Dear Sirs,

Re: Regulation 28: Report to Prevent Future Deaths in respect of Ms Nicola Lacey

I am writing in response to your report to prevent future deaths dated 26th June 2024 addressed to me, I am grateful for the opportunity of responding to your concerns.

The Trust is always keen to learn from any tragic incident and I hope that this response satisfies you that we have reviewed the issues raised appropriately.

Your concern:

Procedures should be clear and known to employers concerning appropriate disclosure of a colleagues ongoing mental health difficulties for the benefit of both the individual concerned and the safety of the wider public.

The Trust can confirm that when working with patients with ongoing mental health difficulties we routinely assess the risks associated with themselves and others. If it is identified that this risk relates to or is relevant to their employment, we would in the first instance discuss this with the patient and seek informed consent for the employer to be advised of any necessary concerns. The importance of a therapeutic relationship is critical to supporting patients in their recovery. If a patient does not agree to discussions taking place with their employer about their health, practitioners have very clear parameters when they need to consider if they should breach confidentiality. In order to support such a decision, our clinical staff have access to both management and clinical supervision, safeguarding supervision, as well as access to other professional advice such as through our legal or information governance teams, or our Caldicott Guardian.

If we have any concerns about anyone who works or volunteers with adults with care and support needs we would also consider this in regards to ‘A Person in a Position of Trust’ (PiPoT) framework.

The Person in a Position of Trust Framework is applicable where there is an allegation or concern about an adult who works or volunteers in a position of trust with adults with care and support needs, employers, student bodies and voluntary organisations. In Herefordshire this framework is agreed and overseen by the Herefordshire Safeguarding Adult Board and a copy can be found here Positions-of-Trust-Framework-1.pdf (herefordshiresafeguardingboards.org.uk) In this situation where concerns arise the clinical team notify our Safeguarding team who then co- ordinate an appropriate discussion with professional advice and a decision is made using the Position of Trust Framework as to whether information is shared with an employer or not.

Action:

To ensure this process is clear, known to staff and followed routinely we have developed 2 Standard Operating Procedures (SOPs), one within working hours and one for out of hours. These SOPs are now in place and will be added to our Position of Trust Policy. Please find both SOPs attached for your information.

In addition, I can confirm the author of the report who adduced oral evidence at court has been contacted to ensure she is happy with the above process. As an organisation, we always prioritise the mental health and well-being of our staff. We understand that mental health is just as important as physical health, and we are committed to creating a supportive and inclusive work environment that promotes mental wellness.

We hope the above reassures you that we do offer resources and support for employees who may be struggling with mental health concerns. Our goal is to ensure that all staff members feel supported valued and able to thrive both personally, and professionally. We believe that by promoting mental health we create a positive and protective work culture for everyone.

Conclusion:

I would like to thank you for drawing this matter to my attention, I confirm that the point you raised has been carefully considered and the response set out above. I confirm that I have no submissions to make about publishing this response.

If you have any further queries do not hesitate to contact me.