Webley v St George's Hospital NHS Trust & Anor

Police officers transferring a mentally disturbed person owe a duty to take reasonable care for his safety, including providing relevant information to those assuming responsibility for him. Hospital security staff supervising a patient at risk of absconding must actively guard against escape, while balancing that duty against the principle of minimal restraint and the risk of escalation. Where the patient is visibly agitated and presents a known escape risk, two guards should be positioned so as to cover both available exits. Mere observation from one doorway is insufficient where reasonable positioning would probably have prevented escape.

The claimant, a protected party, claimed damages for serious injuries sustained after escaping from an A&E cubicle at St George’s Hospital while subject to detention under section 2 of the Mental Health Act 1983. He alleged that the police failed to pass on information about his volatile behaviour and that the Trust’s security staff failed to supervise him properly.

The trial concerned liability only. The central issues were whether the police had provided adequate information and whether the security guards had taken reasonable steps to prevent escape while using minimal restraint.

1. Police liability. The police owed a common law duty to take reasonable steps to prevent the claimant suffering physical harm while in their custody, to release him only into a safe environment, and to provide relevant information to those taking over his care. They had passed on the material information: that he was sectioned, had previously attempted to escape in police custody, and was at high risk of absconding. The claim against the police was therefore dismissed.
2. Applicable standard. The court did not decide whether the Bolam test applied to hospital policies or the training of security personnel. That issue was unnecessary because the case turned on the guards’ conduct at the time of the escape.
3. Balancing restraint and safety. Minimal restraint and de-escalation were desirable when managing a disturbed psychiatric patient. They had to be balanced against the more important requirement to prevent escape where there was a foreseeable risk of serious harm. The guards were not required to seize or restrain the claimant physically.
4. Reasonable supervision. The claimant’s agitation, his recent attempt to leave, the insecure A&E environment, and the information available to the guards required active guarding rather than passive observation. Both guards should have covered the two doors of Cubicle 9. One could have stood inside or outside the side door, or sat in the chair immediately beside it. Having both guards standing together at the main door left one effectively wasted and made escape highly likely.
5. The Trust, acting through the two guards, failed to take reasonable steps to ensure the claimant’s safety, and that failure caused his injuries. There was judgment for the claimant against the Trust for damages to be assessed. No contributory fault arose.