Webley v St George’s (2014)

The police were called in April 2010 to the home of Mark WEBLEY in London.  During the incident, he appeared agitated and threatened police officers with furniture before then climbing on to a window ledge, with the appearance that he would try to jump.  Officers restrained him to prevent him harming himself, he was arrested for affray and then detained at Wimbledon police station.

It was known at the point of arrest that Mr WEBLEY suffered with mental health problems but Metropolitan police officers encountered him in his own home so could not detain him under the Mental Health Act.  He was assessed the following day by an AMHP and psychiatrists and an application for his admission to Springfield hospital under section 2 of the Act resulted.

In considering conveyance of the patient, the AMHP delegated authority to the police under section 6 MHA and as officers moved him from the cell to an ambulance in the police yard, Mr WEBLEY ran and was detained a few yards away.  Once in the ambulance and en route to Springfield hospital, Mr WEBLEY appeared to suffer from a fit and the ambulance diverted to the Accident & Emergency department at St George’s Hospital.

Having arrived and been triaged by an A&E Sister, it was noted in his records that he was a “high risk patient, risk of absconding.”  Police officers remained in A&E until hospital security came and took over responsibility for his ongoing detention.  The officers left around 3pm and two hospital security guards, along with staff in A&E, became responsible for his security and immediate welfare.  Around 4:30pm, Mr WEBLEY managed to leave cubicle 9 in A&E and walk out to a nearby ramp and jump from a height of fifteen feet.  As well as causing various fractures and other injuries, he sustained a significant head injury which has caused permanent damage and had a lasting effect.

He initiated legal against the hospital and against the Metropolitan Police for negligence and judgement was recently given in February 2014.

A COMMON LAW DUTY OF CARE

This is not a long court judgment, so I would encourage interested parties to read it in full.  However, the judge stated that the case against the police depended upon whether the officers had made it known to staff that Mr WEBLEY was detained under the Act, whether he had made attempts to escape and that he was still a high risk of absconding.  It was accepted that the officers had done all of this and had not left the A&E department until they were satisfied that hospital security were on hand to take over from them.  They had discharged their “common law duty of care”.

Stephen MILLER QC, acting for the Metropolitan Police, accepted that this duty of care included three components:

  1. A duty to take reasonable steps to ensure that he did not come to physical harm while in their custody;
  2. A duty to take reasonable care only to release him into a safe environment;
  3. A duty to provide relevant information to those into whose care he was transferred.

Because the court found these three things fully satisfied, the case against the Metropolitan Police was dismissed.

In reaching a judgment concerning the liability of the hospital trust, the Court examined in detail the movements of security guards, their comings and goings and whether they could be said to have been observing Mr WEBLEY or actively guarding him.  Whilst much debate occured in court about what would constitute the “least restrictive” approach, the court rejected suggestions that a less intrusive, less restrictive approach was reasonable because of the risks that were known about the potential of Mr WEBLEY to abscond.  In particular, there were two doors in the cubicle where the patient was detained and the security officers did not position themselves in such a way as to block both exits.  The second security officer, who arrived after the police left, had not been briefed on the issues highlighted by the police about the risk of absconding.

Paragraph 53 of the judgment summarises fourteen seperate considerations put forward by those acting for St George’s.  They make interesting reading!  The courts view on the approach to striking the balance between intrusion and least restriction, the detail of briefing and planning that should have occured amongst the security and clinical staff, in the court’s view.

It was for all of these reasons, that the court found the hospital trust liable for the injuries that Mr WEBLEY suffered and the fact that he is now in a secure hospital facility, detained under s3 of the Act having suffered life-altering injuries.

IMPLICATIONS

One thing that struck me reading this judgment, was the issue of whether and to what extent the A&E department were obliged to take responsibility for Mr WEBLEY.  After all, he was in the police’s legal custody having had authority delegated to them by an AMHP.  An easy way of acute trusts with A&E departments avoiding the kind of liabilities that arose in this case, is to decline to allow their security officers to take over the legal responsibility from the police.  I have known A&E departments do exactly that and as Stephen MILLER QC accepted, the common law duty of care is not discharged until the police have released him into a safe environment.

Another argument for improved partnership arrangements! … yet there has to be some duty upon the AMHP who made the application to become re-involved in the issues around that patient, in light of the new information that took the patient to A&E.  But as with all things “policing and mental health”, unless these kinds of things are discussed and agreed in advance and expectations achieved between organisations, you will get the uncertainty and unwillingness in the NHS that is potentially more likely as a result of cases like this.


IMG_0053IMG_0052Winner of the President’s Medal from
the Royal College of Psychiatrists.

Winner of the Mind Digital Media Award.


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One thought on “Webley v St George’s (2014)

  1. This is a salient and sad account that needs to be carefully reflected upon by all agencies that are likely to encounter similar challenges in the future.
    I would not like to comment on this case directly. I will however observe that consequent of resourcing difficulties across all sectors of public service, future similar events have a high likelihood of occurring.
    I work solely “out of hours” as part of an Adult Social Care Emergency Duty Team. For the majority of my time I am the only AMHP covering an area of 655 square miles and a population of over 0.5 million. I frequently require to delegate authorisation to convey a patient liable to detention under the Mental Health Act to either ambulance, private secure ambulance or police services. On having achieved this task, my work load and area of responsibility would usually preclude me from being able to accompany the client to the point of detention at the receiving hospital. However, I would expect to be contacted in the event any arising complications.
    I experience A & E as one of the most risk exposed area of contact when attempting to engage clients experiencing mental health crisis. The A & E departments I work with are very limited in their abilities to work with risks associated with absconding or physical confrontation. I personally would not wish to see them wittingly be placed in or accept responsibility a situation which I know to be outside the limits of their resource and expertise.

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