Cornwall and the Isles of Scilly

Action Planned (AI summary) MoJ and MHCLG are working on a long-term strategy to end homelessness, including for prison leavers, with publication expected next year. Funding for homelessness services is increasing, and MHCLG will promote a partnership approach to statutory referrals and information sharing.

Action Planned (AI summary) Royal Cornwall Hospitals NHS Trust is implementing changes to improve patient flow, including a Clinical Decision Unit model, converting the Same Day Medical Assessment Unit (SDMA) to a Same Day Emergency Care (SDEC), and supporting the move of acute medical resource from the emergency department to Acute Medical Unit.

Action Planned (AI summary) Cornwall Council has instructed its contractor to erect 'Farm Traffic' warning signs and is willing to work with the landowner on potential relocation options for the access. Harpers Farm suggests that signs approaching the entrance would be appropriate.

Action Planned (AI summary) The DHSC acknowledges concerns about ambulance response times and handover delays. Royal Cornwall Hospitals NHS Trust is implementing changes including a Clinical Decision Unit model, converting the Same Day Medical Assessment Unit (SDMA) to a Same Day Emergency Care (SDEC), and moving acute medical resource from the emergency department to Acute Medical Unit.

Action Planned (AI summary) Royal Cornwall Hospitals NHS Trust is implementing changes to improve patient flow including a Clinical Decision Unit, resetting the Same Day Medical Assessment Unit, ensuring medical discharges by 19:00, and identifying a space for a discharge lounge. A system clinical leaders event focused on community alternatives to improve urgent care access.

Action Planned (AI summary) The practice has developed a comprehensive practice policy for opioid prescribing. They plan to disseminate the new policy to all staff, discuss it at a practice-wide meeting, and review patients currently prescribed strong opioids who haven't had a review in the last six months.

Action Planned (AI summary) The Trust is setting up a facility in Truro run by the CHAOS Group which will have up to 14 step up / step down beds, 4 crisis beds, a 24/7 crisis/sanctuary facility plus support at home. NHS England has also increased the mental health workforce. Cornwall NHS is developing a 24/7 crisis care pathway including a crisis sanctuary for those with complex PTSD and EUPD, involving multiple partners. They are also working to address unmet demand for autism assessments. The ICB is developing a 24/7 crisis care pathway in phases, including a reablement bedded unit (4 beds) and a community reablement service with crisis sanctuary, aiming for trauma-informed mental health crisis prevention. They also plan to upscale sanctuary support for autistic people and expand the Crisis Resolution Home Treatment Team.

Action Planned (AI summary) Devon & Cornwall Police are delivering further communications to all response officers confirming that the responsibility for actively reviewing logs resides with the CIM and response Sergeants. They have also introduced a new auto transfer process to their resource and incident management officer (RIMO) receive within a shorter period of time. The HM Prison and Probation Service is consulting on new guidance clarifying when Probation Officers (POs) or Probation Services Officers (PSOs) should prepare pre-sentence reports, and is giving careful consideration to how collaborative relationships with other agencies can be improved. Cornwall Council is working with colleagues through the Domestic Homicide Review process to identify actions stemming from the Senior Coroner’s proposed recommendations. Safer Futures is reviewing practices around family involvement and consent. Safer Cornwall and Safer Futures are exploring a pilot around ‘affected others’ groups.

Action Planned (AI summary) The intensive care and anaesthetic departments will create a preoperative handover checklist by February 29th, 2024, to ensure the anaesthetic team considers all relevant factors for the patient's ongoing care. The National Trust will contact Cornwall Council regarding installing further signage on the road and will review the risk assessment at Chapel Porth annually. The MHRA will raise the issues with the manufacturers of the Cook Airway Exchange Catheter and Manujet III ventilator and explore if further risk communication or information is required.

Action Planned (AI summary) Cornwall Partnership NHS Foundation Trust will update a SOP and training video regarding side effects of anticoagulation medication, make POCT training mandatory, seek investment for additional CASP training sessions for registered community nurses and develop learning from experience posters.

Action Planned (AI summary) Royal Cornwall Hospitals NHS Trust will run Snapcoms about the importance of checking ePMA along with written entries which will be aimed all staff working within the Trust. They are also working with specialties to look at record-keeping policies.