Hertfordshire

Action Planned (AI summary) Nottinghamshire Police has revised its policy on s.136 detentions and will consult with EMAS regarding implementation. It will explore extending the hours of the Street Triage Team (STT) until 0300hrs, subject to collaboration with NHS partners. The force agrees that the concerns about mental health services for dual diagnosis is not a matter for them. EMAS will revise its policy on s.136 detentions and provide mandatory training for all frontline staff. It will engage with commissioners to advocate for service development to address the gap for patients with dual diagnosis (mental health and substance misuse) and strengthen guidance around dual diagnosis in training. National Highways will undertake a Road Restraint Risk Assessment Process (RRRAP) to assess the need for VRS or other mitigations at the specified location. They will complete the assessment before 31 December 2025 and report findings by 13 February 2026.

Action Planned (AI summary) The government will publish its 10-Year Health Plan which will set out reforms for the NHS and focuse on shifts in the way health services deliver care to reduce ambulance handovers and patients waiting over 12 hours for admission from an emergency department.

Action Planned (AI summary) NHS England published the National Framework and Operational Guidance for Autism Assessment Services in April 2023, setting out expectations for integrated autism assessment pathways and that referrers must not omit providing assessment or intervention for health-related needs. Hertfordshire and West Essex ICB notes long waiting times for ASD assessments and outlines actions including pathway investment, implementing a service model redesign, providing additional funding, and creating resource packs for parents and carers. The council erected notices signposting to the Samaritans immediately after the death and will assess the feasibility of raising or replacing bridge parapets with new, higher versions once a Principal Inspection is complete, after liaising with Network Rail to undertake the Principal Inspection at the first opportunity.

Action Planned (AI summary) The ICB acknowledges the need for integrated care for patients with Type 1 Diabetes and Disordered Eating. They plan to implement a care pathway for these patients once national guidance is available and are working to resolve funding challenges to extend data sharing across more care providers. NHS England has provided funding for eight Integrated Care Boards to develop T1DE services, including services accessible to patients in Hertfordshire and West Essex. They have invested in pilots to test integrated diabetes and mental health pathways and are sharing learning nationally.

Action Planned (AI summary) Hertfordshire County Council will promote a Traffic Regulation Order to prohibit loading/unloading on the A4251 Tring Road and will engage with NuYard regarding their safety protocols by the end of November 2023; the Active and Safer Travel team will engage with cycling groups to raise awareness of risks.

Action Planned (AI summary) West Hertfordshire Teaching Hospitals NHS Trust has developed a Prevention of Future Deaths Action Plan for 2020/21 including measures to improve the maternity pathway and is scoping the possibility of a three bedded induction bay on the current Delivery Suite.

Action Planned (AI summary) NHS England is reviewing the Good Practice Guidance 2011 on prisoner transfers under the Mental Health Act, aiming for more clinically informed timescales. A revised document has been developed with stakeholders and is currently being prepared in readiness for public consultation anticipated in early 2019. NHS England is conducting service reviews across all adult high, medium, and low secure services, considering service capacity, security levels, gender, service types, and geographical location. It is also reviewing prison transfer and remission guidance and implementing a new service specification for integrated mental health services in prisons.

Action Planned (AI summary) Network Rail has increased the frequency of fence inspections to three-monthly and scheduled renewal of the fencing in the Inckneild Hitchin area for 2019/2020. Platform End Anti-trespass measures have been added to Hitchin Station.

Action Planned (AI summary) West Midlands Railway (operated by West Midlands Trains) removed an outdated Samaritans sign and will install new signs at the Hemel Hempstead Railway Station. Network Rail have submitted a remit to install fencing and a swing gate, and to fill gaps between platforms 2 and 3 with sliding gates.

Action Planned (AI summary) Luton and Dunstable Hospital prioritise cubicle space for new patients from ambulances, transfer existing patients, open contingency areas, and transfer patients to wards where beds will shortly become available. The East of England Ambulance Service will increase frontline patient staff by 330 FTE by 2020/2021 and is planning to arrange a further briefing for HM coroners; other actions include reviewing PSIT and HALO functions, adding staff to the Emergency Operations Centre, and collaborating with CCGs to review inter-hospital transfers. East North Hertfordshire NHS Trust reconfigured the ambulance handover process, removing non-essential tasks and reducing handover time; they are conducting a focus week in June 2018 to improve performance further, monitoring it weekly. Princess Alexandra Hospital NHS Trust refurbished the Emergency Department, introduced a Steaming Process and Rapid Assessment of patients (RAT), and has a clear escalation process for ambulance handover delays, supported by an allocated Paramedic.

Action Planned (AI summary) Hertfordshire Trading Standards will liaise with national government agencies and regulators regarding food product safety, offering input into developing a national strategy if requested by the Food Standards Agency. The FSA Incidents Team investigated Mrs. Baranowski's case and the National Food Crime Unit has been actively working against the sale of dangerous food, including DNP, promoting awareness campaigns and monitoring the internet for sales.