Dismissal gross misconduct and criminal offences

Camden and Islington NHS Foundation Trust did not have the information requested.

christina moriarty

Dear Camden and Islington NHS Foundation Trust,

Please provide the following information for the last 10 years:

(1) How many staff employed by the Trust have been dismissed for gross misconduct?

(2) How many of these were health or social care professionals or allied professionals?

(3) How many of these were nursing staff?

(4) How many health or social care staff have been referred by the Trust to their professional body - including those not dismissed?

(5)How many healthcare staff have been convicted of an actual criminal offence or struck off the professional register either whilst in employment of the Trust or where the offence took place at time of employment?

(6)How many of these offences or professional breaches involved:
(a)crimes against the person including assault, sexual inpropriety,murder
(b)fraud
(c)immigration offences

With regard to (6) it is accepted that the data may be held in non conventional format however it is held and legal requirements of the time required action.

Yours faithfully,

christina moriarty

Information, Freedom, Camden and Islington NHS Foundation Trust

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Dear Ms Moriarty,

Please find attached the acknowledgement to your request for information under the Freedom of Information act.

Kind regards

Jessica Robson | Information Governance Manager
Camden & Islington NHS Foundation Trust | P: 020 3317 3115 | F: 020 3317 2730 | E: [email address]

Information Governance Department, 3rd Floor, West Wing, St Pancras Hospital, 4 St Pancras Way, London, NW1 0PE

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Information, Freedom, Camden and Islington NHS Foundation Trust

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Ms Moriarty,

Please find attached the response to your request for information under the Freedom of Information act.

Kind regards

Jessica Robson | Information Governance Manager
Camden & Islington NHS Foundation Trust

Information Governance Department, 3rd Floor, West Wing, St Pancras Hospital, 4 St Pancras Way, London, NW1 0PE

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christina moriarty

Dear Jessica Robson,

Thank you for your response.

I request some clarification which hopefully can be done without the need for an internal review or raising a new request.

Firstly you state that re Q4 this data is only held back to 2010. Why? The Trust must hold this data. It would be acceptable to not have the complete data set for 2013 but it is not acceptable to not have this since the beginning of 2010.

I am assuming you have been wrongly informed as the Trust has had employees in high profile cases that have been struck off their respective professional registers and in 1 case convicted of murder since 2010 whilst in Trust employment as a nurse.

If what you state is correct then this would mean the Trust did not report for eg these 2 individuals to the professional bodies? Seems like an anomoly unless there is an alternative explanation.

There is also concern that while 25 nurses and allied health/social care professionals have been dismissed for gross misconduct only 15 were referred for professional misconduct.

The reason why this is concerning is that Gross Misconduct will only usually be a dismissal offence for the most serious breaches of behaviour. This is usually for violence/threat, unacceptable behaviour and practice, fraud, poor record keeping and unsafe practice.

Given this it would be expected that the Trust would be referring almost all cases. Again you may have been given incorrect figures and of course the referral rate can be confirmed with the bodies concerned if disputed.

Please tell me if the Trust has made decisions on referral in the missing 10 cases based on legal advice - were you concerned that there were challenges against dismissal and were therefore advised not to refer to limit potential compensation payments?

This would potentially mean that employees considered to be unsafe to practice within the organisation being allowed to continue to practice elsewhere to protect the Trust and would be a financial decision. Please confirm who/which committe has responsibility for making the decsion NOT to refer in these cases.

Please also confrim and provide details/policy document on how many of the 25 case and 15 cases respectively were reported as a safeguarding issue to the local authority or logged as such within the Trust. Is there an automatic procedure and if not why not?

How many formal investigations were launched and completed. Was dismissal seen as an alternative to reporting safeguarding concerns (which would have artificially kept the figures lower than they should have been across both boroughs)

As the offences for dismissal and referral are very serious then clearly a safeguarding concern arises and there is strong argument that it is good practice to do so.

Many Thanks for you attention in this matter.

