What price freedom? Counting the cost when DoLS goes wrong

a post by Jeremy Hyam (a barrister at One Crown Office Row) for the UK Human Rights blog

[Deprivation of Liberty Safeguards discussed in relation to a specific case]

Esegbona v Kings College Hospital [2019] EWHC 77 (QB)

Twenty years on from Bournewood, the case that prompted the introduction of DoLS, and as the Mental Capacity Amendment Bill tolls the death knell for DoLS and introduces as their replacement Liberty Protection Safeguards, the High Court (HHJ Coe sitting as a Deputy High Court Judge) has given a sharp reminder of the human and financial cost of what happens when a hospital fails properly to discharge its obligations under the Mental Capacity Act and as a result, falsely imprisons (in a hospital) a patient.

Briefly (the judgment runs to over 200 paragraphs) Ms Esegbona was a 68-year-old who was initially admitted to hospital with shortness of breath. She was fit for discharge within a week, but before she could leave hospital suffered a hypoglycaemic episode and went rapidly downhill. She ended up staying in hospital for nine months, by which time she was confused, had a tracheostomy and PEG feeding tube, and was incontinent of urine. From around mid-February 2015 and while she was still very unwell, she said she wanted to go home. The hospital, despite the urging of its junior psychiatrist, failed to implement the DoLS procedures, and failed to authorise (what was latterly admitted by the Trust to be) her continued detention in hospital. As a result there was no proper best interests assessment of whether she should be discharged home, no proper capacity assessment, of the deceased, and no proper involvement of the deceased in the discharge decision-making. Although it was apparent from the notes that Ms Esegbona continued to express a desire to leave the hospital, and was supported in this wish by her family (at least two of whom were medically qualified) both she and they were told it was ‘impossible’. Ms Esegbona was eventually discharged to a nursing home a good distance from her family’s home. 9 days after discharge she died after her tracheostomy tube came out.

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Engaging employers with the 14-19 Diplomas: the employer perspective

an article by Gill Haynes (University of Exeter, UK) and Pauline Wade and Sarah Lynch (National Foundation for Educational Research, Slough, UK) published in Journal of Education and Work Volume 26 Number 2 (April 2013)

Abstract

While many studies of work-related learning (WRL) in the English 14-19 curriculum have examined the impact on young people of WRL programmes and initiatives, this article explores why employers become involved with WRL, the mechanisms by which engagement takes place and the opportunities and challenges faced by employers and by those who seek to engage them.

Drawing on data from surveys of teachers and interviews with employers in 15 Diploma consortia across England, undertaken as part of the national evaluation of the 14-19 Diplomas, we consider the factors which are influential in the foundation and sustainment of employer involvement with WRL in schools and colleges. Although previous studies have considered employer engagement at the level of policy making, there have been fewer empirical studies of employers' perceptions and experiences of engagement at the level of curriculum delivery.

Our findings indicate that employers who had become involved in providing WRL for Diplomas could identify a range of benefits to their organisations.

We argue that use can be made of both policy levers and drivers to engage employers but these need to be differentiated to acknowledge that employers do not form a homogeneous group.

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