3 Mar 2020 Shaun Lea Turner · Prevention of Future Deaths report Manchester South
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Concerns raised 1
Delays in accessing appropriate mental health services and receiving support View source
Linked response
Department of Health and Social Care
Stated actions An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised. 8
Department of Health and Social Care
Introduce mental health access and waiting-time standards, including standards for early psychosis intervention and psychological therapies.
View source
Department of Health and Social Care
Test and roll out comprehensive adult and children’s mental health waiting-time standards.
View source
Department of Health and Social Care
Expand access to talking and psychological therapies through the Improving Access to Psychological Therapies programme.
View source
Department of Health and Social Care
Ensure additional adults and older adults can access NICE-approved Improving Access to Psychological Therapies services by 2023/24.
View source
Department of Health and Social Care
Implement emergency mental health waiting-time targets from 2020/21, aligned with emergency physical-health targets.
View source
Department of Health and Social Care
Establish round-the-clock community mental health crisis services in every local health service by 2021, with self-referral for escalating needs.
View source
Department of Health and Social Care
Allocate national funding to transform urgent and emergency mental health care and provide alternative provision, including safe havens and crisis cafes.
View source
Department of Health and Social Care
Provide additional funding from 2021 to further strengthen urgent and emergency mental health crisis services.
View source See 5 more actions
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AI-generated summary
Shaun Lea Turner · Prevention of Future Deaths report
This summary was generated using AI from the published report. Please read the original report for the complete account.
Report summary
Shaun Lea Turner was found unresponsive at home after ingesting a fatal amount of codeine. The inquest concluded that his death was suicide, with drug toxicity on a background of bronchopneumonia. His family raised concerns about delays in accessing appropriate mental health services and the effect of a missed call from those services.
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How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below.
PFD Monitor interpretation Delays in accessing appropriate mental health services and receiving support
Wider context from the report “During the course of the inquest, evidence was given by Mr Turner's family that whilst they accepted that there had been attempted contact of him by mental health services he was worried about how long it would take him to be able to access appropriate mental health services and receive support . He was aware through previous contact with Mental Health services that there could be delays and when he missed a call from them, the impact of that in relation to accessing mental health services preyed on his mind .
” Source location Shaun Lea Turner · Prevention of Future Deaths report
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Introduce mental health access and waiting-time standards, including standards for early psychosis intervention and psychological therapies.
Verbatim wording from the response “We have introduced the first ever access and waiting time standards for mental health services, including standards for early intervention for people experiencing a first episode of psychosis and accessing psychological and talking therapies. These are being met or are on track for delivery. In addition, the NHS has committed to testing and rolling out comprehensive waiting time standards for adults and children over the next decade.” Source location 2020-0050-Response-from-the-Department-of-Health-and-Social-Care-1
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Test and roll out comprehensive adult and children’s mental health waiting-time standards.
Verbatim wording from the response “We have introduced the first ever access and waiting time standards for mental health services, including standards for early intervention for people experiencing a first episode of psychosis and accessing psychological and talking therapies. These are being met or are on track for delivery. In addition, the NHS has committed to testing and rolling out comprehensive waiting time standards for adults and children over the next decade.” Source location 2020-0050-Response-from-the-Department-of-Health-and-Social-Care-1
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Expand access to talking and psychological therapies through the Improving Access to Psychological Therapies programme.
Verbatim wording from the response “We are expanding access to talking and psychological therapies and improving quality through the Improving Access to Psychological Therapies (IAPT) programme¹. Already, over 1 million people a year are starting treatment and we are aiming to increase access to psychological therapies for an additional 600,000 people with common mental health problems each year by 2020/21. The NHS Long Term Plan² commits to ensuring that an additional 380,000 adults and older adults will be able to access NICE³-approved IAPT services by 2023/24.” Source location 2020-0050-Response-from-the-Department-of-Health-and-Social-Care-1
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Ensure additional adults and older adults can access NICE-approved Improving Access to Psychological Therapies services by 2023/24.
Verbatim wording from the response “We are expanding access to talking and psychological therapies and improving quality through the Improving Access to Psychological Therapies (IAPT) programme¹. Already, over 1 million people a year are starting treatment and we are aiming to increase access to psychological therapies for an additional 600,000 people with common mental health problems each year by 2020/21. The NHS Long Term Plan² commits to ensuring that an additional 380,000 adults and older adults will be able to access NICE³-approved IAPT services by 2023/24.” Source location 2020-0050-Response-from-the-Department-of-Health-and-Social-Care-1
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Implement emergency mental health waiting-time targets from 2020/21, aligned with emergency physical-health targets.
Verbatim wording from the response “The NHS Long Term Plan also commits to specific waiting times targets for emergency mental health services which will take effect for the first time from 2020/21 onwards and will align with the equivalent targets for emergency physical health services.” Source location 2020-0050-Response-from-the-Department-of-Health-and-Social-Care-1
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Establish round-the-clock community mental health crisis services in every local health service by 2021, with self-referral for escalating needs.
Verbatim wording from the response “We recognise the need for people experiencing a mental health crisis to get the care that they need quickly. Every local health service has now signed up to having a round the clock community mental health crisis service by 2021, with people whose needs might be escalating to crisis point able to self-refer in the same way they can for urgent physical health care. More than £200million of national funding has been allocated to local areas to transform urgent and emergency mental health care and provide new, alternative forms of provision, such as safe havens and crisis cafes. An additional £140million will bolster these services further from 2021 onwards.” Source location 2020-0050-Response-from-the-Department-of-Health-and-Social-Care-1
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Allocate national funding to transform urgent and emergency mental health care and provide alternative provision, including safe havens and crisis cafes.
