Dear Ms Mutch, Re Peter Stojiljkovic Thank you for your letter of 12th March 2018. would firstly like to pass on my condolences to the family: We much regret any suicide and welcome a review of such situations: You have set out range of recommendations, and have commented specifically on those that relate directly to the CCG. We accept that from the infommation in the letter that there has been a breakdown in communication with the patient. You have written to the practice and we assume they will respond to that issue However, our Medical Director will review the case with the practice to identify any further learning: 2 Melatonin is on both the CCG and the GM restricted Iists currently, and CCGs across Greater Manchester aim to have consistent lists as far as possible. Although worded differently the interpretation would be the same in this case. We have not tracked the position of the GM list at the time of the incident; and accept that - may not have been consistent at that time. acknowledge your point about the difficulties that practices face in navigating through the various different lists, for this reason, as long as practice works with one of the lists, we would support them in their decision.
3. The practice followed what we would expect to be the usual process: identified that it was not a drug the practice would usually be expected to prescribe were prepared to prescribe the first prescription They applied to the CCG for a review of the case via the CCG's process The case is on file at the CCG. A decision would then have been made as to the clinical reason for the prescription, and if it was appropriate for a GP or secondary care consultant to take the responsibility for Mrs. Jane Crombleholme Chair Dr. Ranjit Gill Chief Clinical Officer Mrs. Gaynor Mullins Chief Operating Officer Floor, very they - They They

its prescription: The panel however never reviewed this case as the request was withdrawn: From the dates it would appear that this was following his suicide. 4 We would not expect anybody to be told that should access medication via the internet and we will discuss this with Pennine Care, and identify any further action that needs to be taken in respect of this finding: However; as you have written to Pennine Care assume that they will respond to you directly on this issue. In addition, we will raise the issue of the provision of medication at discharge was handled by Pennine Care, and again identify any improvements that need to make hope that this confirms the CCGs actions in relation to this tragic case. However;, if you have any queries, please contact me: