Dear Mr Gittins Response to your Regulation 28 Report following the Inquest into the death of Mr Anthony Gwyn Williams write further to your Regulation 28 Report following your investigation into the circumstances of Mr Williams death: Thank you for providing the Health Board with the opportunity to advise you of the steps we are taking to improve our Mental Health Services and prevent future deaths_ During the course of your Inquest acknowledge some of the evidence produced revealed matters that gave rise to concern as follows: Although a memorandum from the Chief of Staff was circulated to all Medical, Inpatient and Psychiatric Liaison staff on 8 September 2014, it did not provide these staff groups with any guidance as to what constitutes 'exceptional cases' in terms of where out of hours psychiatric assessments should take place. am pleased to report that since this incident, we now have larger number of psychiatric nurses present on the Heddfan Adult Unit out of hours and in similar situations in the future, socially anxious patients such as Mr Williams could be assessed at the Unit and would not need to await psychiatric assessment at the Emergency Department Notwithstanding this, our Business Manager for Safety & Regulation will fully discuss this matter at the next Operational Management meeting to ensure full understanding and compliance across the Mental Health & Learning Disabilities Division_ 2 In respect of medical and nursing staff having access to patients' records, such as Care and Treatment Plans at all times, can advise you that the adoption of an electronic case record is currently being explored as par of the Community Information System national procurement: The Health Board will determine its preferred approach to developing electronic records by March 2015. 3 In relation to greater engagement with the families and carers of mental health patients to ensure their awareness of the contents of patients' Care and Treatment Plans , as Cyfeiriad Gohebiaeth ar gyfer y Cadeirydd a'r Prif Weithredwr Correspondence address for Chairman and Chief Executive: Swyddfa'r Gweithredwyr Executives' Office, Ysbyty Gwynedd, Penrhosgarnedd Gwynedd LL57 2PW Gwefan: WWw pbc cymru nhsuk Web: www.bcu.wales nhs.uk Care Bangor,

general principal if a patient has capacity to make decisions about whether family members or carers are involved in patient's care planning and care then services are obliged to respect that decision unless there is an overriding public interest; which merits disclosure of information: Where the involvement of family and carer's is accepted by the patient; the sharing of the Care and Treatment Plan would be appropriate am assured that all patients are provided with copy of their Care and Treatment Plans: If a patient lacks capacity to make decisions about the involvement of family or carers there should follow a best interest decision; would suspect in the majority of cases the involvement of family and carers would be in person's best interest. Please do nof hesitate to contact me if can be of further assistance in this matter.