Verbatim wording from the response “We recognise the need for people experiencing a mental health crisis to get the care that they need quickly. Every local health service has now signed up to having a round the clock community mental health crisis service by 2021, with people whose needs might be escalating to crisis point able to self-refer in the same way they can for urgent physical health care. More than £200million of national funding has been allocated to local areas to transform urgent and emergency mental health care and provide new, alternative forms of provision, such as safe havens and crisis cafes. An additional £140million will bolster these services further from 2021 onwards.” Source location 2020-0050-Response-from-the-Department-of-Health-and-Social-Care-1
Open published response
×
Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Provide additional funding from 2021 to further strengthen urgent and emergency mental health crisis services.
Verbatim wording from the response “We recognise the need for people experiencing a mental health crisis to get the care that they need quickly. Every local health service has now signed up to having a round the clock community mental health crisis service by 2021, with people whose needs might be escalating to crisis point able to self-refer in the same way they can for urgent physical health care. More than £200million of national funding has been allocated to local areas to transform urgent and emergency mental health care and provide new, alternative forms of provision, such as safe havens and crisis cafes. An additional £140million will bolster these services further from 2021 onwards.” Source location 2020-0050-Response-from-the-Department-of-Health-and-Social-Care-1
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13 Dec 2019 Sammi Higgins · Prevention of Future Deaths report East London
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Concerns raised 1
Delays in access to psychotherapy treatment View source
This report raised 2 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
North East London NHS Foundation Trust
Stated actions An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised. 10
North East London NHS Foundation Trust
Implement additional BIT pathway programmes, including group sessions and structured psychological interventions, within the AABIT service offer.
View source
North East London NHS Foundation Trust
Consult on and integrate the B&D MAP Specialist Psychological Service into BDAABIT as a single multidisciplinary service with clear pathways.
View source
North East London NHS Foundation Trust
Review panel processes and internal referral points between AABIT and specialist psychological services.
View source
North East London NHS Foundation Trust
Use zoning meetings to verify completion of psychological-intervention actions and escalate outstanding clinical actions to case-holders.
View source
North East London NHS Foundation Trust
Assess needs and risks of patients waiting more than 18 weeks and identify additional support required while they remain on the waiting list.
View source
North East London NHS Foundation Trust
Add MAP waiting-list times to the Trust risk register and monitor them monthly across mental health services.
View source
North East London NHS Foundation Trust
Develop the multidisciplinary team function alongside the referral pathway to identify psychological interventions and reduce higher-intensity referrals.
View source
North East London NHS Foundation Trust
Review and collate outstanding vacancies across BDAABIT and Psychosis teams and service disciplines.
View source
North East London NHS Foundation Trust
Review monthly 18-week waiting reports and develop a time-tracked plan to monitor the maximum wait through divisional business meetings.
View source
North East London NHS Foundation Trust
Prepare a psychological-services demand and capacity report and present an improvement plan to commissioners detailing service gaps.
View source See 7 more actions
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AI-generated summary
Sammi Higgins · Prevention of Future Deaths report
This summary was generated using AI from the published report. Please read the original report for the complete account.
Report summary
Sammi Higgins had mental health conditions and a deteriorating mental state, including voices telling her to harm herself. On 3 February 2018, after presenting to mental health services following an overdose and self-harm and being discharged without weekend mental health support, she ingested a fatal combination of alcohol and tablets. Concerns included the absence of an overarching care plan or key-worker, failures in communicating and implementing a medication change, and lengthy delays in accessing psychotherapy.
Read the report on judiciary.uk
× Source evidence
How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below.
PFD Monitor interpretation Delays in access to psychotherapy treatment
Wider context from the report “2. Sammi suffered from emotionally unstable personality disorder and mood congruent psychotic symptoms. She required psychotherapy treatment. She was referred to the psychotherapy services in March 2017. By the time of her death in February 2018, Sammi had not received psychotherapy. The Inquest heard that there could be delays of 17 months from referral to receipt of treatment. It is considered that these ongoing lengthy delays give rise to a risk of future deaths .
” Source location Sammi Higgins · Prevention of Future Deaths report
Open source report
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Implement additional BIT pathway programmes, including group sessions and structured psychological interventions, within the AABIT service offer.
Verbatim wording from the response “3. Policy/practice update – Compliance with terms of AABIT SOP
Implement additional intervention pathway (BIT pathway) programmes (e.g. group sessions and structured term psychological interventions) as per the BDAABIT team’s development plan to ensure there is compliance with the AABIT SOP and that services are responsive to their users. The AABIT short-term support service will be responsive to their users. These programmes will form part of the whole service offer; patients will step up or down to alternative services or remain with their individual care plan.” Source location Response from North East London NHS Foundation Trust
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Consult on and integrate the B&D MAP Specialist Psychological Service into BDAABIT as a single multidisciplinary service with clear pathways.
Verbatim wording from the response “13. Service change – clinical risk management
Action: Formally consult and integrate the B&D MAP Specialist Psychological Service into the BDAABIT service to ensure a single service, with clear pathways that are fully multi-disciplinary. The role of the managerial role (to be repeated for the Psychological Service in the Community Recovery Service). This is to streamline the delivery of psychological services and to ensure that capacity released (due to an expansion of capacity released) is used effectively to shorten the waiting times. The Trust will provide support and oversight in practice with determining best practice and Trust-wide learning.
Deadline: 30.09.2020
Lead: ████████, Director Adult Services; ████████, Trust wide PS lead; Operational Lead AABIT” Source location Response from North East London NHS Foundation Trust
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Review panel processes and internal referral points between AABIT and specialist psychological services.
