A mental health trust has admitted a serious health and safety charge after a patient fell to his death from a hospital chimney tower.

A representative from Surrey and Borders Partnership NHS Foundation Trust (SABP) admitted one charge of an employer breaching their general duty to another at Guildford Crown Court on Friday, January 27.

The Trust will be sentenced in June.

From January 2016: Mother tells inquest of moment son Adam Withers fell to his death from Epsom Hospital chimney

The charge related to the death of Adam Withers, who died after falling from a chimney at Epsom Hospital on May 9, 2014.

The 20-year-old from Orchard Gardens, Epsom, had been diagnosed with acute and transient psychosis in April 2014.

He had climbed onto a conservatory roof and up a ladder attached to a chimney while his mother and twin sister were visiting, an inquest was told last year.

His mother, Michelle Withers told Woking Coroners' Court in January 2016 that she pleaded with him to climb down.

He had become agitated after Mrs Withers arrived late for their scheduled Friday evening visit, and used a flower pot to climb onto a conservatory roof in the courtyard of the hospital’s Elgar Ward before his fatal fall.

Mrs Withers also told the court there were no doctors or nurses present at the time.

On January 22, 2016, a jury concluded that Adam Withers climbed to the top of a 130 foot chimney and fell from it unintentionally whilst suffering an acute psychotic illness.

The jury also concluded his death was "caused or more than minimally contributed to by" multiple failures of Surrey and Borders Partnership NHS Foundation Trust (SABP) and Epsom and St Helier university Hospitals NHS Trust (ESTH).

These included: 

  • a failure by SABP to take effective steps to address the known risk of detained patients absconding from the Elgar Ward courtyard via its flat roof;
  • a failure by SABP to reassess Adam’s risk levels after his comment in relation to climbing the ladder on the chimney;
  • a failure by SABP to take effective steps to prevent Adam from absconding from Elgar Ward pending reassessment of his risk levels after his comment in relation to climbing the ladder on the chimney;
  • a failure by ESTH to take effective steps to prevent access to the ladder on the chimney;
  • a failure by both Trusts to effectively communicate changes to the environment and take remedial action to address identified risks.

From December 2014: Raft of security measures after patient fell to his death from Epsom Hospital chimney

From June 2015: Mental health patients barred from hospital courtyard after 20-year-old climbed and fell from chimney

SABP is responsible for mental health provision at Epsom Hospital.

The Trust introduced a raft of extra security measures - including making drainpipes and ledges harder to climb, and making the courtyard off-bounds for mental health patients - at the hospital after Mr Withers' death.

The sentencing hearing for SABP will take place at Guildford Crown Court on June 22.