A University Teaching Trust
Date: 29 June 2011
George Hine House
Leicester LE5 0TD
Telephone: 0116 225 6485
Fax: 0116 225 6679
Dear Ms. A Smith, Request under Freedom of Information Act 2000 – Ref: FOI/1112/191
Thank you for your request for information under the Freedom of Information Act 2000 which we
received on 3 May 2011 relating to Harm-Prevention Strategies for the new ‘Centre of Excellence’.
Please accept our apologies for the delay in responding to you, which was due to the complex
nature of your request and the need to carry out the public interest test on exemptions claimed. We
are, however, now pleased to provide the following response to your request:
1. The precise number of suicide attempts that have resulted in a loss of life for inpatients on the
Heather ward of the Bradgate mental health unit over the 15 month period it has been open
(since December 2009) OUR RESPONSE:
2. The number of suicide attempts that have resulted in a loss of life for inpatients on all LPT
psychiatric wards for the corresponding 15 month period (broken down for each ward) OUR RESPONSE:
It is important to understand the local and national context when
considering these statistics:
Suicide rates per annum in East Midlands:
15.2 per 100,000 population
5.3 per 100,000 population
5,000 people commit suicide every year in the UK and of these 1,200 (24%) will have been in
touch with mental health services in the past 12 months (Rethink Mental Illness). 14%
receive inpatient care during the 12 months and one-fifth of these (3-4% of all suicides) will
die while in hospital (Suicide in Psychiatric Inpatients – David Baldwin, Andrew Mayers &
Leicestershire Partnership NHS Trust serves a population of approximately 1 million people.
Based on national and local figures there might expect to be 126 suicides in the 15 month
period from December 2009 to March 2011. 30 of the 126 people might be expected to have
been in contact with our services and of these between 3 and 5 people might be expected to
commit suicide as inpatients.
Although in some cases the individuals were not on the ward at the time, the numbers of
suicide attempts that have resulted in the loss of life for inpatients on all LPT psychiatric
wards for the corresponding 15 month period are:
Aston Ward = 1
Fosse Ward = 1
Heather Ward = 2
3. Details (dates of meetings, who attended, minutes, incident reports, investigation reports and
proposed and implemented actions) of the response to each incidence of self-inflicted death
on the Heather ward OUR RESPONSE:
I can confirm we hold
a Risk Assessment for Heather Ward. However,
we are withholding this information under Section 38 of the Act, as disclosure would be likely
to endanger the health and safety of patients, as ligature risks are identified. Section 38 is a
qualified exemption and after considering the public interest test it is determined that, in all
circumstances of the case, the public interest in maintaining the exemption outweighs the
public interest in disclosing the information.
I can also confirm we hold investigation reports relating to each incidence of self-inflicted
death on Heather Ward, which have been shared fully with each of the deceased’s personal
representatives. Please find attached the Action Plans (Appendices i & ii) issued in response
to the investigations.
However, we are withholding the remainder of the information contained within the
investigation reports under Sections 41 and 36 of the Act. Much of the information contained
within the report is the personal medical record of the deceased individuals. This information
is withheld under Section 41 of the Act, as although anonymised in the reports, when put
together with other information available elsewhere could lead to the individuals being
identified and, therefore, disclosure would result in an actionable breach of confidence.
Section 41 is an absolute exemption and the public interest test does not apply.
I can further confirm we hold incident reports for each incidence and these, together with the
remaining sections within the investigation reports are being withheld under Section 36 of the
Act, as in the reasonable opinion of our Chief Executive (the qualified person defined in the
Act), disclosure would prejudice the effective conduct of public affairs through inhibition or
likely inhibition of the free and frank reporting of incidents by staff and the internal processes
within the organisation when investigating them. Section 36 is a qualified exemption and after
considering the public interest test it is determined that, in all circumstances of the case, the
public interest in maintaining the exemption outweighs the public interest in disclosing the
4. Details of how local commissioners are going to be held to account for the deaths on the
Heather ward in relation to meeting the NHS outcomes framework (as suggested in the 'No
health without mental health' government policy document- 2011)
I have to inform you that we do not hold this information.
commissioners are accountable to the Strategic Health Authority. You will, therefore, need to
apply to the East Midlands Strategic Health Authority for this information. Information on how
you can do this is available at: http://www.eastmidlands.nhs.uk/about-us/access-to-
5. Details (minutes, reports, actions) relating to how these deaths on Heather ward are going to
inform the development of 'ward 2' and any further ward developments during the planning of
the 'centre of excellence' OUR RESPONSE:
Please see attached Appendices A to F inclusive.
6. What consultation processes have taken place already in Leicester concerning the
development of the 'centre of excellence'; specifically consultations relating to the split
between in-patient and outpatient psychiatric consultant lists, the closure of the Brandon unit
and the development of a single-site psychiatric facility (at the Bradgate unit). Specifically I
request details of when and where these consultations took place, which stakeholders were
invited, who identified the stakeholders and who accepted the invitation to attend, how, when
and where the meetings were advertised, minutes of the consultation events and any reports
that came out of these consultations with a view to informing the development of the centre of
'excellence' OUR RESPONSE:
Much of this information is already in the public domain and would
therefore be exempt under Section 21 of the Act. Please see our website at:
However, in an effort to assist you we are pleased to provide the following information: Engagement regarding Centre of Excellence
The Trust first proposed its plan to develop Centres of Excellence for inpatients when it
developed the 2012 Vision in 2007/8. As part of this development work, work-streams were
set up to move this vision forward. The proposed model of stakeholder engagement used for
the 2012 project is attached (Appendix 1).
