Dear Mr Morris Re: Ian Bromley DOD 18th February 2019 write following the Inquest of Ian Bromley heard on the 1gth August 2019. Your concers after hearing all the evidence into the circumstances surrounding the tragic death of Ian Bromley have been brought to my attention and have subsequently reviewed the Regulation 28 letter. am writing to respond to the below mentioned concerns raised: The lack of access to a dedicated Consultant Psychiatrist allocated to the Home Treatment Team service, recruitment to such a post and interim cover from sector Consultant Psychiatrists The Home Treatment Team national core fidelity model does not mandate that teams should have a full time designaled Consultant Psychiatrist but that the team should have access to a medic: How this is achieved differs dependant on how local services are commissioned and provided. Some services operate on a model where consultant work will be divided by function i.e one for inpatient wards, one for CMHT, one for HTT and other areas work on a sector model where the patient is allocated t0 a consultant dependant on the postcode in which reside and will have the same consultant no matter where they are in the pathway: Stockport mental health service operates on a sector consultant basis for the majority of services and s0 patients who come into the service will be allocated a consultant dependant on the postcode where they reside The exception to this is where there has been specific additional investment The Home Treatment Team in Stockport had a part-time Associate Specialist who provided input into the team however this person was on long term sick leave at the time of Mr Bromley s referral and sO cover reverted to the sector model with which staff are very familiar. disability Trust Headquarters: 225 Old Street; Ashton under-Lyne; Lancashire OL6 7SR Tel : 0161 716 3000 confident Visit us at VV penninecare nhs uk COMMITTED they

There are also additional specialist clinical roles in the team which enhance the medical offer. The Home Treatment Team has an Advanced Practitioner in post whose role is to assess, diagnose, treat, prescribe and make referrals for patients, and who works closely with medical colleagues She will also review crisis patients in clinic and where clinically indicated support home visits. This has been in place for 7 months. The team manager is also now a qualified prescriber and can review and amend patient's treatment. In addition the Home Treatment Team has acquired additional CCG funding to extend the medical cover t0 the Home Treatment Team This was known and already agreed at the point of the inquest In the short term the Trust Medical Director is providing part-time cover t0 the team. hope that the information provided offers assurances that the findings of your investigations were already in progress and are focus of our continuing commitment to improving mental health services in Stockport Please do not hesitate to contact me should you require any further information: