Changing the nursing culture in a special hospital.

In August 1992 a damning report was published on the mental health services provided at Ashworth Special Hospital in Merseyside. It described a brutalising and damaging regime in which nurses were singled out for the strongest criticism. In November 1994 the Health Advisory Service (HAS), which has a watchdog role, spent three weeks at Ashworth reviewing developments in the wake of the inquiry report. The HAS report, published last March, praised the hospital for undergoing tremendous change and recovery. Areas of exemplary practice were evident and major dehumanising practices had been eliminated. This paper attempts to analyse some of the difficulties confronting nurses at the hospital during the years of change between the public inquiry and the HAS visit, and identifies recent major achievements and areas for further work.