Inpatient Services – Centre of Excellence
Since being established in 2002, LPT has been working to improve the quality of its inpatient
facilities. In autumn 2002 the Trust began a scoping exercise to establish its future inpatient
bed requirement and, in particular, re-provide outdated and unsuitable accommodation at the
Brandon Unit. This exercise culminated in the development of the Acute Mental Health
Inpatient Re-provision Project (AMHIRP) Strategic Outline Case (SOC). AMHIRP proposed
the closure of the Brandon Unit and development of four inpatient units across the county.
This proposed solution was the subject of formal consultation in 2005/06 (Appendix 2). The
capital cost of AMHIRP was circa £73m and the proposed procurement route a Private
Finance Initiative (PFI). In 2006 the Trust and its PCT commissioners made the decision not
to pursue AMHIRP, primarily due to affordability problems.
In 2007, LPT launched its 2012 Vision around the creation of Inpatient Centres of Excellence
to deliver an improved environment and model of care for inpatients. Public engagement on
this vision ran from September 2007 to June 2008 (Appendices 3-6). The Vision included the
Improve the inpatient environment.
Reduce the size of many wards.
Ensure greater levels of privacy and dignity.
Enhance flexibility around the use of bedrooms.
Reduce the use of seclusion.
Ensure a safer environment for patients and staff.
As part of the 2012 Vision, a work-stream was set up to look at the development of inpatient
services. Please see Appendices 7-14 for minutes/summary actions of meetings. Outcomes
from this group can be found in Appendices 15-17.
At the same time, the Trust identified an opportunity to bid for Privacy and Dignity funding
from the Department of Health and completed an application for funds on the back of the
2012 Vision. This bid was successful and LPT received an allocation of £2.7m towards the
cost of refurbishing an existing empty ward at the Bradgate Unit – Heather Ward.
In early 2008 the Trust participated in the LLR wide Local Health Services Review (‘Darzi
Review’) and further discussed its concept of Inpatient Centres of Excellence with the local
public. During January-March 2008 the Trust participated in three major public workshops
which were supported by MORI. One of the key discussion points in relation to mental health
services put forward during this engagement process was on the development of centres of
excellence; a proposal that was well received by participants. This work resulted in the
publication of the health community document ‘Excellence for All’, presenting the 10 year
vision for health and health services in this area, including mental health services
In autumn 2008 LPT formally consulted on its proposals to become an NHS Foundation Trust.
The consultation set out LPT’s future plans and priority improvements and, again, included
proposals to redesign inpatient models of care and consolidate acute adult mental health care
into a single Centre of Excellence. 85% of respondents supported the Trust’s priorities for
service improvements (Appendices 21-22).
Service users and their representatives were directly involved in the planning discussions for
these changes in acute inpatient services. In May 2009 they took part in a 2-day planning
event and they are also involved, in an ongoing basis and alongside managers and staff, as
members of our Inpatient Programme Board and our Acute Care Forum.
From March to May 2011 the Trust is undertaking a further engagement exercise as a
continuation of its discussions on the development of Inpatient Centres of Excellence.
Proposals for adult acute inpatient care is a particular focus of this exercise.
Centre of Excellence Project
A centre of excellence project board was set up in 2010 and oversees the centre of
excellence development. A centre of excellence project team and communications work-
stream supports this project. A Consultation/Communication Plan was developed (Appendix
23). A stakeholder list was developed and shared with the project team (Appendix 24).
Minutes of the Project Team Meetings can be found in Appendices 25 – 38.
The ‘Delivering Excellence’ engagement document was developed and sent directly to
stakeholders with a letter promoting the public engagement meetings and offering to go out to
meet with individual groups upon request. See Appendices 39-41 for an example of the letter,
the engagement document and the pull out feedback form. The engagement document was
also made available in all public facing areas of the Trust, sent to wards, outpatients,
community teams etc. and was available online on the Trust website with a link from the home
Posters were sent to all wards, outpatients departments etc advertising the public and staff
meetings. The engagement document and an invitation to the public engagement meetings
were also sent by e-mail to Trust members and shadow Governors. Centre of excellence
development has been discussed at length on the Panj Pani Radio station, covered in an
article in Leicester Mercury which included the dates of the public meetings.
Trust staff have made presentations to all 3 Local Involvement Networks, the Joint Overview
and Scrutiny Committee. The Chief Executive also met with the Mercury Patients Panel to
discuss future Trust plans.
The Patient & Advice Liaison Service has also been talking directly to service users about the
plans to develop a centre of excellence.
Centre of excellence plans have been covered regularly in the Trust’s newsletter People
Matters (Appendices 42-45). The closing date for feedback was 27 May 2011. Feedback will
then be collated by the Communications work-stream and presented to the Project Team.
Please see attached paper to the Trust Board in May 2011 (Appendix 46) showing the
project’s current status.
7. The number complaints (formal and informal) made regarding the split of inpatient and
outpatient psychiatric consultant lists made by patients /service users, staff employed by LPT
(clearly stating the number made by each category) OUR RESPONSE:
10 Formal Complaints
1 Informal Complaint
I trust this response is helpful to you. However, if you are dissatisfied with the handling of your
request, you have the right to ask for an internal review. Requests for an internal review should be
submitted within two months of the date of receipt of the response to your original request and
should be addressed to:
Lynne Wray, Head of Information Governance,
Leicestershire Partnership NHS Trust,
George Hine House, Gipsy Lane, Leicester LE5 0TD.
Please remember to quote the reference number above in any communications.
If you remain dissatisfied with the handling of your request, you have a right of appeal to the
Information Commissioner at:
The Information Commissioner's Office,
Wycliffe House, Water Lane, Wilmslow, Cheshire, SK9 5AF.
Phone: 0303 123 1113. Website: www.ico.gov.uk .
There is no charge for making an appeal.
If you need any further assistance, please do not hesitate to contact me.
Mary Stait, Healthcare Records & FOI Manager