patients to engage with treatment programmes.