Verbatim wording from the response “14. Service change in recommended best practice
Action: Review the psychological services panel process and internal referral points between the AABIT and the specialist psychological pathway to ensure that the correct clinical intervention/pathways are available to support release of clinical capacity for front line delivery as per action 12.
Deadline: 31.07.2020
Lead: ████████, Trust wide PS lead” Source location Response from North East London NHS Foundation Trust
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Use zoning meetings to verify completion of psychological-intervention actions and escalate outstanding clinical actions to case-holders.
Verbatim wording from the response “15. Audit – clinical risk management
Action: Each zoning meeting to ensure that actions regarding psychological interventions has been completed and clinical actions will be escalated to the relevant clinical case-holder. Any uncompleted actions will be escalated to the relevant clinical case-holder.
Deadline: 30.01.2020
Lead: ████████, Operational Lead AABIT” Source location Response from North East London NHS Foundation Trust
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Assess needs and risks of patients waiting more than 18 weeks and identify additional support required while they remain on the waiting list.
Verbatim wording from the response “16. Policy/practice update – clinical risk management
Action: In the meantime and while the development are being implemented, the service manager has been asked to contact the services waiting list for more than 18 weeks (national standard) to: 1. Assess the needs/risk of the patient to ensure that the person has not deteriorated and it is safe for the service user to remain on the waiting list. 2. Identify if any additional support is needed while the service user is on the waiting list. The above practice will be carried out until the required changes within the service will be completed.
Deadline: 30.01.2020
Lead: Service lead for MAP and Specialist Psychological Services” Source location Response from North East London NHS Foundation Trust
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Add MAP waiting-list times to the Trust risk register and monitor them monthly across mental health services.
Verbatim wording from the response “17. Audit – clinical risk management
Action: Waiting list times for MAP service to be added to the Trust risk register as a high risk and monitored on a monthly basis for all mental health services.
Deadline: 30.01.2020
Lead: Head of Service – Adult Mental Health services” Source location Response from North East London NHS Foundation Trust
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Develop the multidisciplinary team function alongside the referral pathway to identify psychological interventions and reduce higher-intensity referrals.
Verbatim wording from the response “18. Service change – clinical risk management
Action: Develop the multidisciplinary team function in conjunction with the referral pathway – see Action 4 above (BFT pathway) – for the identification of psychological interventions as a way of reducing the need for higher intensity psychological interventions.
Deadline: 31.07.2020
Lead: Operational Lead AABIT; ████████, Trustwide PS lead” Source location Response from North East London NHS Foundation Trust
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Review and collate outstanding vacancies across BDAABIT and Psychosis teams and service disciplines.
Verbatim wording from the response “19. Recruitment – clinical risk management
Action: Review the current vacancy levels in the BDAABIT and Psychosis teams to collate outstanding vacancies across the service disciplines in order to create additional 7 psychology posts. This will increase the BDAABIT capacity within Psychosis Services to meet the demands of the increasing caseload and to shorten waiting times for psychological interventions.
Deadline: 31.01.2020
Lead: Service – Adult Mental Health services S/SBT” Source location Response from North East London NHS Foundation Trust
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Review monthly 18-week waiting reports and develop a time-tracked plan to monitor the maximum wait through divisional business meetings.
Verbatim wording from the response “20. Service change – clinical risk management
Action: Review the monthly 18 week wait report to ensure current configuration and develop a time-tracked development and monitor 18 week maximum wait of the 18 weeks will be maximum wait for achievement via the divisional business meeting.
Deadline: 28.02.2020
Lead: Head of Service – Adult Mental Health services” Source location Response from North East London NHS Foundation Trust
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Prepare a psychological-services demand and capacity report and present an improvement plan to commissioners detailing service gaps.
Verbatim wording from the response “21. Service change – clinical risk management
Action: A Demand and capacity report to be prepared and relation to Psychological Services, and a plan to improve to be presented to the commissioners to ensure the service gaps in addition to any adverse service improvements are detailed in this action plan.
Deadline: 31.05.2020
Lead: ████████, Assistant Director Adult Services” Source location Response from North East London NHS Foundation Trust
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26 Feb 2019 Danyon Robert Chesters · Prevention of Future Deaths report Manchester South
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Concerns raised 1
Delays in accessing NHS mental health services View source
This report raised 2 other concerns. They are not shown here because they do not form part of this recurring concern.
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AI-generated summary
Danyon Robert Chesters · Prevention of Future Deaths report
This summary was generated using AI from the published report. Please read the original report for the complete account.
Report summary
On 2 July 2018, Danyon Robert Chesters went onto a railway line under Trafford Bridge Road and was struck by a train. The inquest heard concerns about delays in accessing mental health services, the resulting use of private therapy, and a lack of joined-up care and information sharing. It also heard concerns that private therapists might not obtain information about prescribed mental health medication and its impact on therapy.
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× Source evidence
How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below.
PFD Monitor interpretation Delays in accessing NHS mental health services
Wider context from the report “1. Mr Chesters had previously sought help for Mental Health issues and had found significant delays in accessing services . Subsequently he had lived and worked in Germany. Whilst there he had been treated by German Mental Health Services. Following his return to England, he required further treatment. He saw his GP who indicated that there were significant delays in accessing Mental Health Services via the NHS . He felt this reflected his previous experiences with the NHS and that he could not wait and went to a private therapist. This expense caused him additional worry and he saw his therapist less regularly than would have been seen as the optimum frequency consequently. As a result of seeing a private therapist there was no joined up care in relation to his mental health and no information sharing between professionals involved in his care.
” Source location Danyon Robert Chesters · Prevention of Future Deaths report
Open source report
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Expand IAPT services to increase access to psychological therapies for people with common mental health problems.
