A paramedic who lived in Pateley Bridge took his own life the day after he lost his job with the NHS, an inquest has heard.

Andrew Pickering was 57 when he was told he had committed gross misconduct at work, leading to his immediate dismissal from Yorkshire Ambulance Service on February 2 last year.

The inquest held today heard Mr Pickering had attempted to take his own life at home the same day, but was unsuccessful. He had gone to Harrogate District Hospital by ambulance, where he was assessed by the mental health crisis team in the early hours of February 3.

Senior crisis clinician Glen Wilson, from the Tees, Esk and Wear Valleys NHS Foundation Trust, which provides mental health services in the Harrogate district, told the inquest:

“He openly engaged with us. He was happy to talk to us. He answered questions about himself.

“Although he had [tried to take his own life], he then alerted someone to his actions. He agreed to come to the [emergency] department to be checked over. He agreed to be seen. He agreed to talk about the events leading up to it.”

Mr Wilson said Mr Pickering, a former RAF serviceman, agreed to follow-up appointments over the next few days and went home at around 6am.

Today’s inquest heard the loss of his job followed a six-month investigation, during which he could have been placed on other duties that would not have involved dealing with the public.

However, the inquest heard Mr Pickering was “embarrassed” by this and was instead signed off work sick. He had not told his family about the problems he faced.

‘Desperate person’

It had also been a stressful period in his personal life, including the breakdown of his 27-year marriage, which saw him move out of the family home he shared with his wife and two teenage children.

His former wife questioned why someone who had attempted suicide was sent home alone. She added:

“A desperate person was left to go home on his own in a taxi in the early hours of the morning to an empty home.”

Mr Wilson said follow-up phone calls were due to be made that day, and Mr Pickering would have been visited daily for at least three days by someone from the crisis team. He said:

“He was saying to me he worked in this field, he can see the devastation on families when people end their lives. He said he would never do that to his family and he was happy to engage with us.”

Staff at the crisis service called Mr Pickering four times between 9.30am and 1.15pm on February 3. They received no answer but, knowing he had been in hospital through the night, thought he must be catching up on sleep.

A friend and colleague, Jonathan Mellor, who knew Mr Pickering had gone to hospital the previous night, called by his house at 10.30am. Seeing Mr Pickering was not yet dressed, he suggested the pair go for a walk later and said he would return in a couple of hours.

When Mr Mellor returned at 12.50pm, he found Mr Pickering had taken his own life. Coroner Jonathan Heath today concluded he had died by suicide.

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The inquest, held at the Coroner’s Court in Northallerton, heard Mr Pickering had been an “extremely popular and hard-working” paramedic but had struggled to deal with difficult family circumstances, leading to the situation that saw him put through the disciplinary process – which had lasted six months instead of the recommended four.

At one point, the inquest heard, comparisons were drawn between Mr Pickering and Wayne Couzens, the police officer who murdered Sarah Everard.

Prior to joining YAS in 2009, he had been in the RAF and served in Afghanistan soon after the birth of his son in 2007. His former wife said:

“He came back a very different person. Things were never quite the same.

“Over the years, I asked him to talk to someone, but he didn’t. He wasn’t abusive or violent, but he was more withdrawn.”

The inquest heard Yorkshire Ambulance Service had undertaken a ‘lessons learnt’ review following Mr Pickering’s death.

His brother Richard questioned the way the investigation following the death had been carried out. He said the family felt they had not been listened to and were not trusted to be part of the process.

YAS head of employee relations Alison Cockerill said:

“It was decided it should be internal. We were aware Andrew had deliberately kept some of what was happening from his family and we were still trying to navigate what that meant for us in terms of respecting Andrew’s wishes.”

Mr Heath said in future, the trust should consider adopting a policy of explaining the process to the family at the outset and showing them the findings at the end.

Mrs Cockerill said, following the review, YAS had put in place new measures to support people who were going through disciplinary processes, including assessing the impact on the individual alongside the risk to the public.

All managers and supervisors would now receive skills training to help them support people subject to disciplinary investigations, she added.

