NHS Trust fined £300k after two employees stabbed by service user

NHS Oxleas Foundation Trust was last month (20 December) fined £300,000 after two nurses 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, Francis Barrett was preparing toasted sandwiches for the staff and some of the patients in the kitchen on the Burgess Ward of the Bracton Centre, which is 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 Francis Barrett multiple times in the chest and stomach.

Julius Falomo, 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 Francis Barrett to lock the kitchen door. Julius Falomo was then stabbed multiple times.

Armed police attended and arrested the service user.

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

Francis Barrett 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.

Julius Falomo 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 nurses 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.

An investigation by the Health and Safety Executive (HSE) found that although the Bracton 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.

NHS Oxleas Foundation Trust pleaded guilty to breaching Section 2(1) and 3(1) of the Health and Safety at Work etc. Act.

In addition to the £300,000 fine, the trust was also ordered to pay costs of £28,000.

HSE inspector Joanne Williams said: “This incident has had a profound impact not only on the two nurses 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.”

Williams added: “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, including Burgess Ward 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 Francis Barrett and Julius Falomo would not have suffered the serious injuries that they did.”