The internal inquiry, held by Camden and Islington Community Services Trust, makes over 60 recommendations, including the proposal that people working with vulnerable adults should undergo the same police checks as staff working with children.

Sarah Andrews: "I was profoundly distressed by the findings"

The abuse of the 13 elderly and mentally ill patients at Beech Ward in London's St Pancras Hospital only came to light after a health care assistant informed on five colleagues in 1996.

Three were sacked for gross misconduct after a disciplinary hearing, another retired and one had already been made redundant, but was denied redundancy money.

However, the health workers, who had known the patients for up to 10 years, have not been struck off by the UKCC, nursing's regulatory body, and could be working in other hospitals.

Sarah Andrews, author of the 150-page report and co-director of nursing at the Camden and Islington Community Health Services NHS Trust, said: "It is worrying that these people could still seek employment as nurses and we would have no means of warning an employer of their past.

"It is for that reason that we would like to see a central register established to alert other trusts to these potential dangers."

The ward was closed in December 1996. The inquiry began after the disciplinary hearings had been completed.

The inquiry reported that up to five staff had tried to report the abuse.

But many had been threatened by the abusers, who said they would not be believed because they were black.

Catalogue of abuse

The patients, in their 70s and 80s, were subjected to a catalogue of abuse, including:

• Being verbally bullied;
• Being slapped and dragged across the ward;
• Being tied up;
• Being punched in the stomach;
• Being regularly moved around at night;
• Being bathed in cold water;
• Another resident at Beech House was found to have been bound with his hands behind his back and locked in his room;
• One patient was hit so hard in the face that bruises in the shape of finger marks were left behind.

One patient was hit in the face with a brush and assaulted with a shower fitting.

And a health care assistant told one patient that she would "break her neck".

The inquiry, which covered events on the ward between March 1993 and April 1996, found that all the health workers "either perpetrated or knowingly supported the abuse of patients" and "severely intimidated those who worked with them when they threatened to expose them".

Camden and Islington Community Health Services NHS Trust says it is determined to ensure such abuse never happens again.

The Trust has drawn up an action plan based on the inquiry's recommendations, which include measures for encouraging whistleblowers to come forward.

Swift action

Dr Usman Khan, its chairman, said: "I would like to apologise unreservedly to the patients and families of patients who were mistreated and to assure them that the Trust acted swiftly and decisively as soon as it discovered the abuse."

The Trust is meeting the patients' relatives on an individual basis and says if any wants to raise the issue of compensation, it will consider their demands.

A spokeswoman for Age Concern said it welcomed the inquiry's recommendation for tighter regulation of people who work with vulnerable adults.

It has been pushing for an extension to new rules on people working in elderly people's homes to be extended to cover individuals as well as agencies.

"We want more regulation and monitoring of people who work with the elderly," said the spokeswoman.

Negative attitudes to the elderly is the route cause of abuse, say experts

Dr Simon Festing of Help the Aged said the Beech Ward case was an extreme example of the treatment elderly people receive in hospitals.

He said the problems were due in part to the negative attitudes people had to the elderly.

He said nurses treating the elderly needed better training.