Verbatim wording from the response “The Five Year Forward View for Mental Health² set out a commitment to expand IAPT services and improve quality further, with an ambition to increase access to psychological therapies for an additional 600,000 people with common mental health problems each year.” Source location 2019-0079-Response-by-Department-of-Health-and-Social-Care
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Invest in IAPT and expand community mental health services and access to psychological interventions in community and primary care.
Verbatim wording from the response “As well as investing more in IAPT, we are supporting the NHS with an additional £2.3billion investment in real terms by 2023-24 in a comprehensive expansion of mental health services. Outlined in the NHS Long Term Plan³ published in January 2019, this includes an expansion of community services and better access to psychological interventions in the community and primary care.” Source location 2019-0079-Response-by-Department-of-Health-and-Social-Care
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How this respondent position was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Local NHS bodies are responsible for commissioning psychological therapy services to meet their populations’ needs.
Verbatim wording from the response “It is the responsibility of the local NHS to commission services to meet the needs of their local populations. With regard to access to psychological therapies, one of the stated targets of the Improving Access to Psychological Therapies (IAPT) programme is that for new referrals, 75 per cent of people referred will enter treatment within six weeks, and 95 per cent within 18 weeks.” Source location 2019-0079-Response-by-Department-of-Health-and-Social-Care
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12 Feb 2019 Heather Louise Carey · Prevention of Future Deaths report Manchester South
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Concerns raised 3
Insufficient psychotherapy capacity causing prolonged waits View source Lack of available in-patient psychotherapy View source Inappropriate waiting-time target for urgent psychotherapy View source
Linked responses
Department of Health and Social Care NHS Greater Manchester Integrated Care Board Tameside Borough Council
Stated actions An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised. 6
NHS Greater Manchester Integrated Care Board and Tameside Borough Council
Complete the review of access and quality in psychological therapy services for people with complex mental health needs.
View source
NHS Greater Manchester Integrated Care Board and Tameside Borough Council
Develop a new psychological therapy model for people with complex mental health needs in Tameside and Glossop.
View source
NHS Greater Manchester Integrated Care Board and Tameside Borough Council
Provide £271,000 of additional funding to increase access to psychological therapies during 2018/19.
View source
NHS Greater Manchester Integrated Care Board and Tameside Borough Council
Increase annual funding for psychological therapies by £673,000 by 2021.
View source
Department of Health and Social Care
Make funding available to test new community mental health care models and improve timely access to psychological therapies for people with severe mental illness.
View source
NHS Greater Manchester Integrated Care Board and Tameside Borough Council
Invest £600,000 recurrently to improve staffing on Tameside Hospital inpatient mental health wards.
View source See 3 more actions
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AI-generated summary
Heather Louise Carey · Prevention of Future Deaths report
This summary was generated using AI from the published report. Please read the original report for the complete account.
Report summary
Heather Louise Carey was admitted to mental health services in July 2017, later took an overdose of paracetamol, and was placed on a 24-week waiting list for Cognitive Analytical Therapy. She hanged herself at home on 20 December 2017. The principal concern was that lengthy waits for psychotherapy and inadequate action to address her high suicide risk may have contributed to her death.
Read the report on judiciary.uk
× Source evidence
How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below.
PFD Monitor interpretation Insufficient psychotherapy capacity causing prolonged waits
Wider context from the report “The inquest identified a number of issues which likely contributed to Heather's decision to end her life. One of those issues related to the long wait following discharge before psychotherapy would begin.
At the time of Heather's admission to TGH there was no psychotherapy available to her as an in-patient because there were insufficient funds available to provide the same. I was told that had been addressed by further funding being made available.
At the time of Heather's assessment on 22.11 staffing levels were reduced, through illness and a vacancy, and there was only one psychotherapist available . That was the reason given for the 24 weeks wait .
At the inquest I heard evidence that the target waiting list was 18 weeks. Further, that by the time of the inquest that target time was being met. A target waiting time of 18 weeks, I was told, was comparable to ‘cancer waiting times’. However, it transpires that those are the maximum waiting times for non-urgent consultant led treatment for any treatment from the point of referral. Heather was already in receipt of consultant led care. Her need was urgent. Thus such a comparator on waiting times to justify an 18 weeks wait for psychotherapy is not an appropriate measure.
By letter dated 3rd January 2019 Pennine Care responded to my concerns about the long waiting list as follows,
“The CCG are currently in dialogue with Pennine Care in relation to waiting times for Secondary Care psychological therapies to ensure that existing (emphasis added) resources are effectively utilised and capacity and demand is reviewed to inform commissioning requirements.”
It was clear from the evidence heard, not only from Heather's mother and partner but from those involved in her care, that Heather had placed great faith in psychotherapy as the means by which she would bring mental stability back to her life, a release from the increasingly extreme mood swings of her bi-polar disorder. It is not difficult to imagine the despair and distress felt by Heather to be told that it would be almost 6 months before she could even begin the help/treatment she was seeking on voluntary admission some 4 months previously.
A target waiting list of 18 weeks is far too long but I was told that this was a funding issue.
Unless adequate and sufficient measures are taken to significantly reduce waiting times for acute mental ill-health, comparable to physical life threatening illnesses, NOT simply a redistribution of existing resources, more patients with mental health issues will end their lives while on a waiting list for treatment.
” Source location Heather Louise Carey · Prevention of Future Deaths report
Open source report × Source evidence
How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below.
PFD Monitor interpretation Lack of available in-patient psychotherapy
Wider context from the report “The inquest identified a number of issues which likely contributed to Heather's decision to end her life. One of those issues related to the long wait following discharge before psychotherapy would begin.
