Dear Sir Inquest touching upon the death of Luke Moulding This is a formal response to your Regulations 28 Report dated 13" April in which you set out your concerns relating to the care Mr Moulding received East London NHS Foundation Trust, Your concerns related specifically to a in sending Mr Moulding an 'opt-in' letter following his last appointment with a psychiatrist at the Community Mental Health Team (CMHT) on 11*h November 2016_ understand that you were assisted at the Inquest by statements from staff involved in Mr Moulding's care. psychiatrist who saw Mr Moulding on 11"h November highlighted in her statement that Mr Moulding had left his appointment stating that he did not wish to engage with the CMHT. Following this appointment the psychiatrist had decided that Mr Moulding should be sent an opt-in' letter setting out that he still had the option to call the CMHT for an appointment if he wished, The psychiatrist set out that opt-in letters are normally typed and sent within 10 working days However, this had not been sent at the time of Mr Moulding's death: Itappears that your concern is around the timing of such & letter and you suggest that a pre-printed letter could be sent providing sufficient information, thereby cutting down on any delay incurred by waiting for the letter to be typed. Chief Executive: Dr Navina Evans Ian from delay The

Following Mr Moulding's untimely death the Trust undertook & Serious Incident Review: This review identified the delay in sending Mr Moulding an opt-in letter as & care delivery problem. The reviewers identified that the Operational Policy for CMHT did not provide guidelines on the service timescales for providing opt-in letters and were concerned to find that the lead time in November 2018 was up to 30 days_ It was therefore recommended that the Operational Policy be updated to provide appropriate tirescales Action was subsequently undertaken to the Operational Policy which now requires that opt-in letters should be sent within 5 working days_ Compliance against this timescale will be the subject of Iocal audit to ensure compliance_ Whilst a pre-printed letter was not thought to be suitable , hope that the action taken provides you with assurance that the Trust has taken appropriate action and that your concerns have been adequately addressed. If you do require further information please do not hesitate to contact me_