A senior doctor has admitted that the NHS did not do enough for a 14-year-old who died at a private hospital it sent her to and kept her in despite knowing it was understaffed daily, an inquest has heard.
The doctor, Dr Gillian Combe, has also warned that children’s mental health units across the country are struggling to staff their wards every day and that the NHS does not have the money to build its own wards.
Ruth Szymankiewicz died after self-harming while she was left alone at Huntercombe Hospital, also called Taplow Manor, near Maidenhead in Berkshire, despite requiring constant one-to-one observation, Buckinghamshire Coroner’s Court was told last week.
The inquest into her death last week revealed the hospital was “severely short-staffed” on the day of her death and that staff had repeatedly warned leaders over the lack of workers.
A note written before her death, read out at the inquest, revealed she had said hospital staff would fall asleep on shift, that there was no access to therapy and that the hospital “should be shut down”.
On Monday, Dr Combe, a clinical director for the Thames Valley provider collaborative, which is responsible for commissioning children’s inpatient mental health care for the area, gave evidence.
She told the jury there no other choice but to admit Ruth to Taplow Manor’s psychiatric intensive care unit (PICU) on 4 October 2021, despite a warning from her parents that this was not appropriate for her.
A month later, Dr Nishchint Warikoo Ruth psychiatrist at Taplow Manor, made a referral to the NHS asking for her to be moved to a different unit, as the PICU “environment wasn’t the best for [her]…but that there wasn’t any other suitable place”.
When asked about Ruth’s admission to the hospital, Dr Combe said: “We had concerns, I was in the [provider collaborative] we had the CQC, we were living and breathing trying to turn this hospital around but hospitals around the country were facing the same challenges…all the units were really struggling…it was a really stretched really difficult system.”
She said the concerns over the quality of care prompted NHS officials to be “breathing down their necks” and that she was visiting the hospital weekly.
“We were really trying and I’m really sorry, what we did it wasn’t enough for Ruth but we were really trying so hard to come alongside as the NHS to help this hospital improve,” she said.
“We were in a situation where beds were closing across the country. We have seen mainly independent sector providers pull out across the country…there were really high level discussions we decided we would throw everything at Huntercombe Maidehead and we worked really hard.”
Dr Combe led the closure of Taplow Manor in 2023 after Ruth’s death.
When asked if the provider collaborative was aware of the staffing issues at Taplow Manor, Dr Combes said: “Yes…absolutely they were struggling on a daily basis…there are training issues we don’t train enough nurses it difficult to recruit every day on my ward we’re struggling to staff up to the next day and this is happening all across the country. It is really tough all the time.”
She also said the NHS had concerns over the use of restrictive practices at the hospital, which can include restraint, and suggested there were more care assistants than qualified registered nurses.
She also revealed that the NHS had quality concerns over other PICUs across the country, and all were struggling with staffing.
Dr Combes admitted, “The NHS does not have the capital to build the hospitals for these young people that we desperately need. This is embedded in my lessons learned following the closure of the Huntercombe, it is a massive problem.”
If you are experiencing feelings of distress or are struggling to cope, you can speak to the Samaritans in confidence on 116 123 (UK and ROI), email [email protected], or visit the Samaritans website to find details of your nearest branch. If you are based in the USA, and you or someone you know needs mental health assistance right now, call or text 988, or visit 988lifeline.org to access online chat from the 988 Suicide and Crisis Lifeline. This is a free, confidential crisis hotline that is available to everyone 24 hours a day, seven days a week. If you are in another country, you can go to befrienders.org to find a helpline near you.
For anyone struggling with the issues raised in this article, eating disorder charity Beat’s helpline is available 365 days a year on 0808 801 0677. NCFED offers information, resources and counselling for those suffering from eating disorders, as well as their support networks. Visit eating-disorders.org.uk or call 0845 838 2040