Yours sincerely,

christina moriarty

christina moriarty left an annotation ()

I have asked for clarification with the hope of avoiding an internal review or new request. However no option on site for this route hence the 'awaiting info' status!

Information, Freedom, Camden and Islington NHS Foundation Trust

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Dear Ms Moriarty

I refer to your request below for information requested under the Freedom of Information Act.
Please find acknowledgement attached..

Yours sincerely

Lorna Jackson
Interim Information Governance Manager

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Information, Freedom, Camden and Islington NHS Foundation Trust

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Dear Ms Moriarty,

With reference to your request for information under the Freedom of Information Act 2000, I attach the Trust’s response, which I hope you will find satisfactory.

With kind regards

Yvonne Wright | Information Governance Officer
Camden & Islington NHS Foundation Trust | : 020 3317 3107 | : 020 3317 2730 |: [email address]

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christina moriarty

Dear Peter Gooch,

Thank you for your response and explanation of why there are no figures released for Gross Misconduct dismissals prior to 2010. This was not made clear in the original response hence the discrepency and further enquiry.

From what I have been informed I understand that the following is the position:

Since 2010 25 nurses and allied health/social
care professionals have been dismissed for gross misconduct.

Of these ONLY 15 were referred for professional misconduct to their professional bodies.

There is no explanation given of why the remaining 10 were not referred and the Trust witholds this information. It has not been denied that these decisions were based on concerns re potential litigation from the employee.

Not a single case out of 25 gross misconduct dismissals has been referred BY THE TRUST to the local authority as a safeguarding issue.

Cases NOT referred include where criminal offences against the person has occured and at least one case where the dismissal offence was for offences against the patient.

No documents or policy information have been supplied in relation to safeguarding protocols as requested.

The Trust believes that the Local Authority will know about safeguarding concerns 'by default' as these are logged on the local authority's systems.

The Trust does not explain how it believes the Local Authority will know 'by default' if the Trust is not reporting employees conduct.

It is unclear from the response if this means the Trust takes the position that they therefore do not need to ever refer to the local authority in such cases

In the absence of requested clarification and policy documentation it can be assumed that there is no formal process for considering safeguarding issues when an employee is dismissed for Gross Misconduct.

Yours sincerely,

christina moriarty

Francesca Falk left an annotation ()

This is an incredible admission by a Trust and we presume the assessment of the information provided is accurate as it has not been disputed.

So they have not once considered that a case of Gross Misconduct may have safeguarding implications for patients and service users. Out of 25 cases.

These cases include a senior Psychologist dismissed and struck off for sexual relationships with patients and a high profile murder case involving a ward nurse. Plus several fraud cases and only last week another immigration fraud case where one of their nurses was convicted (the Trust had not adequately checked her visa). These are not trivial offences .

So why no referral action? All 25 cases cannot have just 'slipped through the net'. This is a much more serious issue than at first glance and has come to light through their own admissions on a public site.

If I was a patient or carer I would be extremely concerned that (a) 25 healthcare staff had been dismissed for Gross Misconduct since 2010 and (b) how safe is it for patients in a Trust where this occurs

MadSadBad left an annotation ()

We should be worried and are worried as the abuse and violence and threats that happen are criminal and these staff and all the managers and the chief executive should be prosecuted for the abuses. Restraint abuses where 4 large men attack a small woman, sexual assaukt and rape on wards which dont get reported to police, forced searches and taking away personal possessions to punish patients, abusive medication forced on people who complain and nurses that cant speak English properly and tell people about God.

christina moriarty

Dear Yvonne Wright

I am requesting an internal review for the following reasons.

My follow up request was dealt with as a new and separate FOI request rather than an internal review.

However this part of the request was not clarified in full:
Please also confirm and provide details/policy documents on how many of the 25 and 15 cases respectively were reported as a safeguarding issue to the local authority or logged as such within the Trust. Is there an automatic procedure and if not why not?

The Trust has confirmed that not one of the 25 cases of Gross Misconduct were referred to the Local Authority as a safeguarding issue which answers part of the request.

