With the operation and staffing levels in A&E Departments under scrutiny, this recent High Court decision explores the duty of care owed by A&E staff to vulnerable patients.
In Webley (a protected party) -v- St Georges Hospital NHS Trust & Metropolitan Police  EWHC 299 (QB), the claimant had been arrested by police after a disturbance at his flat. He was taken into custody having tried to escape. He was assessed by a mental health team as being a risk to himself and possibly others, and in need of compulsory hospital admission. The police accompanied the claimant to hospital in an ambulance, but en route he suffered a seizure and so was sent to casualty for assessment before being admitted to the psychiatric ward. Unfortunately, the claimant left the casualty cubicle, ran through the ambulance doors and across the ambulance roadway to the top of a ramp before climbing over low railings onto a ledge, then falling down a of some 15 feet. In addition to various fractures and internal injuries he sustained a serious head injury.
The Claimant's case against the police was that they failed to pass on to the Trust's staff information about the Claimant's volatile behaviour in the previous 24 hours, and his attempt to escape in the police station yard. It was argued that this failure led to the A&E security staff being insufficiently alert to the risk of the claimant escaping from the casualty cubicle. As a matter of evidence the trial judge found the police had told casualty staff that the claimant was a high risk patient who was likely to abscond and they had not left him until they had handed him over to security staff. The case against the police was dismissed.
The case against the Trust was in relation to the lack of training and guidance for security staff in dealing with vulnerable patients, the absence of risk assessments, and the actions of the security staff themselves in failing to take into account the likelihood of the claimant absconding through the unhindered access side door. The trial judge Mr Justice Bean, had the benefit of reviewing CCTV footage. It was his judgement that Mr Webley should have been guarded, and not simply observed, by two security guards both of whom had been properly briefed about the risks of absconding, and such the Trust was negligent for failing to take reasonable steps to protect the claimant.
Damages to be assessed at a later date.