East London

Action Planned (AI summary) Barts Health NHS Trust is working through process pathway redesign to reduce pressure in emergency departments and reduce levels of risk. The trust also plans to work alongside North East London to support paediatric flow from the Emergency Department, exploring ambulatory step down from the paediatric ward and increased use of paediatric clinical decision unit to work into the community to support early discharge. Barts Health Trust has updated guidance on managing gastroenteritis in children and revised the Emergency Department's policy on observations prior to discharge, and is prompting clinicians to consider adding urine output assessment to the online patient documentation system; learning summaries from the incident will be shared trust-wide.

Action Planned (AI summary) The Trust is continuously recruiting temporary staff and plans a Quality Summit to redesign services based on demand and need. They are also recruiting 8 additional Band 6 Community Psychiatric Nurses and will review resource and staffing levels.

Action Planned (AI summary) The Trust has implemented staff awareness sessions, amended guidance documents, introduced a ward clerk's checklist, and a complex transfer protocol. They are also reviewing and updating their Physical Health Care and Slips, Trips and Falls Policies, with updates expected by September 2022. The Department of Health and Social Care notes current NICE guidelines on falls and reports that NICE is beginning a full update due in 2024. NHS England will continue to encourage mental health trusts to participate in the National Audit of Inpatient Falls, which has seen increased uptake.

Action Planned (AI summary) The hospital implemented a new electronic stent register in August 2022 to track stents and warn staff of overdue stents. The Trust also retrospectively reviewed all stents inserted over the preceding 3 years and has started contacting patients who had been missed. The hospital has also introduced a lithotripsy service to reduce the need for stent insertion and has secured financial approval for a third Urology Consultant. The Trust has completed a Serious Incident/Root Cause Analysis and made recommendations, including providing patients with information leaflets and stent cards, establishing an electronic stent register, creating a standard operating procedure for stent management, investigating non-attendance, auditing patients with stents, assessing demand and capacity for treating stone patients, and strengthening incident reporting. BAUS acknowledges the need to log and track ureteric stents and improve patient/GP communication. BAUS will consider carrying out an audit of contemporary stent management practices and liaise with the Royal College of General Practitioners to discuss how information regarding stent symptoms and the importance of timely stent removal can best be disseminated to GPs.

Action Planned (AI summary) The Department of Health and Social Care acknowledges concerns and states that the mental health workforce is being expanded, aiming for an additional 27,000 healthcare professionals by 2024. NHS England is also considering new waiting time standards for community mental health treatment.

Action Planned (AI summary) The LFB plans to conduct a regulatory audit of the premises, issue a clarification of LFB policy on vetting of fire safety audits, conduct a full review of training material for vulnerable sleeping risk premises and develop refreshed CPD, apply the new national scheme for third-party accreditation of fire safety inspecting officers, review guidance on portable electric fan heaters, highlight the issue to housing providers, and continue to press for guidance on fitting of digital keypads. The NFCC will report the coroner's concerns to BSI committees (FSH12 and FSH14) to encourage debate and petition for positive outcomes, and will continue to work with the Home Office to ensure the matter of Concern is suitably addressed in any Guidance revision. Sequence Care has revised its competency checklist, re-assessed staff against it, arranged additional training sessions and updated fire alarms in homes to link to an Alarm Receiving Centre (ARC); ARC links at two homes will be completed by 24 June 2022. BSI's committee FSH/12 will pass on concerns to technical committee FSH/14 and sub-committee FSH/12/1, who will consider the issues and update progress in due course; the sub-committee FSH/12/4 may consider the issue of electronic locking as part of a forthcoming amendment to BS 7273-4.

Action Planned (AI summary) The NPCC and College of Policing outline actions taken, including updating the Death Investigation Manual and associated training to emphasize treating deaths as suspicious until proven otherwise. They have also highlighted existing guidance on handling personal effects and assessing handwritten notes, and initiated a review of the Forensic Submissions Good Practice Guide. DCMS states that the Online Safety Bill will place new requirements on companies in relation to illegal content and anonymity online and services will have to identify, mitigate and effectively manage the risk of anonymous profiles. Ofcom will set out the types of verification methods a company could use in guidance. The Metropolitan Police Service has updated its Death Investigation Policy to emphasize treating deaths as suspicious until proven otherwise and is providing refresher training to detectives. The CONNECT Investigation platform, which is replacing CRIS, will have improved functionality to track the completion of investigative actions.