by Christopher Alexander
This paper will explore the successes and failures of risk and crisis management within corporate healthcare environments. The escape of two mental health patients detained in a secure private mental health hospital in Northampton will be analysed to demonstrate this. This event will be further explored with the risks private psychiatric environments face throughout the operational and strategic levels, which, if unmanaged, can cascade into company-wide crises. This paper will also examine factors of how crises develop, with particular emphasis on the failures of operational intervention in risk mitigation, the utility of past events, and how this can inform and develop further risk and crisis management frameworks.
Johny Brady, aged 19, was placed on a hospital order and detained at St. Andrews Private Secure Hospital due to arson and acts of serious assault, which included burning multiple schools. Mr Brady escaped this hospital on Saturday 31, st December, at 3:30 pm; whilst out of the hospital, Mr Brady set fire to multiple bins. Mr Brady was found five days later at 9:30 am, 3.7 miles from the hospital. Nicholas Courtney also escaped the hospital at the same time as Mr Brady; Mr Courtney was a convicted child sexual offender and was later found the same day, as described by Osborne (2023).
The issues faced by private psychiatric environments are unparalleled; the dangerously low staffing levels, the omission of following such risk and management policies that the hospital did not have in place, and not following the correct escorting procedures all led to the crisis occurring. It currently needs to be determined by external authorities how this failure in security arose. However, what’s certain is the management of this crisis was complex, the missing person of two seriously dangerous forensic detainees and the multi-agency engagement, led by Northampton police, coordinated by Detective Sergeant Torie Harrison. (Osborne, 2023). Due to the large-scale nature of this crisis and the high potential of loss of life with the probable risk of social disorder Detective Harrison released a statement on social media to communicate quickly and clearly to the general public, urging them not to panic and not approach these individuals. This communicative framework allowed communication to be delivered and reciprocated in hopes of the general public locating these individuals, also ensuring social order by maintaining the corporate reputation and the socially competent image of both St. Andrews Healthcare and Northampton Police.
It is unlikely that this type of operational crisis which quickly cascaded into a large corporate crisis showed no earlier spikes in risk or smaller crisis. From an operational level, the two patients may have revealed a type of sign or risk factor which may have been mitigated. One internal contributing factor to this crisis is low staff morale, subsequently affecting staff performance. This had shown as a trend much before the initial crisis took place between regulatory assessment of a low grade on 12th September 2014 continued to 14th June 2022, 18 th October 2022 until the present date; these reports from the Quality Care Commission outline the performance and strategic leadership failure, this corporate level failure will be explored further later within this paper.
The lead commission saw many successes throughout the organisational decision-making and response management process. The practical crisis management procedures included enhanced patrol within a specific mile parameter around the hospital, which became effective in early response to the crisis in detaining the second patient who escaped. Multi-dimensional agency response was actioned. Local police forces, security agencies and mental health staff presence appeared both inside and outside of the hospital grounds, and external agencies organised clear lines of communication. This was one of the success factors in the detainment and recapture of these individuals. Additionally, within the command centre, the Northampton police force provided relief communication which anticipated the general public interaction, so an extended number of staff was deployed so a higher amount of calls could be answered; this forms part of the general public ‘Keeps safe’ protocol, also ensuring confidence is maintained by crisis response agency; this control centre also facilitates interagency communications to ensure the crisis is dealt with smoothly and promptly.
As previously explained, the past events experienced by St. Andrews Healthcare, Northampton, lack strategic and operational oversight, which have been failures within the strategic and corporate levels of the company. We can see this throughout many sources and forms of evidence, one of which includes data provided by Markhayes (2019), published by Autism Eye. In 2018 between July and October, 57 injuries were sustained by staff during the operations; following in the same report, the team on tactical and strategic levels stated they simply did not feel that they could manage the patient’s needs within the hospital. Furthermore, the governance of St. Andrews Healthcare was not available in any public domain accessible to the general public, including the organisation’s mission, vision and statement values. Also, the Care Quality Commissioning reports detail a lack of strategic oversight received a ‘requires improvement’ rating within this area from 6 March 2014 to 10 th February 2023, with a slight improvement to organisational culture and strategic leadership. All these factors combined led to a lack of sight and direction in the company, as well as service effects from the operational crisis as well as tactical incapable service delivery in 2019 provided reason enough to improve governance, standard operating procedures and associated policies within all three levels of operations at St and Andrews Healthcare, Northampton.
The company-wide failures shown within this corporate environment present indisputable evidence as an indirect factor causing this crisis, affecting all operational competence. Corporate and strategic communications, governance associated with the social leave and escort of patients and the security risk and crisis management protocols present within this hospital must be revised. From this, many lessons could have been learned from previous events and the crisis of 2023. Furthermore, staff recruitment and retainment should be invested in to combat organisational culture as detailed in the CQC report as mentioned earlier, as well as the development of governance, which should be freely available to inform staff and the general public, the strategies of the company and how they ensure the personal safety of staff and patients, of which has come under threat by social and political factors over the past few years should be reviewed and published.
To conclude, the successful factors of this crisis occurred in the management and containment of the risk; we saw the increased multi-agency response, multi-dimensional coordination and risk containment from various agencies and services that supported detaining the patients within five days with limited harm. The corporate reputation was protected due to clear, reassuring and confident lines of communication held internally and externally with key shareholders and members of the general public. However, failure occurred within long-term risk mitigation before and after the crises, seemingly needing to learn lessons from past risks, which eventually cascaded into corporate disasters.
- Osborne, S. (2023) Teen arsonist Johnny Brady located after escaping mental health facility and spending four days on run, Sky News. Available here (Accessed: 28 May 2023).
- Markhayes (2019) Independent Medics brought in to review care at St Andrew’s Healthcare, RSS. Available at: https://www.autismeye.com/independent-review-st-andrews-healthcare/ (Accessed: 29 May 2023).