Local children face waits of up to two years after being referred by a doctor for autism or attention deficit hyperactivity disorder (ADHD) assessments, a meeting has heard.

North Yorkshire’s scrutiny of health committee heard there were 377 children currently waiting for an autism spectrum disorder assessment, of which 27 had been waiting more than 12 months.

Councillors were told a further 400 children had been waiting for a ADHD assessment, 76 of which have been waiting for more than a year.

The figures from Tees, Esk and Wear Valley NHS Foundation Trust follow it revealing three months ago that the number of children in contact with its Child and Adolescent Mental Health Services (CAMHS) in York had jumped by more than 40 per cent over the previous two years.

A Healthwatch report into the service showed young people are facing delays, lost paperwork and other issues when trying to get support.

Brian Cranna, care group director at the health trust, told the scrutiny committee meeting at County Hall in Northallerton the last 12 months had seen 9,000 referrals into CAMHS across North Yorkshire and York.

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He said while 5,000 children were active referrals or currently receiving interventions, the service was facing challenges over assessing developmental disorders.

Mr Canna said the length of wait depended on which part of North Yorkshire a child lived in, adding It could be up to two years for an assessment.

Community mental health teams

The meeting heard the trust had created mental health teams working in schools to prevent the need to access specialist services, and referrals to them were being seen within four weeks.

He added while people could expect to be seen by community mental health teams within eight weeks of routine referral, the majority of children and young people were being seen within 28 days.

Mr Canna underlined 86% of children referred to the crisis team were being seen within four hours.

However, the meeting heard the delays were being exacerbated by a struggle to recruit staff, ranging from consultant psychiatrists and psychologists to administrative staff.

He said raised public expectations of the service had increased the pressure on staff.

He added: 

“People expect a better level of care. They expect a level of support that’s tailored to their individual needs and that increases the demand on the services.”

Mr Canna said staffing pressures varied across the county. 

He said Harrogate had a range of healthcare providers who people living there could work for instead, while it had proved difficult to attract people to move to Scarborough.

Nevertheless, he said the trust was examining what it could do to attract people into the area and following some success recruiting staff for its eating disorders team the trust was hopeful that “this positive trajectory” would continue.

He said: 

“Maintaining staff wellbeing in a pressured environment is a significant challenge for us and a challenge we are responding to.”

County council bosses are “examining the best options” for land at Cardale Park in Harrogate after purchasing it for £1.8 million.

The three-acre site on Beckwith Head Road in Harrogate was previously owned by Tees, Esk and Wear Valleys NHS Foundation Trust, which runs mental health services in the district.

North Yorkshire County Council completed the purchase of the land last year.

At the time, the authority said it had bought the site in order to progress a “scheme to assist with social care market development in the Harrogate area”.

Cllr Michael Harrison, executive county councillor for health and adult services, said the council was now assessing how to use the land.

He said:

“We acquired the Cardale Park site with the intention of increasing the care services available in Harrogate. 

“We are still in the process of examining the best options for meeting the community’s needs and will bring forward a scheme in due course.”

The land was previously given approval for a 36-bed mental health facility on the site, following the closure of Harrogate District Hospital’s Briary Unit, which helped adults with mental illness.

However, those plans were dropped in 2019 and inpatients on the unit were sent to Foss Park Hospital in York instead.

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Mental health services for people across the Harrogate district still require improvement, according to the health regulator.

The Care Quality Commission (CQC) found the services provided by Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV) were below the standards expected.

However, inspectors said there had been some improvements since the last inspection report in December 2021.

At that time, TEWV’s forensic in-patient and secure ward services were found to be inadequate, with the trust ordered to make urgent improvements. Now, the service is rated ‘requires improvement’, though the ‘safe’ aspect of the inspection is still rated ‘inadequate’.

The report said:

“Fifteen patients we spoke to raised concerns regarding there not being enough staff on the wards. Patients told us staff spent a lot of time in the office which sometimes made them feel neglected.

“Two patients told us that they had not received their prescribed medication on the day we arrived due to staffing. Another patient told us they did not know who their key worker was.

“However, most patients said that staff were caring towards them.”

