Northern Ireland

Highest level health service probe into handling of Muckamore abuse scandal

Muckamore Abbey Hospital is at the centre of major abuse probe
Muckamore Abbey Hospital is at the centre of major abuse probe

A HIGH level investigation is to take place examining the Belfast trust's handling of allegations of serious abuse of vulnerable adults at Muckamore Abbey Hospital.

Information obtained by The Irish News reveals that an independent 'level 3' Serious Adverse Incident (SAI) probe was triggered last September - to run parallel with separate trust and police investigations - and will examine the trust's "effectiveness" in managing adult safeguarding concerns over the past five years.

Reviews of this kind are extremely rare, with less than 10 carried out over the past two years.

The most recent case was a confidential SAI ordered into the murders of elderly Co Armagh couple Margaret and Majorie Cawdery by a former psychiatric patient, Thomas McEntee.


  • Major abuse probe at Muckamore Abbey Hospital
  • Muckamore analysis: Investigators must act quickly to protect most vulnerable in society (Premium)
  • Belfast Trust 'apologises unreservedly' to Muckamore patients and families

The development comes a week after it was confirmed that 13 staff were suspended from Muckamore hospital after CCTV footage apparently showed nurses striking patients with severe learning disabilities and mental illnesses.

Some were allegedly kneed in the testicles, while there were also claims of 'unauthorised seclusion' and adults 'being left in the dark' without supervision.

The allegations relate to two wards, including a psychiatric intensive care unit.

The expert charged with heading up the Muckamore SAI review is Margaret Flynn, author of the 'serious care review' into the Winterbourne View care home scandal in Bristol in 2011.

Six care workers were jailed after an undercover Panorama report filmed horrific abuse of disabled residents.

Significantly, the SAI team has been tasked with probing the trust's "effectiveness" in investigating serious adult safeguarding concerns "both in August and October 2017" and "between 2012 and 2017".

Former and current patients at the Co Antrim facility will also be asked by the independent team for their views on the "safety and quality of care and support" at the facility.

A Health and Social Care Board spokeswoman said: "The terms of reference for this (SAI) investigation will look at the principal factors responsible for historic and recent safeguarding incidents at Muckamore Abbey Hospital and lessons arising from these factors.

"It will also look at the effectiveness of adult safeguarding reporting investigations, and protection plans, and wider safeguarding issues in the hospital over specific timeframes, both in August and October 2017 and between 2012 and 2017.

"The investigation will engage with current and former patients to ascertain their views on the safety and quality of care and support in Muckamore Abbey Hospital. It will also identify areas of good practice."

In a statement released last week, the Belfast trust "apologised unreservedly" and said it had acted "swiftly" to deal with the crisis.

Trust chiefs also confirmed they had secured the services of an "expert panel" to "independently review the standard of care in Muckamore Abbey Hospital" - but they did not refer to the high-level SAI.

The Co Antrim facility cares for adults with severe learning disabilites
The Co Antrim facility cares for adults with severe learning disabilites

Janice Smyth, director of the Royal College of Nurses in Northern Ireland, last night said she was "reassured" the independent probe was taking place - but was "taken aback" it had been going on for almost a year.

"We are seriously concerned about the allegations of abuse relating to patients accommodated in Muckamore Abbey and indeed the alleged level of violence against staff employed there," she said.

"Our members only became aware last week a level 3 independent review was being conducted in accordance with the Serious Adverse Incidents procedures and I am taken aback this was ordered over 10 months ago.

"We would urge the trust to bring its safeguarding and SAI reviews to a conclusion as soon as possible in the best interests of the patients and staff."

When asked about the timescale for completion, a trust spokeswoman said: “This has always been a level three SAI and therefore the timescale is agreed with DRO (Designated Review Officer).

“We will investigate thoroughly and only when those investigations are complete will report back to DRO, and going forward look at any areas of learning coming out of the investigation.”

What is a 'level 3' SAI probe?

INDEPENDENT 'level 3' Serious Adverse Incident probes are only ordered when cases are 'particularly complex' and 'attract a high level of both public and media attention', according to the organisation which oversees them.

The Health and Social Care Board also confirmed they require the "highest level" of independent expertise.

While there is an eight-week target for SAIs to be submitted to the board for level two probes, a timescale is 'agreed' between a health trust and the board for level three SAIs.

The Muckamore Abbey Hospital SAI has been ongoing for 10 months.

An SAI itself is defined as "any event or circumstance that could have or did lead to harm, loss or damage to patients, property, environment or reputation during the course of the business of a health and social care organisation".

The purpose of the probe is to ensure "timely learning" from all reported incidents - and is shared across agencies, organisations and healthcare professionals.