A privately-run mental health ward caring for children in crisis is closing down because of staffing problems, the Cable can reveal.
Banksy ward at the Priory Hospital Bristol is the only psychiatric intensive care unit (PICU) in south west England. Amid a national shortage of mental health beds for young people, the nearest ward of this kind will now be almost 100 miles away in Maidenhead, Berkshire.
The 12-bed ward, which opened in 2017 and is largely funded by the NHS, is run by the Priory Group, one of the UK’s largest private mental health providers.
Since the start of the year, Banksy ward has had no more than four patients instead of its usual capacity of 12. Admissions were halted in autumn 2019, patients referred elsewhere, and admissions restarted a few months later.
During an inspection in January 2019 by regulator the Care Quality Commission (CQC), there were seven serious incidents on Banksy ward, including violence towards staff, and young people swallowing parts from broken equipment, and self-harm using a blade. On Banksy ward there were 118 incidents in the 12-month period up to July 2018. However, overall the hospital was rated as ‘Good’ by the CQC.
Following a serious incident on the ward in June this year, which is now being investigated by police, NHS England and the Priory discussed the future of the ward. It was decided that Banksy should close because the Priory will struggle to staff the ward sufficiently in the long term.
The Priory said they have struggled to keep a team of permanent, experienced staff. This has meant the hospital has had to use a high number of agency staff. The Priory said the four remaining patients will be referred elsewhere, and staff will be moved onto other wards at the hospital.
Children sent to wards like Banksy are often a risk to themselves or others, so the aim is to keep them safe and set them on a route back to recovery by, observing them closely, prescribing medication, and offering therapy until they are ready to ‘step down’ to a less restrictive setting.
The ward is commissioned by NHS England, who pay the Priory Group hundreds of millions every year to deliver specialist services nationally. There is one other ward for children at the hospital in Stapleton, which also offers services for adults.
Problems in children and adolescent mental health services (CAMHS) are well known. The CQC’s most recent State of Care report highlights CAMHS as a particular issue, as young people often struggle to access community services, which is in part due to under-investment.
In the last 18 months, three separate Priory hospitals or wards in England for children and young people have been forced to close down after being rated inadequate by the CQC, in Buckinghamshire, Norfolk and Dorset. Each time the Priory has blamed a national shortage of qualified staff. The CQC said the impact of workforce challenges on the quality and safety of inpatient care was their “greatest concern”.
In 2019 the Priory Group was fined £300k by the Health and Safety Executive for their role in the death of 14-year-old Amy El-Keria in 2012 at Ticehurst House in East Sussex. In December 2019, the CQC found Ticehurst House to be ‘Inadequate’.
The Priory Group – one of the largest private providers of mental health services in the UK – is reportedly up for sale for roughly £1 billion.
A spokesman for the Priory Hospital in Bristol said: “Due to challenges in recruiting specialist, permanent staff, we have taken the difficult decision to close the ward. We are working closely with the patients, their families, and NHS England to ensure the four young people on the ward receive a smooth transfer to a setting which best meets their needs. Staff from the ward will be redeployed across our hospital in Bristol, which is rated ‘Good’ by the Care Quality Commission for its child psychiatric and adult services.
“Following an internal investigation, an incident was reported to the police in June where our clinical policies were not followed by an agency member of staff, and they are currently investigating the issue. The agency employee is no longer working at the hospital.”
Annie Tysom, Head of Development, Direct Commissioning South West at NHS England said: “NHS England and NHS Improvement is working with healthcare providers across the region to put additional alternative plans in place as the Priory Group work to close their Banksy Unit in the coming months.”
The Cable has been investigating the circumstances behind the closure of the ward. More to follow.
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