In-patient and secure wards for Harrogate district residents are provided elsewhere in the north-east after the mental health unit at Harrogate District Hospital, the Briary Ward, was closed down in 2020. The CQC inspection of TEWV’s services was carried out at Roseberry Park Hospital in Middlesbrough.

The Briary Wing, Harrogate District Hospital, which was closed in May 2020.

Inspectors said data provided about staffing levels over an eight-week period suggested the service was regularly understaffed to an unsafe level. However, managers said the data was inaccurate and there was always a nurse and support staff on duty.

The report said:

“Staff were frequently being moved to different wards during their shift based on risk, which meant they were often working in environments and with patients they were unfamiliar with.

“This was impacting on several areas within the service; incident data showed staff were not always able to provide a timely response to incidents. Staff were unable to carry out all clinical duties on time, such as administering medication and completing clinical audits.

“Staff were regularly unable to take their breaks off the ward. Patient’s hospital ground leave, Section 17 leave (permission to leave the hospital) and visits from friends and family were being cancelled daily at short notice.

“Patients told us they felt neglected and did not have enough time with staff. Carers we spoke to highlighted staffing pressures as a concern and felt it was impacting on patient’s continuity of care and their ability to visit their loved ones.”

Areas for improvement

The CQC set out 12 areas where the service must be improved in order to meet legal requirements, including adequate staffing levels, cleaning all wards, ensuring staff have up-to-date training, and reporting all incidents quickly and accurately

Naomi Lonergan, care group director of the secure inpatient services at TEWV, said:

“We have been working hard to improve the service since the previous Care Quality Commission inspection in June 2021 and we are encouraged by the improvement in the rating.

“We have recruited 70 health care assistants since the last inspection and we are working with local universities to support the recruitment of registered nurses. This is in addition to developing an international recruitment strategy which is already making a difference.

“We have set up a health care assistant council and one for nurses to improve how colleagues contribute to the quality of care within our trust.

“We are also focused on creating a community on our wards, through the work we do with our recovery and outcomes team who put on events and activities for people in our care that help their recovery.

“We recognise that there is more to be done. This includes an unrelenting focus on patient safety with our absolute priority being on safe staffing and safeguarding our patients. We continue to prioritise the experience of our patients, their carers and colleagues to make the improvements we need to and we are confident the service is making these changes and will continue to do so.”

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Children’s mental health services ‘requires improvement’

Meanwhile, TEWV’s specialist community mental health services for children and young people which were rated ‘inadequate’ in the ‘safe’ category last year have now been rated ‘requires improvement’.

In a report published in September, following inspections over the summer, the CQC said:

“Although staffing levels, caseloads and waiting times for treatment had improved since the last inspection, the service did not always have enough nursing and support staff to keep patients safe. Vacancy rates varied by team…

“Caseload sizes had reduced across the community teams. Most of the staff told us there had been significant improvements to caseload sizes and caseloads were more manageable. Only two of the staff we spoke with raised concerns about staffing levels and caseload sizes.”

Inspectors said a recruitment drive meant two new matrons were about to begin work, with a focus on managing staff caseloads.

The average waiting time for treatment had reduced to 104 days, compared to 371 days in 2021, and the number of children waiting more than 12 months had reduced to 275 from more than 1,000 in the same time period.

The CQC, which inspected six teams within the community mental health service for children, said TEWV must adequately staff its service and continue to work to reduce waiting times.

Brent Kilmurray, chief executive of Tees, Esk and Wear Valleys NHS Foundation Trust, said:

“We are pleased that the CQC have raised the rating for our community children and adolescent mental health service (CAMHS) in the safe category.

“The CQC report acknowledges improvements that have been made, including how quickly we responded to address the issues identified at the previous inspection. It also recognises that we are achieving our targets of maintaining contact with children and young people on waiting lists.

“This is a step in the right direction, and a testament to the hard work from our CAMHS community teams across the trust.

“We know there is still work to do and more opportunities to improve the service. We will now focus on embedding the recommendations from the report to ensure that we provide the best care to the young people in our communities.”

A community psychiatric nurse who was based in Harrogate has been struck off after facing a series of charges of misconduct.

