Spearman v Royal United Bath Hospitals NHS Foundation Trust [2017] EWHC 3027 (QB) (04 December 2017)

On 5 May 2011 C suffered a hypoglycaemic attack (being Type 1 diabetic) and he was taken by ambulance to D Hospital, arriving at 22.00 hours. Within 15 minutes, he had left the emergency department of the hospital, climbed five flights of stairs to a flat roof, climbed over a protective barrier and either fallen or jumped into a courtyard below where he suffered serious injuries. (paragraph 1)

The issue which I have to decide is whether this accident occurred as a result of the breach of duty of D whether owed to C under the Occupiers Liability Act 1957 and/or the Occupiers Liability Act 1984 or at Common Law, or whether C was the author of his own misfortune. If I decide that D is liable for the accident, then there is an issue whether I should find any contributory negligence on the part of C. (paragraph 2)

D owed C a duty pursuant to the Occupiers Liability Act 1957 to take reasonable steps to ensure that the premises were reasonably safe for him as a vulnerable patient who was confused and mentally unstable at the time that he was in the Emergency Department of the hospital. I further consider that the hospital owed C a superimposed duty at common law which encompassed his reasonable safety not merely by reference to the state of the premises but also by reference to the overall operation of the enterprise which included supervision of patients, flow and management of patients and restriction of access to areas where patients did not need to go. These duties complement each other so that whilst, for much of the time, supervision will be adequate, there will also be times when it is not possible for D to maintain constant supervision of a patient and, at those times, other duties step in to fill the breach by restricting access to dangerous or unauthorised areas and by taking reasonable steps to see that areas to which vulnerable patients might gain access are reasonably safe. The best way to address these duties is through risk assessments, there being well established risk assessment tools which assist a hospital in identifying and assessing appropriate risks and taking reasonable steps to mitigate or avoid them. In breach of duty, D failed to carry out a suitable risk assessment with a result that there was the potential for an unsafe environment to arise… This was an accident which could and should have been prevented and there shall be judgment for the Claimant accordingly. (paragraph 75)