IHEEM HISTORY AND HERITAGE
alternatives to the current mechanism were one internal to the door, or a closure in which the arms folded flat against the door when closed. Replacement with internal fittings ‘would have been very expensive’, and the other type of fitting – the panel was informed –would still provide the facility for suspension of a rope or cord, even though the closure arm would no longer project from the door.
‘Balancing the benefits with the risks’ The report adds: ‘No description of similar events in hospitals was found in Department of Health Hazard Notices or Safety Information Bulletins. The panel therefore took the view that they had to balance benefits and risks, and recommended that the (existing) door- closing devices be retained. Panel members also recommended a ceasing of the practice of keeping doors open with towels.’
Unfortunately, a year later another patient hanged himself in the same way, after which the review panel was reconstituted, and now recommended replacement of all the implicated door closures. This time, however, it was decided to drill a hole through the bottom arm of each door closure, thus weakening the arm when subjected to a vertically applied load, and causing it to collapse immediately, which, it was anticipated,
would free up the top arm to bend downwards, ‘and hopefully tear the top arm fixing screws out of the door frame’. However, the article explained, ‘as this was unproven, it could not confidently be adopted without much further research’.
Change in guidance pointed out The authors explain that discussion also took place with the Estates Directorate’s officer responsible for fire advice and Building Regulation standards, who pointed out a change in Government guidance. The new advice stated that ‘with the exception of fire doors to patients’ bedrooms, and doors kept locked shut, fire doors should be fitted with an automatic self-closing device (HTM 81, 1996)’. As a result, and with the fire authority’s authority, the door closures were removed, ‘thus saving the Mental Health Directorate many thousands of pounds, and staff and patients much inconvenience’. The article concludes: ‘In consequence, a suicide risk was removed, and patients could once again be observed without their sleep being disturbed by self-closing doors.’
A ‘tightrope to be trodden’ The authors say at the article’s conclusion: ‘Such then is the tightrope to be trodden when planning and equipping a health facility for the mentally ill; managers and
clinical staff must take care that one risk does not arise when another disappears’. Today’s healthcare estates professionals no doubt face many similar challenges. Amos Millington goes on to explain in his second letter – with which he enclosed a number of interesting ‘snippets’ of information, plus both black and white and colour ‘archive’ photographs taken at various points in his career: “In 2001 I was invited by Sodexo to act on a consultancy basis to prepare part of their PFI bid for the new Royal Manchester Children’s Hospital. My brief was to prepare the technical specifications for the Facilities operation (engineering services etc.) of the new hospital. I worked from home, touching base with Sodexo’s Manchester office on a regular basis. This commission lasted about two years.”
He concludes: “It was very satisfying to be able to use my knowledge and experience gained over the 35 years I worked in the health service. In 1985 I became registered as a Chartered Engineer and a member of the Institution of Mechanical Engineers.
“I still,” he adds, “have the opportunity to put my knowledge and experience to use serving as a member of the Diocesan Advisory Committee (Manchester Diocese), which adjudicates proposals for changes/alterations for C of E places of worship.”
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August 2018 Health Estate Journal 43
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