Surrey

Noted (AI summary) The Department of Health states that original paper records should not be destroyed after a patient's death where the death may be subject to investigation. They state that the NHS Records Management Code of Practice is currently under review. The Trust has instigated work to improve the quality of engagement with adult inpatient services using a process of purposeful engagement and revised their Observation Policy to include clearer guidance on recording all clinical interventions. This is a joint strategic statement from NHS Improvement and the CQC about working together to ensure financial rigour while improving quality outcomes for patients. It describes how the two organisations will work together in the future.

Noted (AI summary) The response explains existing protocols and guidance related to the Mental Health Act and assessment/discharge procedures, but does not describe any specific action taken or planned in response to the concerns.

Noted (AI summary) The CQC acknowledges the concerns and explains its role in regulating care providers. They note that the Local Authority is responsible for managing communication lines when a provider closes and suggest they work with ADASS to address the issue nationally. The CQC is undertaking a review to ensure information from Regulation 28 reports is systematically integrated into their processes.

Noted (AI summary) The Royal College of General Practitioners provides information on its role and remit, and references existing guidance and resources related to the concerns raised regarding referral letters and communication with secondary care. The Trust has revised its referral form to improve the quality of information GPs provide, including asking for more detail and highlighting the need to exclude organic causes of weight loss prior to referral to the Eating Disorders Service. The trust has also shared the concern about hospital notes with their medical records team. The Royal College of Psychiatrists agrees with the need for better EDS proformas. They highlight concerns about risk assessment in psychiatry and the need for eating disorder specialists with adequate medical training. The college plans to raise these issues at the next Executive Committee Meeting and will ask for consideration on how best to disseminate robust EDS proformas across the UK health economy. The surgery will ensure all consultations are fully documented in patient notes and proper assessments are conducted. All GPs will complete the BMJ online learning e-module on hyponatraemia. A consultant endocrinologist will give a lunchtime educational meeting at the practice on hyponatraemia and Addison's Disease. All patient referrals will have copies of all investigations attached.

Noted (AI summary) Frimley Park Hospital acknowledges the coroner's concerns regarding urology on-call arrangements but states there are no specific national on-call guidelines for urology. They explain current practices and supervision of trainees, and note the Keogh recommendations will require a review of on-call services and development of an action plan.