A mental health trust which admitted fabricating patients’ records has not launched any internal investigations into the forgeries, we can reveal.
The East London NHS Foundation Trust (ELFT) told a court in spring that up to 12 dead patients’ medical records may have been partially falsified, but claimed there was an ongoing programme of work to tackle the problem.
Board papers last month said the trust has conducted a “comprehensive review” of the 12 incidents and a project launched in 2022 had “made notable progress in addressing falsification of observations”.
But when this newspaper asked for evidence of its investigations, ELFT could not produce any.
We used the Freedom of Information Act to request access to “all internal reports or documents which detail the trust’s investigations into the fabrication of records”.
But the trust – which serves Hackney, Newham, Tower Hamlets and the City of London – responded: “There are no internal reports or investigations into any alleged fabrication of records.”
Its press office said that “a number of staff have been subject to disciplinary processes related to these incidents”, but did not explain how that could have happened without requiring any investigations or the creation of any reports or documents.
ELFT told Inner North London Coroner’s Court earlier this year that it had been working for years on tackling the problem.
“Despite this work, we have seen an increase in occasions where observation records have not been completed, but records falsified to reflect that they had done,” the trust told the court.
Asked this week how it could claim to know this if it was not keeping any internal documents logging falsification incidents, ELFT did not answer.
The fake records scandal became public when a coroner investigated the death of 40-year-old Mahamoud Hussain Ali.
Mr Ali was found unresponsive in a room on Lea Ward at the Tower Hamlets Centre for Mental Health, inside Mile End Hospital, on August 21, 2020.
He died five days later, having suffered brain death.
Mr Ali was supposed to have been checked every 15 minutes on the ward, but a nurse testified at his inquest in April 2024 that he had not been.
After discovering required checks had been missed, the nurse admitted writing fake reports, falsely claiming Mr Ali had been observed sleeping.
ELFT admitted to coroner Saba Naqshbandi KC that there were 11 more “fatal incidents where observation records may have been filled in where observations have not been conducted.”
But the trust did not tell her the dates or locations of the 11 deaths, the circumstances in which the patients died, or details of any investigations into their deaths.
The coroner wrote a report saying the scant information ELFT had provided “gives rise to a concern that future deaths will occur”.
ELFT’s chief medical officer Dr David Bridle has since revealed a 13th possible incident has been uncovered.
But he wrote in a letter to the coroner that it was “unclear if [ELFT] is disproportionately prone to observation records being falsified, or if its investigation processes mean that it is better at detecting when this has occurred.”
Asked this week what it was doing differently to other trusts when it came to uncovering fabricated records, ELFT did not answer.
Dr Bridle also told the coroner: “In some of the identified cases, the incorrect information that was documented may have been through error rather than deliberate falsification, and in some cases it was difficult to establish if falsification had taken place at all.”
He said “the majority of the identified incidents predate the majority of the trust’s extensive work to improve practice around observations.”
This ongoing work included “a review of night-shift culture” and looking for “possible tools for assurance against falsification of observation that does not rely on CCTV”.
ELFT’s board was told last month, despite “recent adverse press coverage”, that there had been “significant work” and “notable progress” over faked observations.
Papers said ELFT was “creating an atmosphere where staff can truthfully note any failed observations rather than falsify records".
A spokesperson said: “The trust sincerely regrets that there have been occasions where observation practice has fallen short of the standard of care expected, and for that we are truly sorry.”
It said a “trust-side quality improvement programme” had been underway for two years and additional staff training had been carried out.
“We recognise the vital importance of getting this right and oversight of this work is held at a board level at the trust,” said ELFT.
Comments: Our rules
We want our comments to be a lively and valuable part of our community - a place where readers can debate and engage with the most important local issues. The ability to comment on our stories is a privilege, not a right, however, and that privilege may be withdrawn if it is abused or misused.
Please report any comments that break our rules.
Read the rules here