_ Mr and Mrs Stokoe had been married for 56 years. Following Mr Stokoe being diagnosed with bladder cancer he attempted to take his own life which prompted a referral to Mental Health Services. Although there were no reported incidents of domestic violence _ it was clear from the evidence before me that the relationship of Mr and Stokoe was a distant and difficult one_ Notwithstanding prescribed medication and the intervention of Mental Health Services, there was an incident on May 2013 at the matrimonial home which led to the unlawful killing of Mrs Stokoe and with Mr Stokoe killing himself. An independent review of the circumstances of the deaths was commissioned by the Northumberland Tyne and Wear NHS Foundation Trust: number of findings and recommendations were made and was informed that the Trust accepted them in their entirety and that an action plan would be in place to progress them. am concerned to ensure that lessons that have been learnt locally are not lost nationally and should be_grateful if You_would confirm that steps will be_taken bY YOU to progress matters Civic Centre; Burdon Road, Sunderland, SRZ ZDN Tel 0191 5617843 Fax 0191 5537803 DX 60729 Sundcrland WWW.sunderland gov.uklcoroncr City City May May Mrs put was also concerned about the possibility that carers or partners of individuals who are subject to the provision of Mental Health Services are not formally consulted about the welfare of the patientlservice user_ Although was satisfied that domestic abuse awareness was an integral part of training for Mental Health staff, the circumstances of the deaths of Mr and Stokoe did raise for me concerns that more formal involvement of a carerlpartner may allow them to make disclosures which might better inform the assessment process For example, information from them may corroborate or verify that being provided by the service userlpatient. In my view carerslpartners may be a very valuable seam of information which may not necessarily be disclosed or volunteered by the service user or patient. Carerslpartners should have more visibility to the Mental Health Services and domestic abuse involving the elderly cannot be discounted and matters should be approached with an open mind. emphasised at the conclusion of the inquests that no one could have predicted the extreme circumstances of the deaths of Mr and Mrs Stokoe and that was in no way criticising the Trust. Whilst risk cannot be entirely eliminated it would be helpful if you indicate what steps can be taken t0 improve service provision. have sent this report to the Home Secretary for her information as the Domestic Homicide Review Report will be progressed very shortly.