Teesside NHS Mental Health Trust sentenced over patient harm offences
The Tees, Esk and Wear Valleys NHS Foundation Trust was sentenced at Teesside Magistrates Court
Last updated 19th Apr 2024
A Teesside mental health trust has been sentenced to pay fines of £200 000 after indicating a guilty plea to two offences in a prosecution brought by the Care Quality Commission.
The Tees, Esk and Wear Valleys NHS Foundation Trust were accused of failing to provide safe care and treatment to two people who were exposed to a significant risk of avoidable harm, contrary to Regulations 12 and 22(2)(b) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
The first offence relates to Christie Harnett (also known as Christie Brayley) who was receiving care at the Newberry Centre at West Lane Hospital. The other offence relates to person X who was being treated at Roseberry Park Hospital.
Both died, as a result of self-inflicted incidents whilst they were under the care of the trust.
The CQC say Tees, Esk and Wear Valleys NHS Foundation Trust failed to provide safe care and treatment in that it failed to mitigate the known risks they were both exposed to following previous incidents.
They say that failure exposed Christie and person X to a significant risk of avoidable harm.
Brent Kilmurray, chief executive at Tees, Esk and Wear Valleys NHS Foundation Trust said: “As we made clear in court today, we are deeply sorry for the events that led to these tragedies.
“We didn't provide the care these two people deserved, and the guilty pleas reflect that. Of course, that is no consolation to Christie’s family and friends, and the loved ones of the other patient, for which I offer our heartfelt apologies.
“The CQC has acknowledged in our latest inspection that improvements have since been made, however now is not the time for this. Today is about us being accountable, and our thoughts are with the families at this incredibly difficult time.”
In a statement read in court, Christie's stepfather Michael Harnett said he had met her at the age of five after starting a relationship with her mother Charlotte, and that "she considered me to be her dad", which he said was a massive honour.
He said Christie was "such a happy child" who dreamed of becoming a singer.
"The day Christie went into hospital was the start of the worst period of our lives," Mr Harnett said.
"Sometimes we would travel for an hour to see her only to be turned away because Christie had misbehaved."
He described watching his daughter "climb over a fence to try to see you" on those occasions, and told how seeing her "covered in scratches, cuts and bruises" during visits was "traumatising" for Christie's family.
Mr Harnett said he would never see Christie turn 18, or 21, or "become a mother which she was looking forward to so much".
"These things people take for granted but not for us. We have had them stolen from us because the place that was supposed to keep her safe, in my opinion, totally failed her," he added.
Christie's sister, Ellis Brayley, said her mental health "declined rapidly" after she was admitted to hospital, adding: "I can't even bring myself to say the name of the place because it fills me with so much anger."
The mother of Service User X said in a statement that her children "will never be able to live their lives normally" after her death.
"My daughter is dead and it's like she is a number on a piece of paper rather than a young lady with amazing potential," she said.
"My daughter deserved better, she deserved to be cared for. The trust, in my opinion, should have done better."
Paul Greaney KC, mitigating, said the trust wished to apologise to the families of Christie and Service User X, and read a statement from its chief nurse - Beverley Murphy - saying how sorry it was for the incidents and that the care on these occasions "had fallen short of that which we would expect".
Mr Greaney said TEWV was not being sentenced on the basis that it caused the women's deaths, and that it did have systems designed to ensure care and treatment were provided in a safe way.
"This is not a case where nothing was done. There were systems and these systems failed," Mr Greaney said.
"Staff on those wards did care for Christie and Service User X."
He told the court the leadership of the trust "has changed beyond all recognition" since the time of the offending and it was "determined to learn the lessons arising out of Christie and Service User X".
Mr Greaney said the money to pay the fine would have to be diverted from funds "that would otherwise be used to support patient care".
This has led to frustration from some, including Middlesbrough MP Andy McDonald.
He said: “I have been an extremely vocal critic of TEWV over the very matters for which they have been prosecuted.
“Nevertheless, taking money out of the trust – and a six-figure sum at that - doesn’t seem to me to be the right response – that doesn’t help them in any way improve on the delivery of services.
“There must be a better way than this to admonish a Trust who have failed in their care of patients.
“And let us not forget that whilst there were clear systemic failures, no individual or individuals have been held personally accountable for their particular errors and failures that were part of the events that led to these avoidable deaths.
“NHS England commissioned independent reports into these deaths and were utterly scathing in their conclusions and their recommendations are far reaching.
“But the anxiety now is that we are not going to get progress with the broader issues that these tragic cases lay bare.
“I have repeatedly called for a public inquiry, not just into these deaths but into the broader provision of mental health for children and young people.
“A financial penalty against TEWV is not the answer here. Again, I have been extremely critical of the Trust and how it failed these patients and I will not hesitate to do so again, as and when that is appropriate, but a financial penalty is ludicrous.”
For mental health support, contact the Samaritans on 116 123, email them at jo@samaritans.org or visit samaritans.org to find your nearest branch.