At the time of Heather's admission to TGH there was no psychotherapy available to her as an in-patient because there were insufficient funds available to provide the same . I was told that had been addressed by further funding being made available.
At the time of Heather's assessment on 22.11 staffing levels were reduced, through illness and a vacancy, and there was only one psychotherapist available. That was the reason given for the 24 weeks wait.
At the inquest I heard evidence that the target waiting list was 18 weeks. Further, that by the time of the inquest that target time was being met. A target waiting time of 18 weeks, I was told, was comparable to ‘cancer waiting times’. However, it transpires that those are the maximum waiting times for non-urgent consultant led treatment for any treatment from the point of referral. Heather was already in receipt of consultant led care. Her need was urgent. Thus such a comparator on waiting times to justify an 18 weeks wait for psychotherapy is not an appropriate measure.
By letter dated 3rd January 2019 Pennine Care responded to my concerns about the long waiting list as follows,
“The CCG are currently in dialogue with Pennine Care in relation to waiting times for Secondary Care psychological therapies to ensure that existing (emphasis added) resources are effectively utilised and capacity and demand is reviewed to inform commissioning requirements.”
It was clear from the evidence heard, not only from Heather's mother and partner but from those involved in her care, that Heather had placed great faith in psychotherapy as the means by which she would bring mental stability back to her life, a release from the increasingly extreme mood swings of her bi-polar disorder. It is not difficult to imagine the despair and distress felt by Heather to be told that it would be almost 6 months before she could even begin the help/treatment she was seeking on voluntary admission some 4 months previously.
A target waiting list of 18 weeks is far too long but I was told that this was a funding issue.
Unless adequate and sufficient measures are taken to significantly reduce waiting times for acute mental ill-health, comparable to physical life threatening illnesses, NOT simply a redistribution of existing resources, more patients with mental health issues will end their lives while on a waiting list for treatment.
” Source location Heather Louise Carey · Prevention of Future Deaths report
Open source report × Source evidence
How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below.
PFD Monitor interpretation Inappropriate waiting-time target for urgent psychotherapy
Wider context from the report “The inquest identified a number of issues which likely contributed to Heather's decision to end her life. One of those issues related to the long wait following discharge before psychotherapy would begin.
At the time of Heather's admission to TGH there was no psychotherapy available to her as an in-patient because there were insufficient funds available to provide the same. I was told that had been addressed by further funding being made available.
At the time of Heather's assessment on 22.11 staffing levels were reduced, through illness and a vacancy, and there was only one psychotherapist available. That was the reason given for the 24 weeks wait.
At the inquest I heard evidence that the target waiting list was 18 weeks . Further, that by the time of the inquest that target time was being met. A target waiting time of 18 weeks, I was told, was comparable to ‘cancer waiting times’. However, it transpires that those are the maximum waiting times for non-urgent consultant led treatment for any treatment from the point of referral. Heather was already in receipt of consultant led care. Her need was urgent . Thus such a comparator on waiting times to justify an 18 weeks wait for psychotherapy is not an appropriate measure .
By letter dated 3rd January 2019 Pennine Care responded to my concerns about the long waiting list as follows,
“The CCG are currently in dialogue with Pennine Care in relation to waiting times for Secondary Care psychological therapies to ensure that existing (emphasis added) resources are effectively utilised and capacity and demand is reviewed to inform commissioning requirements.”
It was clear from the evidence heard, not only from Heather's mother and partner but from those involved in her care, that Heather had placed great faith in psychotherapy as the means by which she would bring mental stability back to her life, a release from the increasingly extreme mood swings of her bi-polar disorder. It is not difficult to imagine the despair and distress felt by Heather to be told that it would be almost 6 months before she could even begin the help/treatment she was seeking on voluntary admission some 4 months previously.
A target waiting list of 18 weeks is far too long but I was told that this was a funding issue.
Unless adequate and sufficient measures are taken to significantly reduce waiting times for acute mental ill-health, comparable to physical life threatening illnesses, NOT simply a redistribution of existing resources, more patients with mental health issues will end their lives while on a waiting list for treatment.
” Source location Heather Louise Carey · Prevention of Future Deaths report
Open source report
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Complete the review of access and quality in psychological therapy services for people with complex mental health needs.
Verbatim wording from the response “a. Psychological Therapies Review - commenced in October 2018 this review focuses on access and quality of psychological therapy services for people with more complex needs including those under the care of the Community Mental Health Teams. The review identified that while NICE concordat therapy services are being provided waiting times for treatment are too long in some services.” Source location Response from Tameside Metropolitan Borough
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Develop a new psychological therapy model for people with complex mental health needs in Tameside and Glossop.
Verbatim wording from the response “The reviewing team are using this information alongside an exploration of alternative models of care to develop a new model of psychological therapy for people with complex mental health needs in Tameside and Glossop. This review will conclude by the 31 of July 2019.” Source location Response from Tameside Metropolitan Borough
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Provide £271,000 of additional funding to increase access to psychological therapies during 2018/19.
Verbatim wording from the response “b. Improving access to psychological therapy – the Tameside and Glossop Strategic Commissioning Board has committed additional funding to increase access to psychological therapies. An additional £271,000 agreed in 2018/19 will be increased by an additional £673,000 per annum by 2021 to meet a range of pressures.” Source location Response from Tameside Metropolitan Borough
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Increase annual funding for psychological therapies by £673,000 by 2021.
