Birmingham and Solihull

Noted (AI summary) TfWM's new e-scooter operator Beryl will use the same 'selfie' security process for registering an account as the previous operator, Voi. They will work with local police and schools to identify and act on underage riding reports, and will monitor bank account registrations. Beryl will also implement outreach work with institutions and academies. The Department for Transport will encourage operators to continue additional measures to deter under-age riding, and will work with trial operators to gather and disseminate examples of additional measures. They will also work with operators to understand if anything more could be done to alert them to attempts by under-age riders to gain access to e-scooters. CoMoUK acknowledges the concerns but states they don't have the power to make operational changes to shared transport schemes. They have held meetings with Transport for West Midlands and the Department for Transport and will track the changes being implemented.

Noted (AI summary) The Trust will display laminated posters of joint guidance in acute surgical areas, publish and disseminate a new trust policy, update the online requesting system, engage with the West Midlands Postgraduate School of Surgery to inform trainees, and report the incident to CORESS, with completion expected by 31st October 2023. The Department of Health and Social Care acknowledges the concerns about capacity at Birmingham Heartlands Hospital and outlines national plans to improve A&E waiting times, increase hospital capacity, and support timely discharge from hospital, but doesn't detail specific actions beyond those already in place.

Noted (AI summary) NHS England acknowledges the concerns but states that matters relating to interpreters, communication, and family engagement are for local response. Regarding risk assessment documentation, NHS England states that risk assessments are carried out in line with NICE guidance and templates are available within SystmOne. Birmingham and Solihull Mental Health Trust has begun a 3-month pilot to ensure a Consultant Psychiatrist attends MDT meetings at the prison each week. A risk assessment template has been added to the SystemOne software accessible to Trust staff, and is being rolled out with a dissemination plan to ensure completion. TPP acknowledges the coroner's concerns, explains the capabilities of SystmOne, and states that it is working correctly. TPP defers to NHS England and local commissioners regarding specific configurations and usage of the system for mental health assessments in prisons.

Noted (AI summary) The response outlines the current process for GPs to contact mental health teams, defends its appropriateness, and states that a review by a consultant psychiatrist was not clinically indicated in this case. It also mentions an independent review of the care provided will be shared with the family.

Noted (AI summary) West Midlands Police restructured the Public Protection Department in 2019, increasing staff allocated to DA investigation and replacing Domestic Abuse Teams with Adult Investigation and Adult Complex Investigation Teams; they have also established a scrutiny panel with the CPS to review decisions where no further action is taken. West Midlands Police restructured the Public Protection Department in 2019, increasing staff allocated to DA investigation and replacing Domestic Abuse Teams with Adult Investigation and Adult Complex Investigation Teams; they have also established a scrutiny panel with the CPS to review decisions where no further action is taken. The Home Office highlights the Domestic Abuse Act 2021 and the Tackling Domestic Abuse Plan, committing to assist in funding the rollout of Domestic Abuse Matters training and funding the College of Policing to develop a new module aimed at investigators of domestic abuse; they also mention the Police Uplift Programme and additional funding for West Midlands Police. The College of Policing has created a 'DA Matters' training package for police responders focusing on coercive control, delivered by DA charities, and has rolled out the Domestic Abuse Risk Assessment tool (DARA) to every force in England and Wales. West Midlands Police is publishing a revised Domestic Abuse policy with an initial response action checklist and will launch it with a tailored communication and briefing package; they have also created an improvement plan to increase the number of Domestic Violence Protection Notices and Orders. The Police and Crime Commissioner acknowledges the coroner's report and highlights ongoing efforts by West Midlands Police to address domestic abuse, while also noting resource constraints and the impact of cuts to public services.

Noted (AI summary) NHS England clarifies that while the Liaison & Diversion service model does not directly commission psychiatrists, access can be arranged via urgent referral. They state that a Career and Competency Framework for L&D services, published in 2018, is currently under review, and regional commissioners will consider it for workforce and quality issues. NHS England clarifies that Liaison and Diversion services do not directly commission psychiatrists but are for referral. They are developing a new service specification to clarify expectations for access to psychiatry and are reviewing the L&D career and competency framework. West Midlands Police will create a formal escalation process for custody staff regarding Liaison & Diversion decisions, review mental health training for custody officers/staff, and provide clear advice on the L&D function within six months. West Midlands Police will create a formal escalation process for custody staff disputing Liaison and Diversion decisions, review mental health training for custody officers, and provide clear advice to frontline staff on the L&D function. These actions are planned within six months. Birmingham and Solihull Mental Health Trust plans to discuss liaison clarity with West Midlands Police, develop internal communications about the L&D team's role, and review/update the L&D induction programme and introduce reflective practice groups with psychologists by October 2022. Birmingham and Solihull Mental Health Trust plans to discuss liaison clarity with West Midlands Police, develop internal communications about the L&D team's role, and review/update the L&D induction programme and introduce reflective practice groups with psychologists by October 2022. NHS England clarifies that the Police Custody Healthcare Service (PCHS) policy and commissioning responsibilities lie with the Home Office and Police and Crime Commissioners (PCCs) respectively, not NHS England. They state their role is advisory, and they will continue to work collaboratively with the National Police Chiefs Council (NPCC) to align PCHS and Liaison & Diversion service specifications. The Home Office clarifies that commissioning for L&D services is for NHS England and police custody healthcare services for PCCs, and it is not their place to intervene. However, Home Office officials are working with the NPCC, NHS England, and DHSC to improve escalation processes and mental health management in custody, with a view to the NPCC issuing new guidance.

Noted (AI summary) NHS England and NHS Improvement are writing to ambulance services regarding clinical oversight, including a reminder that Acute Behavioural Disturbance (ABD) calls should have oversight of a senior clinician in the control room and calls should be upgraded to Category 1 if the patient’s condition deteriorates or if the patient is being restrained. The Association of Ambulance Chief Executives (AACE) explains its role and states that it cannot mandate response categories. AACE developed and issued national clinical guidance in 2019, updated in 2020, to UK ambulance clinicians, supported education and presented at conferences and webinars for police and ambulance staff, and continues to develop further guidance around managing patients with extreme agitation. The College of Paramedics clarifies it is not responsible for setting standards for paramedic education, training, or practice, but will ensure its pre-registration curricula review includes the latest evidence on Acute Behavioural Disturbance. The College endorses AACE's response and will share the correspondence with NHS England’s Emergency Call Prioritisation Advisory Group and AACE to propose a review of the current response categorisation of Acute Behavioural Disturbance. NHS Digital provides background information on NHS Pathways, a clinical decision support system used by NHS 111 and some ambulance services, and its governance structure. It states that NHS Pathways is concordant with NICE, the UK Resuscitation Council, and the UK Sepsis Trust guidelines.