From Rt Hon Norman Lamb MP Minister of State for Care and Support Department Department of Health of Health Richmond House 79 Whitehall London SWIA 2NA Andrew Walker HM Coroner for the Northern District of Greater London North London Coroner's Court 29 Wood Street Barnet ENS 4BE Ve UaMes Thank you for your letter to Jeremy Hunt about the death of Mr Henry Marsh. am responding on his behalf as the Minister responsible for mental health policy: Your report detailed Mr Marsh's multiple diagnoses which included depression, a personality disorder, substance misuse issues, Post Traumatic Stress Disorder and alcohol dependence. The inquest concluded that Mr Marsh committed suicide whilst under the care of the local Home Treatment Team You are concerned that the team could not function effectively with its current caseload_ Home Treatment Teams are commissioned by local Clinical Commissioning Groups (CCGs) and resourcing these teams is therefore a matter for the local CCG. There is, at national level, very clear evidence base about the optimal effective composition and functioning of Crisis Home Treatment Teams (CHHTs) and this includes the following: The National Service Framework crisis home treatment policy: The University College London Child Outcomes Research Consortium National Institute for Health Research programme that advises on effective care models for CHTTs and online learning and three courses for those commissioning, establishing and implementing CHTTs. The Royal College of Psychiatrists College Centre for Quality Improvement, Royal College peer accreditation quality network that has robust evidence based standards against which teams can be judged: The National Audit Office report on CHTT optimal operational functioning: day

Department of Health The North East Strategic Clinical Network's published standards for crisis care pathways including CHTTs performance indicators from Monitor and the Care Quality Commission on metrics which CHTTs need to provide to ensure effectiveness: NHS England intends to map this best practice guidance on to the mental health intelligence network in the next phase of its programme of work. There is currently no set timeline for this to take place. In the meantime, NHS England has summary of the guidance with relevant links on the Health and Wellbeing website: http Ilbit lyLIrQNZUZ hope that this information is useful and thank you for bringing the circumstances of Mr Marsh's death to our attention_ ~neRs NORMAN LAMB Key - put