Verbatim wording from the response “b. Improving access to psychological therapy – the Tameside and Glossop Strategic Commissioning Board has committed additional funding to increase access to psychological therapies. An additional £271,000 agreed in 2018/19 will be increased by an additional £673,000 per annum by 2021 to meet a range of pressures.” Source location Response from Tameside Metropolitan Borough
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Make funding available to test new community mental health care models and improve timely access to psychological therapies for people with severe mental illness.
Verbatim wording from the response “This year, funding is being made available to test new models of community mental health care. This includes testing ways to improve timely access to courses of psychological therapies for people with psychosis, bipolar disorder and personality disorder. In addition, NHS England will test four-week waiting times to appropriate care, to help build our understanding of how best to introduce ambitious but achievable improvements to access, quality of care and outcomes.” Source location Response from Department of Health and Social Care
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Invest £600,000 recurrently to improve staffing on Tameside Hospital inpatient mental health wards.
Verbatim wording from the response “The CCG has invested £600,000 recurrently to improve staffing on the inpatient mental health wards at Tameside Hospital with a focus on improving safety, patient experience and outcomes. The Trust has invested this funding in improving the skill mix of the teams, including additional clinical psychology and occupational therapy, as well as nursing and admin. The CCG is formally monitoring the impact of this investment through regular Safer Staffing Reports presented to the Pennine Care Quality Group. Reports from staff on the Tameside wards and the latest CQC report indicate that this is having a positive impact.” Source location Response from Tameside Metropolitan Borough
Open published response
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Source evidence
How this respondent position was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Local commissioners and providers are responsible for taking firm action to address the concerns and failings identified.
Verbatim wording from the response “Your report offers significant learning to the local NHS and I expect firm action to be taken by both the local commissioner and provider of services to respond to the concerns raised and the failings identified.” Source location Response from Department of Health and Social Care
Open published response
7 Feb 2019 Stephen Anthony Kennedy · Prevention of Future Deaths report Birmingham and Solihull
View report summary
Concerns raised 1
Unavailability of timely psychological services due to internal service structures and waiting lists View source
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
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AI-generated summary
Stephen Anthony Kennedy · Prevention of Future Deaths report
This summary was generated using AI from the published report. Please read the original report for the complete account.
Report summary
Stephen Anthony Kennedy had a history of emotional unstable personality disorder, depression and frequent self-harm, and his condition deteriorated during 2018. He was found hanging at his home on 08/10/18 and was declared deceased. Concerns included that psychological therapy was unavailable because of service structures and long waiting lists, and that a lack of acute inpatient beds contributed to further episodes of self-harm and suicide attempts.
Read the report on judiciary.uk
× Source evidence
How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below.
PFD Monitor interpretation Unavailability of timely psychological services due to internal service structures and waiting lists
Wider context from the report “1. The deceased suffered from emotional unstable personality disorder and was in crisis for most of 2018. The recommended treatment for his condition was psychological therapy. He had not had any psychological input since 2010. The inquest heard that whilst he was under the care of the home treatment team there was no access to psychology services . He had to be under the community mental health team to be able to access psychological services . There were periods when he was under the care of the community mental health team but at this time he remained on a long waiting list for psychological services . Throughout 2018 he never received any psychological services . I am concerned that the main treatment option for the deceased was not available to him due to internal structures and long waiting lists .
” Source location Stephen Anthony Kennedy · Prevention of Future Deaths report
Open source report
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Formalise distinct community mental-health treatment pathways through the 2019/20 Service Development and Improvement Plan.
Verbatim wording from the response “3.4 Psychological therapy services for people under the care of BSMHFT forms part of the provider’s internal pathway and as such waiting times are not monitored by the CCG. The CCG’s approach is to increasingly commission for outcomes rather than inputs. In line with this, commissioners have set out their intention that community-based mental health services should operate distinct treatment pathways for people with psychotic disorders and those with mood and personality disorders. Pathways will be focused on the delivery of treatment and support that promotes recovery alongside the proportionate management of risk. Providers will be expected to put in place a workforce model that reflects this approach and affords access to treatment options including psychological therapies.” Source location 2019-0039-Response-by-Birmingham-and-Solihull-CCG
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Establish clinical psychology capacity within every Home Treatment Team.
Verbatim wording from the response “With regard to the matter of Psychological Therapy, I am able to confirm that we now have a plan for investing in clinical psychology capacity within our Home Treatment Team services. From September 2019, subject to recruitment, we anticipate to be in a position whereby every individual Home Treatment Team has a 0.5WTE Clinical Psychologist within their team. Approval has been given to advertise these posts and this will help us to ensure compliance with NICE guidance and to deliver clinically effective care as per recommended guidelines. The Clinical Psychologist will also contribute to multi disciplinary team assessments, discussions and decisions relating to care planning and treatment options for patients, as well as providing supervision to other members of the team. We are also increasing nursing capacity to ensure that community caseloads are more manageable.” Source location 2019-0039-Response-by-Birmingham-and-Solihull-Mental-Health-NHS-Trust
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Develop a community-based Severe Mental Illness offer including psychological therapies, physical healthcare, employment support, personalised care and related support.
Verbatim wording from the response “A new community-based offer for people with Severe Mental Illness will include access to psychological therapies; improved physical health care; employment support; personalised and trauma-informed care; medicines management; and support for self-harm and coexisting substance use. This will give 370,000 adults and older adults greater choice and control over their care, and support them to live well in their communities.” Source location 2019-0039-Response-by-Department-of-Health-and-Social-Care
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Source evidence
How this respondent position was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Local NHS organisations are responsible for providing mental health services, while NHS England commissions specialised services.
