Dear Miss Ballard Response_to Prevent Future_Deaths Report for_Rebecca Marshall (deceased) write as requested following receipt of your Prevent Future Deaths Report of 25th September 2019. have shared your report with my team and other colleagues, and we have, as you would expect;, carefully considered the concerns you raised. As a partnership organisation, we are committed to effective inter-trust and inter-agency working and am deeply sorry that was not the impression of us that you were left with in this extremely sad case_ Rebecca's suicide was tragedy, and want to record here, my commitment as Chief Executive with that of team, to ensuring that where things need to be improved as a result of learning from what happened to Rebecca, the required changes are both made and sustained. Matters of Concern Your report identified two specific concerns where you considered KMPT had not taken steps to address areas of risk; a) The risk that occurs at the point in time when a patient moves permanently or temporarily (such as going to University as in Rebecca's case) from one geographical area to another: b) The innate vulnerability of students who are suffering mental health challenges and the need to ensure at the point of transfer of care there was effective inter-agency communication between trusts to ensure continuity of care of the patient: Chairman Julie Nerney Chlef Executive Helen Greatorex Trust Headquarters, Farm Villa, Hermitage Lane, Maidstone, Kent, ME16 9PH Tel: 01622 724100

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We accept the concerns raised, and agree entirely that anyone who moves in to or out of our area should be confident that we will (with their agreement) seek and share relevant information about their care needs and history in order to ensure their safe transfer. Our Transfer and Discharge of Care policy is designed to achieve exactly that by ensuring that Care Coordinators are clear about their responsibilities in such situations and prompted to contact other areas for background information expect all staff to adhere to this policy and ensure that information is sought and provided from other relevant organisations at the point of a care transfer_ We recognise that the transition to university can be a very anxiety provoking time for young adults_ recognise too that there is a need to work closely, not only with the corresponding mental health trust; but with the relevant university. Actions Taken The Transfer and Discharge of Care policy has been reviewed to ensure that it properly addresses any and all instances of care transfer; including vulnerable populations: This includes students, travellers and refugees_ programme of reminders and sharing of the Transfer and Discharge of Care policy is in place across the Trust, underpinned by sharing the learning about the gaps in Rebecca's care and what should have happened. Development (in partnership with our local universities) of a shared care protocol between KMPT and Higher Education to ensure clear and easy two way communication to further strengthen the safeguards for students' mental health_ Development of a fast track referral route from the Universities to our Community Mental Health Team. Piloting of a new, direct referral form from the University Health Centre. Strengthening of our Consent to Share Information process which now ensures that we are given permission by students to share information with the University Health Centre_ We have liaised with South London and the Maudsley and are incorporating their Transient People policy in to our overarching document You have my personal assurance as Chief Executive, that we will continue to test and refine our processes, sharing our reflection and learning from Rebecca's with staff who deliver front line care every At the next meeting November 2019) with the Kent Universities as part of this review we will seek input our University partners on the process of engagement and joint working when Kent residents attend university out of County: