A Nottingham councillor has questioned whether a crisis-hit NHS trust has been placing finances above the needs of patients at a secure hospital that it runs.
Nottinghamshire Healthcare NHS Foundation Trust runs Rampton Hospital, a high-security psychiatric hospital in the village of Woodbeck.
In January 2024 the hospital was rated “inadequate” by health watchdog the Care Quality Commission (CQC), while the wider trust has been the subject of a review initiated by the health secretary following the Nottingham attacks in June 2023.
While the hospital’s rating has since improved to ‘requires improvement’ as of May following a raft of changes, some concerns remain.
These were discussed at a Nottingham City Council health scrutiny meeting on Thursday (November 20).
Cllr Georgia Power (Lab), the chair of the committee, said: “It talks [in documents] about the key areas patients, families, and carers have raised – one of them being bed capacity and access to services.
“On the refreshed Integrated Improvement Plan where it talks about beds, it talks about beds and financial efficiency, not under safety of care, so that suggests to me decisions are being made about bed access based on finance, not on what has been said by patients?
“I know there has been a reduction of the number of private beds that are accessed, to 25.”
Diane Hull, chief nurse at the trust, said: “I want to assure you access to beds is never about finances.
“What we do know is people are better cared for closer to home, closer to their families.
“The other thing is that at one stage we had a ward and a half at least of people who were ready for discharge. Bed numbers are based on the benchmark around how many beds do we need for the communities we serve based on need.
“That is 25 in addition to the beds we have. That is dependent on people being able to be discharged when they are ready, and having the right support, particularly housing, accommodation, to go home to.
“I do really, really want to assure you it is based on clinical need.”
Following the conviction of Valdo Calocane in January 2024 for the June 2023 killings of Ian Coates, Grace O’Malley-Kumar and Barnaby Webber, the health secretary commissioned the CQC to carry out a rapid review of the trust.
This was done under section 48 of the Health and Social Care Act 2008, and the report required the trust to make a number of improvements.
Trevor Gedeon, associate medical director at Rampton Hospital, said: “I am proud to say over the course of the year we have done a significant amount of work, with many of the section 48 requirements being either signed off and assurance being given, and that has been done through independent groups giving their views.
“The ones that are still to be signed off are in the final stages now, so some of that has been around our medicines delivery, how we engage with patients, how we use our staff and meet the needs of our patients across the hospital, how we meet the needs of patients – particularly those in our national deaf service – and help support our staff to be able to deliver.
“The key message is whilst we have made those improvements and things are getting better, we recognise there is something about the sustainability of this and future work that is needed. The next phase is how do we make sure it doesn’t slip again.”
Nurse Glen Owen, Allied Health Professions and quality director at the trust, added: “Over 50 percent of the section 48 actions have now been signed off.
“We have got a further 30 percent of actions due to be reviewed [on November 20]. Two of the actions that will be remaining will be around longer-term working, embedding continued improvement with working with families.”