Verbatim wording from the response “You will know that the provision of mental health services is a matter for the NHS locally, except where specialised services are required and NHS England is the responsible commissioner. You have issued your report to the Birmingham and Solihull Mental Health NHS Foundation Trust and the Birmingham and Solihull Clinical Commissioning Group (CCG), and I expect the local NHS to take firm action to respond to the concerns and learn from Stephen’s death to ensure the safety of healthcare services.” Source location 2019-0039-Response-by-Department-of-Health-and-Social-Care
Open published response
24 Jan 2019 Mr Viswambaran · Prevention of Future Deaths report Inner North London
View report summary
Concerns raised 1
Excessive waiting times for IAPT therapy View source
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
No linked response statements No respondent-stated action or position is linked to these concerns in the published data.
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AI-generated summary
Mr Viswambaran · Prevention of Future Deaths report
This summary was generated using AI from the published report. Please read the original report for the complete account.
Report summary
Mr Viswambaran, aged 27, was found dead at home on 18 September 2018 after overdosing on co-dydramol tablets. The report raises concerns about lengthy waiting times for IAPT therapy and difficulties contacting the IAPT service, which could contribute to deterioration or disengagement from mental health support.
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How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below.
PFD Monitor interpretation Excessive waiting times for IAPT therapy
Wider context from the report “1) From the evidence of Mr Viswambaran’s GP, ████████, it transpired that the waiting time for IAPT therapy is in the region of 12 weeks but could be up to 18 weeks . I am concerned that individuals may experience a deterioration in their mental health pending an appointment or disengage from mental health services due to the length of waiting times for therapy .
” Source location Mr Viswambaran · Prevention of Future Deaths report
Open source report
Concerns raised 1
Delays in access to IAPT counselling View source
This report raised 3 other concerns. They are not shown here because they do not form part of this recurring concern.
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AI-generated summary
Name not published · Prevention of Future Deaths report
This summary was generated using AI from the published report. Please read the original report for the complete account.
Report summary
The deceased had a history of mental health issues, self-harm and two suicide attempts, and was in contact with mental health services until the evening of 30 April 2018 before taking her own life the next morning. Concerns included a prolonged delay in accessing IAPT counselling and difficulties with the electronic recording, risk assessment and progress-note systems.
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How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below.
PFD Monitor interpretation Delays in access to IAPT counselling
Wider context from the report “1 Delay in IAPT counselling
a) After ████████ turned 18 she moved to adult mental health services. She had parallel contact with her GP surgery ████████. Shortly before her 18th birthday, according to the MPFT clinical review (page 9 of 33), ████████ was referred to Improving Access to Psychological Therapies (IAPT) by the ████████ Access Team for assessment for psychological therapy or counselling. On the 14th November 2017 (page 12 of 33) it was agreed with ████████ to add her to her GP surgery waiting list for counselling in line with her treatment preference. ████████ remained on the IAPT waiting list for counselling at the time of her death.
b) The evidence at the inquest was that a 3 month time interval would be optimal but in ████████ case, in relation to this GP surgery, 10 months would be the norm . Such a delay is sub-optimal and could have an adverse effect on a patient waiting for counselling to commence.
” Source location Name not published · Prevention of Future Deaths report
Open source report
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Redesign IAPT counselling as a locality-based model with increased capacity and flexibility to respond to demand and staffing changes.
Verbatim wording from the response “The revised model eligibility criteria will give the IAPT service increased capacity, enabling greater flexibility with regard to where and when people can be seen. A 3-month transioperiod is currently underway during which a redesign of the IAPT service is taking place, whereby counselling provision will be more consistently provided across the county from a locality based model, which is more efficient and therefore it will be more possible to be flexible in responding to changes in supply of staff to meet changes in demand thus reducing waiting times to within the statutory 18 week target. It is anticipated that once this work is completed, planned within a six month timescale, it will then be possible to keep waiting times within these recommended limits.” Source location Response from Midlands Partnership NHS Foundation Trust
Open published response
4 Jun 2018 John Paul Derwent · Prevention of Future Deaths report Manchester South
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Concerns raised 1
Failure of escalation mechanisms to enable early action on excessive CBT waiting lists View source
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
No linked response statements No respondent-stated action or position is linked to these concerns in the published data.
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AI-generated summary
John Paul Derwent · Prevention of Future Deaths report
This summary was generated using AI from the published report. Please read the original report for the complete account.
Report summary
John Paul Derwent was referred for cognitive behavioural therapy while the waiting time was 12 months against a six-week target. He expressed suicidal ideation, was admitted and later discharged into the community; on 13 November 2017 he was found suspended from a ligature at home. The report raised concerns about insufficient CBT capacity, the substantial waiting list and escalation mechanisms that did not allow early action.
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How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below.
PFD Monitor interpretation Failure of escalation mechanisms to enable early action on excessive CBT waiting lists
Wider context from the report “The Inquest heard that the target time for an appointment for CBT should be 6 weeks. At the time Mr Derwent was referred, the waiting time was 12 months. There was a waiting list review in October 2017 when it was established that 500 people were on the waiting list for CBT. The waiting list time at the date of the Inquest remained 12 months. The Inquest heard that there was insufficient capacity for the number of people referred for CBT which is why the waiting list had become so significant. It was unclear why the list had been allowed to increase to this level. The mechanisms for escalation between the commissioning body and the service provider did not appear to allow for early action to address the issue.
” Source location John Paul Derwent · Prevention of Future Deaths report
Open source report
16 Nov 2017 John Haines · Prevention of Future Deaths report Manchester North
View report summary
Concerns raised 1
Delays in access to Healthy Minds due to long waiting times View source
This report raised 2 other concerns. They are not shown here because they do not form part of this recurring concern.
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AI-generated summary
John Haines · Prevention of Future Deaths report
This summary was generated using AI from the published report. Please read the original report for the complete account.