Gordon Eric Finlay was found to have failed to keep accurate records for patients in his care, or to maintain professional boundaries, when he worked for the Tees, Esk and Wear Valleys NHS Foundation Trust, covering the Harrogate area in 2017.

He was also found to have acted inappropriately with colleagues, including sexually inappropriate behaviour, when working for Bradford District Care NHS Foundation Trust in 2019.

In a nine-day hearing last month, the Nursing and Midwifery Council heard evidence from multiple witnesses in relation to 19 charges. A report from the hearing said:

“It came to light that that Mr Finlay had communicated with a vulnerable mental health patient (Patient A) by telephone and a number of text messages which contained inappropriate content after the patient ceased to be under his care.

“Further regulatory concerns identified from this referral relate to a failure to preserve patient safety, in that Mr Finlay failed to escalate Patient A’s care when Patient A had disclosed a decline in mood and increased thoughts of suicide in a number of text messages to Mr Finlay. Patient A committed suicide during this period of communication.”

The three-person panel also heard he had signed off text messages to Patient A with “Gx”. The report said she had “severe and enduring” mental health problems, “particularly in relation to building trust and maintaining relationships”, and was “particularly vulnerable to any blurred… lines of professional communication”.

Mr Finlay, who was not present or represented at the hearing, was found to have failed to share Patient A’s deteriorating mental health with colleagues not through a genuine mistake, but in order to protect his job.

Relating to other charges of failing to keep accurate records for his patients in both Harrogate and Bradford, the report said:

“The panel considered the written representations of Mr Finlay, in particular, his admission that he was unfamiliar and not comfortable with the electronic diary and therefore recorded appointments in his paper diary.

“The panel was of the view that Mr Finlay would have had sufficient time to learn and use the electronic diary system over the approximate four-month period that was affected and he should have escalated any concerns or issues that he believed were preventing him from completing his patient records as required.”

The NMC panel also heard Mr Finlay’s line manager had offered him additional support with his record-keeping, but this had not been taken up.

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Mr Finlay was also accused of hugging and kissing a colleague on the cheek, as well as touching another colleague’s bottom, and making sexual comments in his workplace as well as showing an inappropriate video to colleagues.

In a written response to the charge of the hug and kiss, he said:

“It felt like a normal thing to do around someone’s birthday and I didn’t give it much thought, it was innocent and I would stress this hopefully reinforced by the CCTV footage that it was non-sexual and did not appear to create a reaction.”

The panel found the kiss and the hug was not sexual in nature, but that touching the other colleague’s bottom was.

It also found the latter – against a colleague described as “a junior colleague and a young and inexperienced person in the workplace” – amounted to bullying and harassment. The other sexual behaviours were found not to be bullying.

‘Undermine public confidence’

Addressing all charges, the panel found Mr Finlay’s conduct had fallen “seriously short” of the standards expected of a nurse and amounted to misconduct. Its report said:

“In considering whether the conduct has been remediated, the panel acknowledged that Mr Finlay cooperated in the local investigation and made admissions to some of the charges.

“He has also engaged with the NMC process and provided detailed written information by way of reflection and further information, although he did not attend the hearing.

“The panel acknowledged Mr Finlay had developed a health issue over the course of these events relating to depression and anxiety. The panel also acknowledged that both Mr Finlay and the rest of the mental health team in the area were under considerable work pressure.”

The report said there were 315 patient contacts which had not been recorded by Mr Finlay and that he had shown “no insight into the impact of his failures… on wider patient care or upon his colleagues”.

It said Mr Finlay’s written submissions had shown he felt he was “prioritising patient care”. However, the panel said having had the matter addressed by one NHS trust, he still failed to keep accurate records when he moved to a new trust.

The report concluded:

“Mr Finlay’s actions were significant departures from the standards expected of a registered nurse, and are fundamentally incompatible with him remaining on the register.

“The panel was of the view that the findings in this particular case demonstrate that Mr Finlay’s actions were serious and to allow him to continue practising would undermine public confidence in the profession and in the NMC as a regulatory body.”

As a result of the panel’s findings, Mr Finlay was struck off the nursing register.