Manchester North

Noted (AI summary) The Department acknowledges the coroner's concerns but refers to the BSG's opinion that a national stent registry is not required and NICE's view that existing guidance remains appropriate. It also mentions the Pennine Acute Hospitals NHS Trust established an ERCP biliary stent oversight meeting, and that NHS Improvement has brought the concerns in the report to the GIRFT clinical lead for gastroenterology. The BSG is in discussion with JAG about adding a stent planning/recall database to key performance indicators and incorporating it into the ISREE programme, with a formal discussion planned for the BSG Endoscopy Committee in October. It also mentions that reduction in variation in practice is an objective of the Get It Right First Time (GiRFT) initiative.

Noted (AI summary) HMR CCG acknowledges concerns about access to psychological therapy and Healthy Minds, explaining investment decisions and waiting time performance. They note a new Primary Care Mental Health Pathway was commissioned in 2016/17.

Noted (AI summary) The Department of Health acknowledges the concerns regarding access to NHS records and services for individuals with co-occurring mental health and substance misuse conditions. They reference existing guidance and reviews on information sharing and integrated care pathways, highlighting the responsibility of local commissioners and providers.

Noted (AI summary) The Department of Health provides background on regulations and describes Operation Pangea and the FakeMeds campaign; MHRA will investigate further once it receives information from Greater Manchester Police.

Noted (AI summary) Bury Council, as Highway Authority, states that all Highway Inspectors are scheduled to undergo specific training and competency checks to ensure they understand how to undertake their role under the new Code of Practice. There will be regular evidence based reviews of the new Code of Practice and monitoring. The Department for Transport acknowledges the concerns but notes that local highway authorities have a duty to maintain the highways network in their area and that Central Government has no powers to override local decisions in these matters. They endorse a code of practice, issued by the UK Roads Liaison Group, providing guidance to highway authorities on how to maintain and manage their highways.

Noted (AI summary) The Department of Health acknowledges the coroner's report and notes NICE's decision not to update its guidelines at this time, but that the information will be looked at when the guidance is next updated in 2017. NICE acknowledges the coroner's concerns about awareness of haemorrhage risk in renal failure patients with head injuries. While they believe their existing guideline covers this adequately, they have logged the concerns for consideration during the next update in 2017.

Noted (AI summary) The RCPCH acknowledges the coroner's concerns regarding Group B Streptococcus (GBS) but states that they are not aware of any new evidence or guidance on GBS and refers to their May 2015 response, deferring to the RCOG guideline. They are unable to comment on specifics of the case and defer to the Pennine Acute Hospitals NHS Trust regarding local matters. The Pennine Acute Hospitals NHS Trust is undertaking a rolling audit program on communication and documentation, and commissioned an improvement program focusing on these three areas. The Preceptorship programme has been updated to provide a competency based framework and a practice development midwife has been recruited to support the preceptorship program.