However the Trust has not provided any guidance or policy documents as requested that would be referred in order to make such decisions. What I am trying to establish is if there is a formalised AND automatic process where the Safeguarding Manager within the Trust is notified of Gross Misconduct cases so that consideration is given to referring to the Local Authority.

So far it appears from the response that there is no process at all but I would like to give the Trust an opportunity to clarify this and provide the policy documentation in case I misunderstand

It would be really helpful if this could be provided as soon as possible so that this request can be completed

Many Thanks

Yours sincerely,

christina moriarty

Information, Freedom, Camden and Islington NHS Foundation Trust

Dear Colleagues,

Please see the request for an internal review and also the attached response letter.

Please could you let me know whether we maintain our original stance or whether we believe the original decision was incorrect.

I would be grateful if we could receive a response by 13th November.

Kind regards
Wayne Elliott | Information Governance Officer (Freedom of Information) |Information Governance Team
Camden & Islington NHS Foundation Trust | P: 020 3317 3114 | F: 020 3317 2730 | E: [email address]

Information Governance Department, 3rd Floor, West Wing, St Pancras Hospital, 4 St Pancras Way, London, NW1 0PE

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Information, Freedom, Camden and Islington NHS Foundation Trust

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Dear Ms Moriarty,

Please see attached, an acknowledgement of your request for an internal review.

Kind regards
Wayne Elliott | Information Governance Officer (Freedom of Information) |Information Governance Team
Camden & Islington NHS Foundation Trust | P: 020 3317 3114 | F: 020 3317 2730 | E: [email address]

Information Governance Department, 3rd Floor, West Wing, St Pancras Hospital, 4 St Pancras Way, London, NW1 0PE

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MadSadBad left an annotation ()

They wont tell you about their victims and women attacked and what they do and their own workers are gulty even if they are churchgoers or in psicologists like that man we know about but were told to be quiet about- they are the same people they create sin.They hurt and kill people by neglect in laffan ward this week and nurse at highgate who was a murderer and others who sex assault. They dont help women who are attacked they tell them go away. Dont you complain they try silence you all ways and inject you if you complain when you have been attacked and sexually assaulted. They cant check the christians from africa they just then sack them or move them to another team.Most of all nurses are african but most of all people in islington are not african we are from all over the world and england. They dont have any muslom nurses for women why no somali nurses and bangladeshi nurses???They might speak for women so hopsital dont get them in. They let men patients come to womens ward undressed and in to rooms because they wont lock the door highgate centre.THEY WONT TELL YOU THE TRUTH ON HOW MANY WOMWN RAPED AND ASSAULTED NY THEIR STAFF AND WHEN THEIR STAFF ON DUTY.ask them about what happens to women who tell people they will be in the grave or locked away we all know this.CALL POLICE on these people

Dr. Sarah Garvey left an annotation ()

In response to the above poster I am so sorry to hear of the distress and trauma you have experienced.

If you want to report serious sexual assault or rape the team in the Metroplitan Police who cover Camden and Islington are based at Camden Sapphire Unit at Holborn Police Station.

Their telephone number is 020 7421 0302/ 0393 and the link to the site which will talk you through the steps is http://content.met.police.uk/Site/sapphire

North London Rape Crisis Centre can provide you with an advocate to talk through this - even if you do not want to proceed amd they have a counselling service. Their contact details are telephone number 0808 802 5565, or email at advice@solacewomensaid.org.

The Sapphire Unit are the police team who have /are currently investigating alleged sexual assaults by Trust staff on patients and service users.

Francesca Falk left an annotation ()

Thank you to the above poster directing victims to the police and rape crisis centres.We assume from the note at the end that you are aware of the situation .

We too are aware of very serious incidents where victims have needed support but as we are all aware the conviction rate for rape and serious sexual assault in London is very low and most victims don't report at the time or ever.

To those reading this and who may have been triggered and distressed please get support in place before you report if it involves the Mental Health Trust or other authorities who support you.

