‘Don’t let blood be on your hands’, mother tells inquiry

• A mother's testimony at the Lampard Inquiry highlights systemic failures in mental health unit care that contributed to her daughter Elise Sebastian's death, raising urgent questions about patient safety protocols and accountability in inpatient psychiatric settings.
• The case underscores the critical need for improved safeguarding measures, staff training, and clinical oversight within mental health units to prevent similar preventable deaths.
• Healthcare organisations must prioritise learning from serious incident investigations and implement robust recommendations to ensure patient safety becomes a tangible priority rather than a procedural formality.

The mum of Elise Sebastian, who died in a mental health unit, gives evidence to the Lampard Inquiry.

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