Decision report 201202797

Summary

In September 2011, the hospital introduced a new clinical model, which set up new hub and cluster units (a central point and areas for activities). 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 a central unit where more formal therapies and educational activities are held.

Mr C, who is a patient in the hospital, complained that patients were unreasonably pressured to attend activities in the hub area and that alternatives to attending there were limited. Our investigation found that the board had already addressed staff recruitment and training issues and reviewed 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 month Mr C's ward had not been closed. They also pointed out that sometimes they cannot keep all areas open because of staffing and safety issues.

The hospital provided details of Mr C's personal programme of activities. We noted the steps that have been taken to review and improve practices at the hospital. Independent advice received from our medical adviser on a previous similar case was that positive progress had been made. Our adviser also said that staff often have to find a balance between encouraging patients to engage with therapies and activities and making them feel pressurised.

We took the view that it was not unreasonable for patients from one area to move elsewhere when there are short term difficulties. The matter of deciding how patients should spend their time, and where, is one for the board to consider and decide upon and we found no evidence of anything having gone wrong in the process of deciding how to go about this. On the basis of the information provided and the advice previously received from our adviser, we did not uphold Mr C's complaint.