A health report documenting failings at a mental health unit - considered to have wide public interest - has finally been made public.

The Holden Report - which looked into the management of the Mental Health Clinical Programme Group in their dealings with the Hergest Unit and a variety of other issues relating to the Hergest Unit at Ysbyty Gwynedd, Bangor - was written as a confidential report in December 2013.

Concerns aired included a lack of understanding from management that patients needs always come first, low staff morale, an atmosphere of bullying and intimidation from senior managers, weaknesses in communication, high levels of occupancy and inadequate staffing.

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For years, campaigners - including the relatives of patients - have demanded full publication of the report. 

Betsi Cadwaladr University Health Board (BCUHB) have now made it public following discussions with the Information Commissioner.

Jo Whitehead, chief executive of BCUHB, said: “Over recent months we have been in discussions with the Information Commissioner regarding the publication of the Holden Report.

"Our priority has always been to agree appropriate redaction in order to protect the anonymity of staff that contributed to it, and ensure that all staff have the confidence to raise concerns in future.

"Having come to an agreement with the Information Commissioner, we are publishing the redacted report in full.

“We acknowledge that the delay in publishing this report has frustrated some of those with an interest in it.

"Having reflected on the way that this has been handled, the Board has decided that in the interests of openness and transparency, future reports of this nature will be made public.

BCUHB chief executive Jo Whitehead. Photo: BCUHB

BCUHB chief executive Jo Whitehead. Photo: BCUHB

“Action was taken and remains in place to deliver all of the Holden Report’s recommendations and this has been reported publicly.

"However, some issues, such as the way we manage the mix of older patients, have proved complex to resolve, due to the design and layout of the Hergest Unit and the staffing resources involved. Options are being considered to address this.

“Reports from unannounced inspections of the Hergest Unit by Healthcare Inspectorate Wales show that standards of care, staff morale and leadership arrangements have improved in recent years.

“Despite these improvements, we have much more work to do to enable our dedicated staff to deliver the very best care.

"In common with other NHS mental health service providers across the UK, we face significant challenges around staffing numbers, managing demand for beds, ensuring the appropriate mix of patients and dealing with the impact of Covid-19.

“We’re committed to working closely with our patients, their carers, our staff and partners to address these challenges and build trust and confidence in the mental health services we deliver.”

In the report, expressions of "helplessness and hopelessness" were noted.

One contributor said: "If everybody is still alive at the end of the day that’s the best I can do."

Another said: “I’ve done the best I can, I haven’t done everything I would have liked to have done.

"It’s a bit like - nobody is dead, there have been no major incidents, I’ve worked flat out and I can do no more”

Names in the document remain blanked out.

The report said: "All the Staff who were interviewed reported low morale.

"Staff reported a decline in morale since the closure of Gwalchmai Ward, further exacerbated when the substantive Modern Matron went off last Christmas; with a further sharp decline following the Ward Managers of Cynan and Aneurin Wards being removed from the unit.

"Staff report that morale, historically, had been good with people looking forward to coming to work, with a smile on their face. Much the opposite is true at present."

Other statements included in the document noted: "Morale is the worst I have ever seen. I have been here 16 years and never seen an atmosphere. Staff are stressed before they come in through the door."

“Nobody has a smile on their face”.

"It was almost surreal, it was just grim, you know...really grim”.

“I’ve worked with a few nurses and we have all gone home crying”,

You can read the full report here

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