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Health workers missed chances to assess mental health of man who killed relative

Independent investigation shows failings by Nottinghamshire Healthcare NHS Trust

Posted on 16 January 2012

An independent investigation has been published into the tragic events that led to the death of 81-year-old grandfather John McGrath at the hands of his seriously ill grandson William Barnard in July 2009.  Barnard, who suffers from schizophrenia, stabbed his grandfather causing fatal injuries, as well as seriously injuring his grandmother. 

Barnard had stopped taking his medication and was not placed in a secure mental health unit. In April 2009, three months before the killing, a health worker went to his home to carry out an assessment that could have resulted in Barnard being sectioned and detained in a secure mental health unit. He was not at home and an assessment was not carried out and Barnard was not seen again by a member of his mental health team before he killed his grandfather. Nottinghamshire Healthcare NHS Trust has apologised to the family and said five recommendations made in the report had been acted upon.  The report said there had been a lack of "robustness" in the multi-disciplinary weekly clinical meeting and an "insufficient number" of funded medical sessions.

In June 2010, an internal report by Nottinghamshire NHS Healthcare Trust said his care had fallen "below acceptable standards." It highlighted 24 times when either family members or other people contacted mental health staff with concerns over Barnard's behaviour. His family said his behaviour was so alarming he should have been sectioned and said there were "systemic failings" on the part of Nottinghamshire NHS Healthcare Trust.

Marjorie Wallace, chief executive of SANE, said:

“It seems barely believable that mental health services should have so consistently failed to heed the warnings of William Barnard’s family and others about his mental state. As the report says, staff were waiting for ‘sufficient deterioration’ of the patient before taking him into hospital. For him, as for so many others, that wait was too long.

“What is most concerning is the apparent drive to keep everybody in the community, while turning a blind eye to the potential costs. Assertive Outreach and other community teams are judged on the number of hours they keep people out of hospital, regardless of whether it is detrimental to the wellbeing and safety of the patient and others.”

Leigh Day and psychiatric cases

Specialist mental health solicitors at Leigh Day have represented a number of people whose relatives have been killed by people suffering from severe mental illness, particularly where psychiatric patients have received inadequate treatment.  Partner Sally Moore represented Christina Kopernik-Steckel whose brother Gilbert who stabbed and killed his mother before killing himself.  Leigh Day represented Christina in her legal action against South London and Maudsley NHS Trust, who were responsible for Gilbert’s care, and who admitted negligence in his care, in what was thought to be the first successful case of its type. The firm has also supported the wife of Jonathan Zito who was stabbed and killed by Christopher Clunis at a tube station. The firm has also secured compensation for the bereaved family of a man fatally stabbed by a mental health patient who had absconded from a psychiatric unit and where the mental health services failed to arrange any follow up, or to arrange any care in the community.

Solicitor Emma Jones, former head of legal at mental health charity Mind, previously represented the mother of Roger Ramm, a man who suffered from paranoid schizophrenic, and who died while in the care of Hounslow Primary Care Trust after being detained under the Mental Health Act.

She says of the Barnard investigation:

“The report makes it clear that there were failings at Nottingham NHS Trust in relation to the way in which staff handled William’s case.  William’s grandfather contacted the mental health team on numerous occasions about his grandson and yet no action was taken.  It is imperative that lessons are learned to ensure that such a tragedy does not happen again.”