We have seen cases where women have trusted mental health workers to support them only to find that the Trust then withdraws all further support once the police are involved and this leaves a women with no support at all for the period of the investigation. The general agreement across agencies is that the Trust ( or indeed other authorities ) do this as part of a strategy of damage limitation and they know that without support the victim is unlikely to be able to proceed even when the police believe there is a case to answer.

We have also seen cases where the Trust/ other authorities have gone out of their way to discredit someones report, account and motivation to undermine the investigation and haven't followed procedures. Often this is based on ' she didnt report at the time' and ' she has a mental disorder so nothing she says can be trusted'. As we know this is a recipe for a culture of allowing abuse to proliferate. There is very little expertise and understanding in mental health services about abuse and sexual assault victims experience

There is also a problem of how a patient can have confidentiality in these situations and the appropriateness of those implicated being the main support option. So an outside advocate from Rape Crisis
is really important - we cannot stress this enough as they are impartial and independent.

For women affected please use the Rape Crisis centres and Haven centres so that you have back up support in place as investigations take a very long time

Reading the Trust's response to the original request is actually very disturbing when you have the alternative accounts from multiple women who feel they have been victims. We are wondering how many dismissed for Gross Misconduct would fall in to categories of offences against the person and if the Trust does not understand the correlations that exist.

christina moriarty

There is very real concern for victims as there is so little support available for those in serious mental distress. This is recognised by all agencies who investigate and advocate who would all endorse your comments about isolating victims by withdrawing support to them if they accuse staff employed.

It is possible that this Trust does have processes but they are not transparent and unfortunately they have the reputation of being 'closed' to sharing these with the public.

However so far it would appear that there are absolutely no automatic and therefore protective measures in place or they would have provided these as the law requires them to do. There is no linking up with Gross Misconduct behaviour and safeguarding issues across all areas of potential abuse.

The internal review may provide different figures or it may just give corporate statements about policies and safeguarding training which ignores the underlying problems identified.And no doubt repeat that as they have a womens crisis house that makes them 'experts' so they know best .

I agree this 'closed' stance does nothing to reassure that patients and service users are safe particularly when we are all aware of serious concerns regarding particular cases not being investiagted and victims mental health deteriorating to the point they are deemed not fit to give evidence even when there is a case for prosecution.

In support terms victims cannot change Trusts in order to get support as there is no right of choice in Mental Health. So unlike in all other circumstances in these types of events they as an extremly vulnerable person ( and treated as a vulnerable witness by the police) are expected to have to turn to the (alleged) perpetrators if they need help. It would not happen under any other circumstances. You are not usually expected to discuss the case details with ( for eg) your rapists friends ( as described by one victim who was not offered any support through the process and whose mental health deteriorated significantly).

It is probably a gross violation of Human Rights legislation. In this Trust's case ( and there are of course others) if there are not formal processes for referring someone for support outside the Trust then the victim is unsupported. Other Trusts have recipricol arrangements with neighbouring Trusts - Camden and Islington don't apparently. They would rather deny there is a problem then act in a way that is helpful and changes the abuse/victim culture.

I hope that they actually respond with detail that is helpful and could actually point to initiatives OUTSIDE the Trust but as we know that is not women victims experience of reporting sexual assault .

Dr. Sarah Garvey left an annotation ()

We have unfortunately seen all of the above with victims in the Mental Health sytem over the years where the allegation is against a member of staff.

We have also seen that despite the very serious nature of allegations and even with ensuing criminal investigation and professional misconduct hearings Trusts have failed to provide support for victims. That includes Camden and Islington Foundation Trust.

What is of particular concern is that some victims of sexual assault have been told that they have to continue to work with the alleged perpetrator or team where they are based. This includes when in severe distress and at risk. As a result we have seen suicides over the years because women have been unable to access the specialist mental health support they need .

This is not a historical issue - there are current cases where victims have been left with no ongoing support and no access to crisis support simply because the allegation is against a professional employed by a Trust.

