Fear of causing patient offence 'led to rapist's hospital escape'

It condemns a London NHS Trust after health workers' fear of causing offence led to serial rapist Terrence O'Keefe escaping from hospital twice in three years. He is still at large.

Staff at Lambeth Hospital failed to properly describe the danger posed by the rapist when he was transferred to King's College Hospital for treatment in February - because they were afraid of "offending" him the report says.

O'Keefe, 39, escaped after he was assigned two nurses instead of a police guard. He had been in the secure mental-facility at Lambeth Hospital after being convicted of a string of rapes.

During the transfer to King's College he was described as a "medium secure patient". That vague language meant staff may not have realised how dangerous O'Keefe was, despite his escape from the same hospital in October 2005, the report concluded.

O'Keefe fled from his ward having not been handcuffed and has been on the run ever since. Police have warned he is "dangerous and should not be approached". The damning report by South London and Maudsley NHS Trust, which runs Lambeth Hospital, said: "Recent events have suggested that certain language such as 'medium secure patient' is not transferable in the understanding of the level of risk posed."

It concluded the Trust needs to find a way of saying how dangerous a patient is without offending them, adding: "Consideration therefore is required as to how we portray or use common language whilst remaining sensitive to the patient's treatment needs." The inquiry found that procedures in place for transferring highrisk patients from Lambeth Hospital were inadequate.

It concluded they did "not address public protection issues and risk of absconding behaviour", and said such patients should now routinely be handcuffed.

The embarrassing report was briefly posted on the Trust's website but was removed after it prompted media enquiries. The Trust has since refused to make a copy of the report available.

A Trust spokesman claimed the report had never been intended for publication as it contained confidential information about hospital security.

He said: "Language used in psychiatric services can sometimes be complicated. This has been highlighted in this report and will be something that we will consider as part of determining any changes to our policies and procedures and their language." Hilary McCallion, the Trust's director of nursingand education, said all medium secure patients would now be individually assessed as a result of the blunder, and they would be doubling the number of staff escorting them patients from two to four.

She added: "Where the risk assessment indicates that it is appropriate we will use a security guard trained in physical restraint to accompany clinical staff responsible for the escort.

"Clearly, it is important for us to learn from this incident and to ensure that our policies are in line with the best available elsewhere in the NHS."

Police believe O'Keefe may be hiding in Liverpool, where he was recaptured after his escape in 2005.