NHS Trust Fined After Two Employees Stabbed

An NHS Foundation Trust has been fined £300,000 after two staff members suffered life-changing injuries when they were repeatedly stabbed by a service user.

The Old Bailey heard how, on 17 July 2016 a health care assistant was preparing toasted sandwiches for the staff and some of the patients in the kitchen on a ward in a medium secure forensic unit in Kent. He went to leave the kitchen to speak to a service user, leaving the knives on the work surface.

As the health care assistant opened the door, which had been locked from the inside, one of the service users who had been seen nearby pushed him back into the kitchen, forcing him onto the floor. The service user then grabbed a kitchen knife from the side and stabbed the health care assistant multiple times in the chest and stomach. In his victim impact statement he described feeling like a piece of meat being prepared for cooking.

A psychiatric nurse, also working on the ward, saw what was happening and shouted for the attack to stop. The service user then went to attack him out on the corridor, allowing the health care assistant to lock the kitchen door. The psychiatric nurse was then stabbed multiple times.

The court heard the psychiatric nurse had lost a lot of blood but was able to get out of the ward and receive emergency first aid. He then went to his room and collected a lighter and some belongings. He came back out to the communal area and set a small fire. Armed police attended and arrested the service user.

Both staff members were treated for multiple stab wounds and were air lifted to Hospital, where they received blood transfusions and surgery to repair the damage caused by the attack.

The health care assistant was found to have suffered several stab wounds to his arms, abdomen and chest, causing serious internal damage which he needed several operations to repair. He remained in hospital till the 29 July 2016 and was able to return to work on a phased return.

The psychiatric nurse was stabbed around 17 times, he also received emergency surgery to repair the internal damage caused and remained in hospital till the 23 July 2016. He was unable to return to work until March 2017 and he has since had several periods off work due to the injuries.

Both victims still suffer pain, medical problems and the psychological damage from the attacks. Two other members of staff who, for their own safety, had to hide on the ward and witness the attacks on their colleagues have suffered both emotional and psychological damage. Both described in their victim impact statements feeling helpless and that they feared they would be next to be attacked. Both took time off work and have received counselling from the Trust.

An investigation by the Health and Safety Executive (HSE) found that although the Centre routinely received high-risk patients, at the time of this incident there was no patient specific risk assessment identifying the risks posed by a patient and the measures required to control those risks prior to admission to the ward.

The investigation also found that the use of knives on an acute ward was fundamentally unsafe. Staff were entering and exiting the kitchen area several times whilst knives were in use and there were no instructions or control measures in place regarding kitchen knives. Following the incident all knives were removed from the acute wards.

The NHS Foundation Trust pleaded guilty to breaching Section 2(1) and 3(1) of the Health and Safety at Work etc. Act, was fined £300,000 and ordered to pay costs of £28,000.

Speaking after the hearing, HSE inspector Joanne Williams said:

“This incident has had a profound impact not only on the two members of staff who nearly died because of their injuries, but also their colleagues who witnessed the attacks. These NHS workers dedicated themselves to a public duty that came with daily challenges and the Trust had a responsibility to keep them safe.

“The treatment of patients in medium secure psychiatric units involves an inherent risk of violence and aggression. The needs of patients can be complex. However, the Trust nevertheless had a duty to ensure the safety of its staff and its patients so far as was reasonably practicable.

“In this case there were relatively straightforward steps that could have been taken prior to the incident to prevent it happening. These included carrying out a patient specific risk assessment prior to admission to the ward; the removal of knives from acute admission wards where patients do not routinely require occupational therapy; and proper training in search techniques.

“The risk of violence posed by patients was entirely foreseeable. Had these steps been taken these two staff members would not have suffered the serious injuries that they did.”

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