HSE Warning that Hospitals have a Duty to Ensure the Safety of Patients from Falls from Windows

The Health and safety Executive (HSE) has warned NHS trusts and other care providers of the importance of having an effective building management programme. The warning comes after an in-patient of Leigh Infirmary fell from a first floor window suffering a broken ankle.

Wrightington, Wigan and Leigh NHS Trust recently pleaded guilty to breaching Section 3(1) of the Health and Safety at Work etc Act 1974 and breaching Regulation 3(1)(b) of the Management of Health and Safety at Work regulations 1999. The Trust was fined £8,000 and ordered to pay £4,141.56p costs.

The injured person was a patient on Taylor Ward, Neurological Rehabilitation ward at Leigh Infirmary at the time of the incident. In the early morning of 5th May 2006 he climbed out of the window of his room and dropped down to ground level, a distance of 4.4m, fracturing his ankle.

Tom Merry the HSE Inspector who investigated the accident said 'The case highlights the importance of an effective management system for maintaining buildings in a safe condition. Window restrictors are fitted as a safety precaution, therefore it is essential that the building maintenance programme ensures that they are properly fitted and are working as desired.

'This is particularly important in the care setting where people may be more likely to be in a confused or disoriented state. In this case the injured patient was very fortunate as falls from four metres usually have much more severe consequences.

'Effective risk assessment is the key to getting it right. The hazard is well known, NHS Estates published a technical memorandum many years ago highlighting the issue of restricting window openings. It's then a case of identifying those windows that open and how that opening is restricted. Then it is matter of establishing a system of inspection and maintenance to ensure the restriction device is working as intended.'

The patient was receiving care in a room of his own that had a window fitted with an integrated opening restrictor in the frame of the window. The window was restricted when the hinge runner reaches a stop in the channel, but this could be depressed to allow the window to open further.

A support worker on the night shift checked on the patient before being called away to assist a colleague. Shortly afterwards the door to the room was found to be closed, the patient missing and the window wide open. The alarm was raised and the injured person was found in the car park at the front of the building.

Whilst all of the uPVC type windows in the trust were fitted with integral restrictors of the type described in this case there was no consideration of the suitability of the restrictor with regard to their being defeated, nor was there a management programme to ensure that such restrictors were working as designed.

Following the incident the trust instigated a programme of work to identify all windows that should be restricted and ensure that any remedial actions were taken as required.