An agency nurse who was filmed turning off a patient’s life support machine before a bungled effort to revive him is suspended pending an investigation. Jane Deith speaks to the patient’s father.
Jamie Merrett, who’s tetraplegic, suffered severe brain damage after his ventilator was mistakenly turned off.
The 37-year old was being cared for at his home in Wiltshire by Violetta Aylward, who was working for the Ambition 24hours agency on behalf of the NHS.
Bedside camera
Mr Merrett had set up a bedside camera because he was concerned about his standard of care. Video footage of the incident, obtained by the BBC for its Inside Out West programme, shows Ms Aylward fiddling with the ventilator before the alarm goes off – showing it’s been turned off.
As Mr Merrett fights for his life, she’s then seen using a resuscitation bag to try to revive him – but holds it over his mouth instead of his throat. Mr Merrett appears to be aware of the mistake – he’s heard frantically clicking his tongue as a warning.
“All providers of healthcare, with whom the PCT contracts, are required to meet recognised standards of care.” NHS Wiltshire Primary Care Trust
Eventually, paramedics arrived, and used the bag correctly, before reconnecting the life support machine 21 minutes after it was turned off.
Although he was left paralysed from the neck down by a road accident in 2002, before the incident Mr Merrett was able to talk, use a wheelchair and operate a voice-activated computer. Since the incident, his sister Karen Reynolds said his mental age had fallen to that of a young child.
“He doesn’t have a life now,” she told the BBC. “He is very brain-damaged compared to what he was before. He was a highly intelligent man and you could have long in-depth conversations with him and now it tends to be more simplistic.”
The Ambition 24hours agency – which describes itself as “the leading independent specialist in healthcare staffing” – has refused to comment while the Nursing and Midwifery Council investigation is underway.
Confidential report
But a confidential report from Wiltshire social services – leaked to the BBC – said that, although the agency knew it was required to supply a nurse who was trained to use a ventilator, it didn’t have adequate systems in place to check what kind of training their staff had received.
In a statement, the NHS Wiltshire Primary Care Trust said it was committed to helping patients receive care at home, provided it was safe, adding “All providers of healthcare, with whom the PCT contracts, are required to meet recognised standards of care.”
The Trust said it had now carried out a series of actions to make sure this kind of incident didn’t happen again.
“What procedures have been put in place now to ensure this never happens again to any disabled person?” Anne Novis, UK Disabled People’s Council
The NHS says all independent home care agencies are regulated by the Care Quality Commission, which has the power to inspect companies and enforce standards. The NHS stipulates that agencies should provide “trained and experienced care workers” to meet the needs of the patient – which should be properly assessed by the agency itself.
Anne Novis, a member of the UK Disabled People’s Council, told Channel 4 News that disabled people had to be able to trust the organisations and individuals providing their care.
“We are very aware of things going wrong,” she said. “The fact that Jamie felt he had to put up a camera probably means he had alerted someone that he had concerns.”
She added: “Some very serious questions need to be asked. What procedures have been put in place now to ensure this never happens again to any disabled person?”
‘Outraged’
The Patients Association said it was outraged by this latest incident – and said it had repeatedly warned the NHS to make sure all its staff – including those hired through agencies – were suitably trained.
Mr Merrett’s solicitor, Seamus Edney, described it as “the worst case of negligence” – and said the family was now campaigning for someone to admit liability for what had happened.
“The agency tells us they do not send nurses out unless they are confident of their competence to manage the assignment.” Care Quality Commision
Agency staff
Ambition 24hours is part of the A24 group – which provides temporary staff for a range of professions, including the NHS, private hospitals and prisons. It has around 27,000 personnel on its books, with offices in the UK and South Africa.
It was awarded the top three star grade in a recent assessment by the Care Quality Commission, whose report singled out its “comprehensive and rigerous” recruitment and selection process, and its “extensive pre-employment checks… of candidates’ skills and training”.
The report added: “The agency tells us they do not send nurses out unless they are confident of their competence to manage the assignment.”
According to the Telegraph, the agency’s founder – Penny Streeter – said a new £1m computer system had just been acquired to help vet staff and build in automatic safeguards. And its guidelines stress “agency workers must never attempt to perform any duties of care or otherwise that may fall outside their expertise.”