Ten NHS trusts referred over monitoring consent

Ten mental health trusts have been reported to the health regulator after problems with patient consent procedures when monitoring patients using camera technology.

The issue emerged during the latest hearings of the Lampard Inquiry, which is examining the deaths of more than 2,000 people who spent time in mental health units in Essex between 2000 and the end of 2023.

The infrared technology is used in patients’ bedrooms and can monitor breathing and pulse without staff having to enter the room.

NHS England told the inquiry it had passed information to the Care Quality Commission (CQC) after reviewing the use of digital monitoring systems, including Oxevision.

Baroness Lampard has said she would introduce interim recommendations on the introduction of some technology if she believed there was a “risk to patient safety”.

The inquiry heard NHS England first became aware of safety concerns linked to Oxevision in 2021.

Giving evidence, Gareth Harry, NHS England’s National Delivery Director for Mental Health, Learning Disability and Autism, said concerns had been raised about consent, patient observations and human rights.

The inquiry was shown an internal NHS England email from 2022 in which one staff member said they had been aware of trusts where patients were “not being given the choice to refuse being filmed”.

In 2023, NHS England wrote to mental health trusts saying monitoring technology should not be introduced as a blanket approach and decisions should be made for each patient individually.

It said if possible, patients should be involved in those decisions.

Harry said NHS England later reviewed practice after concerns were raised by campaign group Stop Oxevision, external.

The inquiry heard that review found 10 mental health trusts were “not operating their consent mechanisms in line with the digital principles”. The trusts that have been referred to the regulator have not been named.

Harry said NHS England wrote to the CQC on 2 October and shared the findings with inspection teams.

Lawyers representing bereaved families questioned why it had taken several years for NHS England to act after concerns were first raised.

Harry said day-to-day responsibility for following the guidance sat with individual trusts rather than NHS England.

Counsel to the inquiry Teniola Onabanjo asked Harry if NHS England recognised that the enthusiasm for innovation might “outpace” the scrutiny of consent and ethics when it comes to camera technology.

“I would expect every provider of mental health services to have their values and behaviours driven by a human rights approach to mental healthcare,” Harry said.

A CQC spokesperson told the BBC: “Providers have a responsibility to offer safe, high-quality care in line with relevant guidelines.

“CQC considers all information of concern that is shared with us, and should a provider fall short we can and do take action.”

The regulator is due to give evidence to the Lampard Inquiry on 7 October.

Giving evidence in July, Laura Cozens, from LIO Health, the company behind Oxevision, said it was important the technology was properly explained to patients. She also said it had helped prevent serious incidents, including falls on a dementia ward.

The current hearings are expected to continue until 15 October, with a further hearing for families on 20 October. Baroness Lampard has said she could issue interim recommendations if urgent patient safety concerns are identified before the inquiry’s final report, which is due in 2028.

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