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Health board fined after failing to protect worker from attack

11 September 2013

Lothian Health Board has been fined for safety failings after a worker was attacked while making a home visit to a patient with mental health issues.

The community psychiatric nurse, aged 55, who has asked not to be named, was visiting a 58-year-old female patient who had been suffering from psychiatric illnesses for more than 30 years when the attack happened.

HSE’s investigation found that the injured person was an experienced nurse whose role involved visiting patients in the East Lothian area who were receiving community treatment for mental or psychiatric illnesses.

During the incident the nurse was forced to the floor, threatened and had her hair pulled so violently that several clumps were pulled out. Since the incident, she has been understandably apprehensive about undertaking home visits and has experienced unwelcome ‘flashbacks’.

Haddington Sherriff Court heard today (11 September), that at the time of the incident there were no risk assessments in place for Community Health team workers dealing with client violence or aggression, or for lone working in clients’ homes. Lothian Health Board had further failed to provide such information, instruction, training and supervision as was necessary for this work, and failed to provide a safe system of work for home visits to such patients.   

The incident, on 25 March 2009, was not reported to the Health and Safety Executive (HSE) until November 2009, despite it being a serious occurrence that should have been reported within 10 days – as required by law.

Lothian Health Board, also known as NHS Lothian, of Waterloo Place, Edinburgh, was fined a total of £32,000 after pleading guilty to a breach of Section 2 of the Health and Safety at Work etc Act 1974 and of Regulation 3 of the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995.

Following the case, HSE Inspector Lindsey Stein, said:

“Lothian Health Board failed to appropriately manage the risks associated with nurses making lone home visits to clients with histories of violence towards staff.

“This employee was not properly supported or trained to deal with a patient she was visiting who was known to have been violent towards staff in the past as a result of her long standing mental health issues.

“The board’s failure to protect its employee was added to by its failure to report the incident for eight months.”

Notes to editors

  1. The Health and Safety Executive (HSE) is Britain’s national regulator for workplace health and safety. It aims to reduce work-related death, injury and ill health. It does so through research, information and advice, promoting training; new or revised regulations and codes of practice, and working with local authority partners by inspection, investigation and enforcement.
  2. In Scotland the Crown Office and Procurator Fiscal Service has sole responsibility for the raising of criminal proceedings for breaches of health and safety legislation. 
  3. Section 2 of the Health and Safety at Work etc Act 1974 states: “It is the duty of every employer to ensure, so far as is reasonably practicable, the health, safety and welfare at work of all employees”.
  4. Regulation 3(2) of  the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995 states: ‘Where a person at work is incapacitated for work of a kind which he might reasonably be expected to do, either under his contract of employment, or, if there is no such contract, in the normal course of his work, for more than three consecutive days (excluding the day of the accident but including any days which would not have been working days) because of an injury resulting from an accident arising out of or in connection with work (other than one reportable under paragraph (1)), the responsible person shall as soon as practicable and, in any event, within 10 days of the accident send a report thereof to the relevant enforcing authority on a form approved for the purposes of this regulation, unless within that period he makes a report thereof to the Executive by some other means so approved.’

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