Report summary
John Haines was admitted to a mental health ward in March 2017 after his anxiety and depression deteriorated, and was discharged on 14 June 2017 with planned follow-up. He was found deceased at home on 17 June 2017 after failing to respond to contact. The report raised concerns about in-patients and Home Treatment Team patients being unable to access qualified psychological therapy, including delays in accessing Healthy Minds.
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× Source evidence
How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below.
PFD Monitor interpretation Delays in access to Healthy Minds due to long waiting times
Wider context from the report “3. Timely access to Healthy Minds is also hindered by long waiting times .
” Source location John Haines · Prevention of Future Deaths report
Open source report
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Commission and mobilise a Primary Care Mental Health Pathway to prepare service users for therapy and support recovery performance.
Verbatim wording from the response “The CCG commissioned a new Primary Care Mental Health Pathway during 2016/17, which mobilised in May 2017. The model has been developed to respond to the local” Source location 2017-0402-Response-by-Heywood-Middleton-and-Rochdale-CCG
Open published response
24 Aug 2017 Jonathan Anthony MEANEY · Prevention of Future Deaths report Inner North London
View report summary
Concerns raised 1
Failure to provide timely and appropriately urgent access to a mental health bed View source
This report raised 5 other concerns. They are not shown here because they do not form part of this recurring concern.
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AI-generated summary
Jonathan Anthony MEANEY · Prevention of Future Deaths report
This summary was generated using AI from the published report. Please read the original report for the complete account.
Report summary
Jonathan Anthony Meaney took an overdose on 13 March 2017 and was assessed at hospital, where inpatient treatment was recommended but no bed was found. He was discharged on 15 March after expressing a wish to leave and took his own life the following day; his medical cause of death was morphine and alcohol toxicity. Concerns included the prolonged wait for a bed, aspects of the pre-discharge mental health assessment, lack of consultation with another team member, and uncertainty about whether a proposed GP referral was made.
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How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below.
PFD Monitor interpretation Failure to provide timely and appropriately urgent access to a mental health bed
Wider context from the report “1. Mr Meaney waited in the emergency unit for 40 hours and so it was unsurprising that he was then keen to go home.
A mental health nurse from the C&I psychiatry liaison team called the bed manager on the morning of Tuesday, 14 March, and then saw Mr Meaney briefly to explain that no bed was available . The same nurse called the bed manager again the following morning, Wednesday, 15 March, and then saw Mr Meaney once again with no news about admission. It was at that point that Mr Meaney expressed a wish to leave.
There seemed no urgency about the need for a bed for such a seriously ill man.
” Source location Jonathan Anthony MEANEY · Prevention of Future Deaths report
Open source report
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Work closely with CANDI to assist its investigation, action-plan development and implementation to prevent similar incidents.
Verbatim wording from the response “It follows that the Matters of Concern will need to be addressed substantively by CANDI, which we note has received your Prevention of Future Deaths Report. We understand that CANDI are undertaking a Serious Incident investigation and we are committed to working closely with CANDI, as necessary, to assist them in completing this investigation, developing and implementing an action plan to prevent similar incidents in future and to otherwise assist them in preparing their response to your Prevention of Future Deaths Report. Additionally, we have asked to be provided with copies of CANDI’s final Serious Incident investigation report and response to your Prevention of Future Deaths Report, to ensure that any opportunities for learning within this Trust are captured and shared appropriately.” Source location 2017-0244-Response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Complete a serious incident review examining the sequence of events and contributory factors in the case.
Verbatim wording from the response “We are undertaking a serious incident review of this case. Part of its scope is to undertake an in-depth analysis to ascertain in further detail exactly what steps were taken as Trust to secure Mr Meaney a bed. We will forward you our serious incident review on its completion. We are aiming to complete our review in November.” Source location 2017-0244-Response2
Open published response
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Source evidence
How this respondent position was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation CANDI, which employs and manages the Mental Health Liaison service, must substantively address the concerns.
Verbatim wording from the response “We have carefully considered the Matters of Concern, all of which relate to care that was delivered by the Camden & Islington NHS Foundation Trust’s Mental Health Liaison service, based within the Royal Free Hospital Emergency Department. The staff working within the Mental Health Liaison service are employed by the Camden & Islington NHS Foundation Trust (“CANDI”), not this Trust (the Royal Free London NHS Foundation Trust), and CANDI manage the Mental Health Liaison service. If a patient attending the Trust’s Emergency Department is considered to have a mental health problem (pertinent to the attendance) or requires a mental health assessment, they are referred to the Mental Health Liaison service, which will then assess the patient and take responsibility for referring onwards to either CANDI’s inpatient facilities or another mental health trust, as appropriate.” Source location 2017-0244-Response
Open published response
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Source evidence
How this respondent position was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Bed allocation urgency was assessed against clinical risk and safety, with priority given to patients not in places of safety.
Verbatim wording from the response “The allocation of a bed is a centralised task, undertaken by the bed management team, managed by Camden and Islington NHS Foundation Trust. The bed management team received the referral from psychiatric liaison psychiatry, requesting a psychiatric bed for Mr Meaney at 04.46am on 14 March. Patients are prioritised according to both their clinical need, and the assessment of risk, for example, whether the patient is in a safe place. Patients who are not in places of safety i.e. at home or in police custody would take priority for acute beds. The referrals list is something that can change rapidly depending on the priority of the new referrals and whether the risk of an existing referral has changed. Senior staff meet daily to review all pending referrals and to estimate when a bed will become available.” Source location 2017-0244-Response2
Open published response
Actions and positions describe what organisations say in published responses. Implementation is not independently verified.