It’s okay, when things aren’t okay. So long as you have a plan…

I spent some time with a consulting client of mine recently and we were discussing situations where things had gone wrong or had not gone to plan in relation to service-user risk. He asked for me to share some experiences that I’ve had of such times (many), and I explained what I did about them.

Those of us that have worked in the healthcare or care sectors know that adverse incidents and events are an unpleasant part of the job. One of the things that makes me anxious about these sectors at the minute is how the demand for services that can support risky, and complex individuals has arrived at the exact same time as the staffing crisis and a seemingly zero-tolerance approach to risk and incidents by some regulators and stakeholders. Within mental health hospitals most people I speak to say that the risk and complexity of their patients has significantly increased over the past fifteen years. Often they say something similar to ‘all of our patients now would have been in low or medium secure services, but now we are left to manage them here…’

This situation will not resolve itself without planning and intervention. In my opinion there are three plans that would help enormously:

  • Increasing the number of mental health services to meet the demand and complexity; and
  • Delivering on the national and local workforce planning priorities (we need more nurses, more doctors, more HCA’s and support workers and so on); and
  • A more understanding inspection and regulation approach from regulators and stakeholders (context is everything).
Dean is a Registered Mental Health Nurse, and Chartered Manager with health and social care experience since 2007. He has managed services and hospitals across the independent and NHS settings and as a nursing director of the Midlands and Wales. 
Dean is an independent healthcare expert available at [email protected]; Senior lecturer in Nursing at NTU and BSc nursing course lead, a member of the East Midlands Clinical Senate, and a bank investigator for Nottinghamshire Healthcare NHS FT.
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