NHS mental health trusts referred to CQC over Oxevision
Ten NHS mental health trusts have been referred to the Care Quality Commission after an internal review found failures in patient consent procedures for digital monitoring systems like Oxevision. The referral comes as the Lampard Inquiry examines patient safety, including the use of infrared technology to monitor patients without proper consent.
NHS England has referred ten mental health trusts to the Care Quality Commission over serious failures in patient consent procedures for remote monitoring technology. The referral followed an internal NHS England review of digital monitoring systems, including the infrared-based Oxevision, which found trusts were not operating consent mechanisms in line with established digital principles.
NHS England first became aware of safety concerns linked to Oxevision in 2021. Following the review, the organisation wrote to the CQC on 2 October and shared its findings with inspection teams. The ten trusts involved have not been publicly named. Gareth Harry, NHS England's National Delivery Director for Mental Health, Learning Disability and Autism, gave evidence on the matter at the ongoing Lampard Inquiry. He stated that day-to-day responsibility for following guidance sits with individual trusts rather than NHS England.
Infrared monitoring used without patient choice in some units
An internal NHS England email from 2022 indicated staff were aware of trusts where patients were not being given the choice to refuse being filmed. The inquiry heard that infrared technology, such as Oxevision, is used in patients' bedrooms to monitor breathing and pulse without staff entering the room. The system is installed in some mental health inpatient units and uses sensors mounted on the ceiling.
Lampard Inquiry examines deaths and safety concerns in Essex mental health units
The Lampard Inquiry is investigating the deaths of more than 2,000 people who spent time in mental health units in Essex between 2000 and the end of 2023. The investigation, covering more than two decades, is currently hearing evidence on patient safety failures. Concerns raised by Gareth Harry at the inquiry included consent, patient observations, and human rights around Oxevision use. The inquiry was shown the 2022 NHS England email about patient choice.
Baroness Lampard said she could issue interim recommendations if urgent patient safety concerns are identified before the inquiry's final report. She stated she would introduce such recommendations on technology introduction if she believed there was a risk to patient safety.
Guidance stresses individual patient decisions and explanation of technology
In 2023, NHS England wrote to mental health trusts advising that monitoring technology should not be introduced as a blanket approach. The guidance stressed that decisions should be made for each patient individually and that patients should be involved in decisions about monitoring technology where possible. Implementing continuous remote monitoring requires explicit, clear communication. NHS England advised that if a patient or their advocate does not fully grasp what the technology does, consent becomes entirely meaningless.
Gareth Harry told the inquiry, "I would expect every provider of mental health services to have their values and behaviours driven by a human rights approach to mental healthcare." A separate statement from Laura Cozens highlighted that "It was important the technology was properly explained to patients. It had helped prevent serious incidents, including falls on a dementia ward."
The Lampard Inquiry’s current hearings are expected to continue until 15 October, with a further virtual hearing scheduled for 20 October.
