North London

Noted (AI summary) The Department of Health and Social Care describes the NHS Community Pharmacy Contractual Framework, which requires pharmacies to accept unwanted medicines for safe disposal. They also mention the National Guideline 46 and the Medicines Value Programme to reduce medicine waste.

Noted (AI summary) The Office of Rail and Road believes the report would be better served to the station operator and infrastructure manager, as ORR does not have the power to take the action proposed by the Coroner. Govia Thameslink Railway has produced a new staff aide-memoire and is briefing staff on it, is updating Local Incident Response Plans, and has ordered new privacy screens for key locations. The Department for Transport is satisfied that measures undertaken by Govia Thameslink Railway should resolve the Coroner's concerns and will continue to manage all of its franchises through normal commercial management procedures.

Noted (AI summary) The Department of Health and Social Care references NICE guidelines on intrapartum care and states NICE will log the coroner's concerns for future review but does not plan to update the guideline at this time.

Noted (AI summary) The Royal College of Psychiatrists will discuss consultant accountability, ownership during transitions, and care involving multiple teams at its Professional Practice and Ethics Committee meeting on November 2, 2017, to determine the college's next steps. The Department of Health acknowledges the concerns raised and highlights existing guidance on care planning and continuity of care, including GMC guidance and consensus statements. It notes that the Royal College of Psychiatrists will consider the concerns and determine if more can be done.

Noted (AI summary) Imperial College London's Toxicology Unit acknowledges the difficulties in accurately analyzing and detecting NPSs due to their changing nature, lack of standards and pharmacological data, and states that no action is proposed. Alere Forensics describes its ongoing efforts to improve the analysis and detection of new psychoactive substances (NPS), including developing novel screening techniques, working with universities to obtain reference materials, and providing training to stakeholders. The Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit at the University of Hertfordshire is engaged in research to identify NPS and provide updated clinical guidelines, including using computational models to identify potential compounds before they appear on the market.

Noted (AI summary) The Department of Health acknowledged the concerns and forwarded the report to the Care Quality Commission (CQC), the independent regulator of health and adult social care providers in England.

Noted (AI summary) The Department refers to existing Royal College of Obstetricians and Gynaecologists (RCOG) guidelines on operative vaginal delivery and General Medical Council (GMC) guidance on record keeping, but does not commit to any specific new actions.

Noted (AI summary) The response acknowledges concerns about PEWS scores and describes ongoing national work by NHS England and the Royal College of Paediatrics and Child Health to develop a framework for recognising and responding to children at risk of deterioration.

Noted (AI summary) The Department of Health acknowledges the concerns and states that adequate guidance already exists for tracheostomy management through the UK National Tracheostomy Safety Project and other resources, with NHS England continuing to work with stakeholders.

Noted (AI summary) The Department of Health acknowledges concerns and explains existing NICE guidelines for monitoring patients on antipsychotic medication. NHS England is working with the Royal College of Psychiatrists to investigate patient safety incidents associated with Clozapine.