Francesca Falk left an annotation ()

This is posted following a further very distressing incident where the Trust has acted in the manner above .

As the Trust is aware this is a very real situation for some women and as very recent events have shown is being played right out now. Possibly with very tragic consequences.

The criticisms laid are valid- we are seeing an example of an appalling situation at the moment . The women who have shared with us are brave and should be commended but have been left severely traumatised.

It will be difficult for the Trust to deny what is happening as more women are prepared to share and sooner or later it will be asked why these victims were treated in this way.

When you deliberately target and isolate very vulnerable patients you cannot say as a Trust that you do not know what you are doing. The notes we have accessed and assessed show a clear pattern. Sooner or later this will come out.

sarah riley left an annotation ()

What is currently concerning myself and my colleagues is that the distress these women are left in when isolated in this way is known to the Trust .As is the risk . And when this happens you really have to question the motivation behind their actions. And of course the chain of events in some cases is clearly evidenced as myself and Sarah Garvey have seen it.

Given the very distressing scenario that is happening at this point in time with a women victim I am going to state publicly that the Trust and Camden's response to her risk is currently being viewed by those of us with professional MH working backgrounds as very poor practice and unsafe. We happen to have a clear recorded history of this case which fits exactly with the above postings. She is now completely off radar with no support and very unlikely to ask now. Leaving someone with this level of known risk is unacceptable

christina moriarty

Sounds like you have solid details and that she has consented to share? We all have anecdotal evidence and direct accounts but the very real risk of deterioration of someone's mental health often prevents direct action.

If what you both describe is accurate then the Trust (and Camden?) have failed this woman and it sounds like a very dangerous situation. God forbid they actually end up having to explain why someone so at risk was left like this. I think from what you have both stated that they appear to have walked away from the situation? Who called them in? Police/Dr/carer?

It is cases like this that have made people so angry with mental health services and these postings and criticisms come from professionals in the field as far as I can tell

Christina Moriarty

Dr. Sarah Garvey left an annotation ()

Yes we have consent to share and access to records. Yes emergency MH services were called by police and paramedics but chose not to attend. Not for the first time. This is a joint Trust and Camden social Worker decision based on the Trust's assessment of the situation despite the issues being those outlined above.

Police waited several hours at scene due to concern.
All authorities had flags prior to this event.Individuals and agencies had raised concerns from what we know and have established.

Matthew Syed left an annotation ()

This is a highly sensitive issue but given that the victim has apparently consented to share information I think it is legitimate to comment on what appears to be one of the most appalling practices I have heard of within this Trust ( I know the above professionals would not be posting unless there was a very serious safeguarding concerns). There is a level of threat and intimidation in these actions that is indefensible.

The reference to Camden also implies that the AMHP service is also involved which raises very serious issues around their legal responsibilities in this. If they are knowingly acting in a way that prevents the victim accessing appropriate emergency intervention - without having to have contact with the alleged offender/team - then they appear complicit in poor practice .And potentially legally liable given the responsibilities they hold under the MHA.

The Trust should have set up an alternative crisis support route for the victim - whether or not they believe the allegation ( my understanding is that the police took it seriously enough to investigate). They have a Duty of Care including towards those where the relationship has completely broken down and it is evident that the victim has a very significant mental health history. It is also evident from these postings from respected professionals that the Trust are aware of her current risk.

On a day when Jeremy Hunt has announced a Duty of Candour obligation on NHS Trusts I wonder how this Trust would justify their actions.

No one outside Mental Health Services would see this as morally or ethically acceptable. And neither would the courts

Helen Schulter left an annotation ()

This Trust has just failed the most recent CQC inspection in October 2013 and has been ordered to provide details of compliance by November 13th 2013.
The report can be accessed on the CQC website under St Pancras Hospital. It states concerns that many of us have been raising for a very long time and the Trust has ignored

http://www.cqc.org.uk/sites/default/file...

