Mental health placements to St Andrew's Healthcare suspended

Ayla Haines Image copyright Family photo
Image caption Ayla Haines has been receiving care in Northampton since 2016

Placements for some Welsh mental health patients at a specialist care provider in England have been suspended.

St Andrew's Healthcare in Northampton looks after patients for Welsh health boards but the Welsh Government said it was "under enhanced monitoring".

The charity said it was "confident" it could resolve any concerns quickly.

It comes as the family of a patient from Carmarthenshire said they had sought legal advice over concerns about her care.

Ayla Haines, 27, from Llansteffan, suffers from mental health problems, including anorexia and obsessive compulsive disorder.

Her mother, Jane Haines, said Ayla's physical health had "deteriorated drastically" since being admitted to one of St Andrew's private hospitals 231 miles (372km) away in Northampton in 2016.

Earlier this month, inspectors for the Quality Care Commission in England found "repeated and systemic failings" in St Andrew's leadership.

Inspectors from NHS Wales also reviewed the site separately.

BBC Wales Live was told the site was one of those being looked at, although it was not clear whether Ayla's ward was involved.

"Our biggest concern at the moment is an ongoing infection on her arm," said Mrs Haines, who is taking legal advice about the treatment of a series of injuries Ayla was able to inflict on herself.

"She bit a chunk out of her arm and she's inserted objects into her arm.

Image copyright Family photo
Image caption Ayla Haines with her grandmother and mother during a recent visit

"At the end of last year she had gangrene removed from her arm - I know that's an ongoing thing, it's still going on at the moment despite finishing one course of antibiotics."

In April last year Ayla's case received national press attention when it was revealed she had swallowed a toothbrush as part of a series of desperate acts.

"She wants to die now, she's lost all hope. That's why she'll insert things into her - in the hope of getting an infection that will kill her off. To me that's a strong possibility," said Mrs Haines.

"You wonder what will get her first - is it going to be sepsis - is the toothbrush going to cause some sort of a thing. She's in a desperate state physically and mentally."

Mrs Haines said she was concerned about both Ayla's current diagnosis and treatment at St Andrew's.

Hannah Mason, from legal firm Simpson Millar, said she was investigating any grounds for a legal challenge around Ayla's care.

"In particular, there are questions surrounding the treatment given to Ayla for physical health conditions," she said.

"This includes the treatment of an infection, and whether the toothbrush she ingested should be removed, and we are looking into the best way to challenge the decision-making in respect of this."

Ayla was first sectioned when she was 19 and spent time at various secure units in Wales before being moved to a medium-secure St Andrew's unit.

Angela Burns AM, the Welsh Conservative's spokeswoman on health and Ayla's local assembly member, has visited her in Northampton and said her case highlighted problems with how the care of mental health patients sent outside of Wales was overseen.

"I find it very difficult to get anyone to take responsibility and say that she [Ayla] is in our direct line of sight," said Ms Burns.

Image caption Inspectors have raised concerns about the way St Andrew's Healthcare is run

"I had to ask the health minister to basically intervene in what was a football match between Hywel Dda University Health Board and the Welsh Health Specialised Services Committee, who commission these kind of services, because they were bouncing her back and forth in terms of who had ultimate responsibility.

"That girl was placed into a secure mental health unit with a very clear remit that she would have a certain type of treatment, that there would be ambition for her to get well and that there would be some sort of outcome.

"To be frank, none of that has happened. She's gone back in terms of health but more importantly there's no sort of goal."

What does St Andrew's Healthcare say?

St Andrew's said it had recently changed its leadership team and was "committed to making improvements".

"We acknowledge that NHS Wales have temporarily suspended new admissions to a small number of our wards, following recent routine audits," said a spokesperson for the care provider.

"We have been in discussions with them this week and we're confident that we will be able to resolve their concerns quickly."

St Andrew's said it could not comment on individual patients, but that it was fully committed to "moving care closer to home" and was working to reduce inpatient beds where possible.

"We care for some of the most complex mental health patients in the country and the majority of our patients are in our care, because they pose a risk to themselves or others. For these vulnerable patients - there is, and will continue to be - a need for very specialist treatment and observation in a safe, secure setting," said a spokesperson for St Andrew's.

Hywel Dda also said it could not comment on Ayla's case but was "very mindful" of her family's concerns and reviewed any issues raised.

Mandy Rayani, director of nursing, quality and patient experience, said: "When a resident of Hywel Dda UHB requires a complex level of care not available locally, we are able to commission the services needed through the Welsh Health Specialised Services Committee.

"We are aware of a recent decision to suspend some services at St Andrew's and we are working very closely with our colleagues at the National Collaborative Commissioning Unit who have been continually monitoring the quality and provision of services at this facility on our behalf. Our absolute priority is listening to and ensuring the safety of our patients and we are addressing this urgently with our colleagues."

Meanwhile the Welsh Health Specialised Services Committee, which is involved in planning out of area placements for Welsh health boards, said it was committed to having patients "as close to home as possible" when their circumstances allowed.

Watch the full report on Wales Live on BBC One Wales on Wednesday 29 January at 22:30 GMT or on the BBC iPlayer.

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