Are hospitals for offenders with learning disabilities as intimidating as we think? Student nurse- Matthew Smyth – not his  real name, – tells Becky Mennell about the human face of Rampton hospital’s’ Learning Disability unit and the way that he and his colleagues worked to ensure that patients’ lives were as ‘safe’ and ‘normal’ as possible.

Matthew was on a placement from university, where he studies Disability Nursing. He worked at Rampton hospital in Nottinghamshire for three months and during this time he had first-hand experience with both patients and employees. Rather refreshingly, he told me that really enjoyed his time working at the hospital and that the services people received were excellent and all above board odd phrase. He said: “(It was) Much better than many other places I’ve worked at and visited.”

The hospital has been running for just over 100 years and was originally used to house the overloaded Broadmoor’s patients. More than 400 people with mental health and learning disabilities reside live there. The most famous patients include; child killer Beverley Allit, cannibal and serial killer Peter Bryan and murderer Ian Huntley.  

However, not all the people in the hospital are offenders. Most have been sent there because their behaviour has been reason for concern, for example suicidal tendencies or abnormal sexual behaviour. And in those cases, they have been admitted under the Mental Health Act of 1983. Behaviour can be controlled more effectively in an institution such as Rampton, where offenders will receive more support there than in prison.

Many of the people in Rampton have learning disabilities, or difficulties, and staff at Rampton aim to give specific care to match each patient’s needs.  Perhaps, not surprisingly, people with learning disabilities are often not charged with offences because of their personal situation. Matthew believes this is wrong, he said: “I believe people should always face charges when they have done something wrong, which thankfully is now being encouraged.” What kind of offences?







Fact Box


  •     Rampton is 1 of 3 High Security Prisons in England
  •     It has approximately 1900 staff
  •     It is situated near Retford in Notiinghamshire
  •     It has five directories: Mental health, Womens Services,     Learning Disability, Personality Disorder and Dangerous /Severe personality     Disorder



Matthew tells me, in some cases behaviour can be controlled better in an institution such as Rampton than a prison. This is because the offenders here will be in a more controlled environment with one-to-one contact, which they would not have if they were admitted to a prison. Matthew said: “It is hard to tailor specific needs of individuals, but staff know the most about the individual and can help to manage problems. Everybody’s needs are different.”






Nurses are in contact with patients all day and have one-to-one sessions, meetings and discussions with them and other officials. Nurses’ work with the disciplinary team which includes; occupational therapists, social workers and psychology nurses. Matthew says person-centred care was always at the forefront of team-member discussions. “Like all healthcare settings, occasionally messages weren’t passed on, but overall it was much better than I expected when I started there. Especially given the size of the place and the number of staff employed.”

The people in the Learning Disability unit are able-bodied and the majority most of the time nurses just oversee their day-to-day activities, such as watching television, making a cup of tea, playing pool and interacting with each another.

Matthew worked as a student nurse during his time at Rampton and helped with patients’ therapeutic needs such as giving medication which had been administered by psychologists. He said: “We overlook all their care and establish the effectiveness of treatment.” Robotic sentence – translate

One of the most important conditions at Rampton is safety. It is of paramount importance that all patients are kept safe from themselves and others. Nursing staff have to ensure that no materials around patients are harmful. Matthew said that nursing staff are responsible for patients and they have a duty of care towards them. He said: “It is all about keeping people safe.” If there were any accidents or illegal acts being committed by patients then staff would immediately ring police and the Criminal Justice System would take over legal proceedings to deal with the matter.

Matthew talks calmly about all of the legal matters nursing staff have to adhere to, but he tells me that there is a lot of staff support at Rampton. Most importantly, perhaps, he said: “It is one of the best places to work for that reason.” He adds that if staff witness anything which has affects them, they can seek free counselling courtesy of the institution.

His experience of working at Rampton has led to him being very interested in working there or in a secure learning disability hospital elsewhere. He says: “The hospital was nothing like I expected. Public perception of Rampton is overall negative”, he was told very disturbing things before he worked there, “Very few people actually understand what the hospital does, and the people it treats.”

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