Matthew Syed left an annotation ()

This link with further information regarding the case referred to has now been sent to Rosemary Westbrook , Director of Adult Social Care in Camden and to David Behan, Chief Executive of CQC ( who are already aware of the case)

Matthew Syed left an annotation ()

LB Camden have acknowledged the report sent to them and plan to 'look in to the matter'. As has the CQC who have asked the Trust for an explanation

Sebastian Lawson left an annotation ()

Please keep us updated on this as it has relevance and consequences for many others.

Sebastian Lawson left an annotation ()

Is this an open source case? Access? Escalated yet?

Dr. Sarah Garvey left an annotation ()

Yes open source case anonymity waived not yet escalated but clock running. Will be listed if inadequate response from LA and CQC.

Priority to try and get safety for victim as very vulnerable and assessed as high risk. No remedy offered by MH services.

Access to crisis support actively blocked by Trust. Victim told to work with perpetrator / team if in crisis.

Victim attempted suicide.

Sebastian Lawson left an annotation ()

The grapevine tells me that as the Trust has not responded either here or to the CQC investigation above that details will now be open sourced from next week. Is the cascade ready to go to the list soon - groundswell is that it should be asap given the serious impact this has had on the victim and to protect other vulnerable service users and patients. Particularly given the failed CQC inspection.

The current understanding based on the information shared so far ( and given that there has been absolutely no denial) is that the victim has had ALL crisis support blocked to her following her co-operation with the police investigation in to sexual assault by a Trust staff member.

And that there was several months delay between her reporting the incident and the Trust acting and that questions are being asked as to why.

We are told ( by some helpful C&I staff) that the Trust are monitoring this post .However it is noted they have NOT corrected any details or speculation. Head in the sand approach. Not really advisable in this case as the victim has been courageous enough to waive anonymity and with that the entire story comes out.

Dr. Sarah Garvey left an annotation ()

We don't believe it is a head in the sand approach.More closing ranks although some C&I employees have shared information all through this.Very leaky organisation as we all know.

The very worst aspect of this is that the victim tried for a very long period of time to resolve this in a way that gave her protection and behaved with a dignity that MH workers could learn from. It is not a case where someone has shouted from the rooftops or used the media or threatened legal action.

But she has left us with a documented trail of what looks more and more like a cover up with subsequent behaviour that can only be described as intimidation.One or two events possibly a coincidence and examples of isolated very poor practice. This many looks like a pattern with management intervention.

Francesca Falk left an annotation ()

Neither Camden or CQC have provided a response as yet.We understand that the victim has again been threatened with an assessment under the MHA after she was interviewed by the BBC and other media.

Discussed plan is to publicise the names of the Trust staff who did not act on the report of sexual assault and of those who then took action that can only be seen as intimidation.

This is a Trust who when got a report of serious assault sent the team where the perpetrator was based to the victims's door.

Those named will only be staff and managers where the documentation confirms their actions and is on record.No speculative action will be taken.

If CQC and Camden Council do not act and in this case leave a very vulnerable person at further risk then they can account in a public for their actions. The details listed here are a tiny snapshot of what has happened - the full details are as disturbing as you could possible imagine and the community and professional anger around this is no longer containable.

THIS WONT BE DISCLOSED ON THIS SITE

christina moriarty

Dear C&I,

Why have you not conducted an Internal Review as requested 5 months a go?

Yours sincerely,

christina moriarty

Information, Freedom, Camden and Islington NHS Foundation Trust

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Dear Ms Moriarty,

I am sorry to hear that you did not receive the outcome of your request for an internal review.

Our records show that, your response was sent out to you on the 3 December 2013. Please see a copy attached to this email of your internal review response.

Again, accept my sincere apologies for this response not reaching you sooner.

Kind regards
Wayne Elliott | Information Governance Officer |Information Governance Team
Camden & Islington NHS Foundation Trust | P: 020 3317 3114 | F: 020 7561 4305 |
E: [email address]

Information Governance Department, 1st Floor, East Wing, St Pancras Hospital, 4 St Pancras Way, London, NW1 0PE

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