Manchester North

Action Planned (AI summary) Greater Manchester Police is working towards an electronic information sharing system with NWAS to improve communication, and plans are in place to develop a training package for OCB staff including clear instructions regarding information sharing with NWAS. NWAS states that a referral process was only due to go live in 2021, but has been brought forward in light of the current COVID-19 pandemic. The current process is that NWAS Clinical Hub will identify two mental health incidents per hour from 999 or 111 that are either a Category 3 or Category 4 mental health incident.

Action Planned (AI summary) The National Probation Service (NPS) launched its Health & Social Care Strategy 2019-22, along with a Suicide Prevention Strategy Action Plan, to support collaborative and multi-agency working.

Action Planned (AI summary) NWAS acknowledges the need to improve its DNA-CPR marker system. The Trust’s EOC Governance Group has been tasked with reviewing the position and making recommendations, and an update will be provided within the next 3 months. Alerts have been placed on the NWAS system for all children with current advance care plans (ACP), to be reviewed annually. Archived paper notes/records for children with palliative care needs known to the Children's Community Nursing Team (CCNT) are being reviewed to ensure any ACP's are included, and the Lead Nurse at the Royal Oldham Hospital Children's A&E department has been given a list of the children known to CCNT who have ACPs to enable them to set up their own alert system.

Action Planned (AI summary) The Trust has implemented measures to improve ambulance turnaround times, including daily meetings to review patient flow, screens displaying ambulance information, purchasing additional trolleys, and having Ambulance Liaison Officers on site during high demand. The Trust also joined a Phase 2 NWAS ambulance handover collaborative project. Blackpool CCG emphasized a Roster Review in commissioner requirements and are involved in initiatives to improve hospital handover times by using improvement methodology with several hospitals. They are also part of a North West Handover Improvement Board. NWAS is trialing a pilot program in the Cheshire and Mersey EOC to manage meal breaks differently, involving a mandatory staggered stand down of resources. They will also be adding 250 paramedics to the service by March 2020. The Department of Health and Social Care outlined actions to improve ambulance services, including implementing an improved ambulance performance framework, issuing revised hospital handover guidelines, and improving monitoring and reporting of patient handover delays. They also made the AACE aware of the coroner's concerns.

Action Planned (AI summary) Oldham CCG is co-ordinating a learning event with Hopwood House Medical Centre and the Oldham Turning Point team to facilitate reflection and agree on actions to improve working relationships. Turning Point conducted a review of GP communication across its substance misuse services and has implemented improvements including changes to prescriber templates, communication frequency, record keeping, and audit processes. These changes have been made across all community substance misuse services. Hopwood House Medical Practice has implemented a DNA policy to discuss patients who do not attend appointments and is considering referring such patients to a Focus Care worker. The practice will also highlight methadone use on patient medication lists.

Action Planned (AI summary) The Trust plans to incorporate awareness of Cushing's Disease into annual training for Core Medical Trainees, using the case as a study, and will discuss the case at local and Salford Royal MDT meetings to disseminate learning.

Action Planned (AI summary) Greater Manchester Police accepts the points raised and will use this case as a study for video briefings to frontline officers, including non-fatal strangulation, VCOP, definitions, markers, flags, and escalating risk, and closing standard risk cases. They will improve the IDVA service and 'field test' practitioners knowledge.

Action Planned (AI summary) Pennine Care NHS Trust has increased staffing levels, issued a memo to staff for greater awareness of the requirement to seek support from On-Call managers, and are planning to update policies and practice on how to respond to information in the public domain in the most effective manner. Greater Manchester Police will participate in a task and finish group and is represented at senior level on the GM Health and Justice Operational Delivery Group and the Greater Manchester Health and Justice Board, with focus on reviewing multi-agency protocols, shared resources, and formal joint working action plans. The partnership has developed a pan-GM protocol for response to mental health crisis, aiming for a common understanding of roles and responsibilities, a shared view of risk, and improved communication.

Action Planned (AI summary) NICE has been commissioned to produce guidance on safe prescribing and withdrawal management of prescribed drugs associated with dependence and withdrawal, with work due to start in early 2019.

Action Planned (AI summary) Persona will include a representative in multi-disciplinary team meetings for customers being discharged between Killelea and Persona services. They are developing a protocol and recording system for observations directed by medical practitioners, and exploring opportunities for managers to observe cases at Coroners Court to increase awareness. Bury Council will invite Elmhurst or Spurr House staff to attend discharge planning meetings at Killelea for customers being discharged to those short stay placements, so they can meet the customer and assess suitability.