West London

Noted (AI summary) • The Trust is the provider for adult ASD assessments in Ealing. • When this service was established in 2021, it was modelled upon historical trends in activity referred to providers outside North West London, and commissioned and resourced by North West London ICB to complete 86 assessments per year. • In the last three full financial years against this target, we delivered 547 assessments (212%), however demand continued to grow leading to a considerable backlog of patients awaiting diagnostic assessment experiencing unacceptable delays.

Noted (AI summary) MHCLG acknowledges the concerns but states that the Department of Health and Social Care is the lead department and has provided a comprehensive response. MHCLG will liaise with DHSC regarding non-statutory measures. The Department of Health and Social Care is liaising with other government departments and plans to engage with stakeholders regarding non-statutory measures to improve patient safety in the area of non-therapeutic male circumcision. They highlight existing guidance and resources available.

Noted (AI summary) CGL Ealing RISE will provide leaflets and website information about consent and confidentiality at the commencement of treatment, addressing how families can share concerns without breaching confidentiality, as well as an alternative point of contact in the organisation. The response explains Change Grow Live's confidentiality policy, including when information can be shared and how families can stay involved while respecting privacy.

Noted (AI summary) The London Fire Brigade has made significant changes to its radio system following the Grenfell Tower Inquiry, improving communication interoperability. They have also installed throwline boards, provided throwline training to businesses and parks patrols, opened a water safety training room, and strengthened operational working with Surrey Fire and Rescue Service. The National Fire Chiefs Council highlights the Fire Control Fire Standard and Guidance, the Multi-Agency Information Transfer (MAIT) system, and ongoing liaison with London Fire Brigade to ensure learning is captured and shared. They support fire and rescue services to improve the effectiveness and maximize the use of digital systems and this is a key priority for them in the Fit for the Future strategic plan. The London Borough of Barking and Dagenham will undertake a survey and asset mapping of waterbodies and riverside locations, assess sites using risk assessment criteria, standardise safety equipment, and implement a structured inspection and maintenance programme. They will advocate for enhanced inter-agency communication. The London Borough of Havering will give further consideration to the lighting of life buoys at inland bodies of water, ensure new buoyancy aids meet British Standards and require white stripes, and consider including a policy for developers to provide and maintain lifesaving equipment. They consider communication between emergency services to be a matter for the emergency services to address. The City of London acknowledges the concerns raised. The text describes various procedures and resources in place for managing incidents and ensuring safety, without stating a change in policy.

Noted (AI summary) TfL intends to implement a permanent pedestrian crossing scheme at the A4/Jersey Road junction in Hounslow by 2026, including signal-controlled crossings. In the interim, temporary customer information signage warning pedestrians to take care when crossing the road will be installed by January 2025. The Department for Transport states that Transport for London (TfL) is responsible for traffic management on its roads, including the pedestrian crossing at issue. The DfT says no consent is required from the Department to enable TfL to make changes to this site, and funding will come from TfL revenue sources. The London Borough of Hounslow is working with TfL to improve traffic conditions on the A4, especially for vulnerable road users. Proposals are being considered for signal-controlled crossings for pedestrians and cyclists across the A4 and Jersey Road, with construction planned for 2026-27, along with interim temporary signage.

Noted (AI summary) The HSE is publishing further guidance, aimed at installers, their managers and supervisors to remind them of the steps they must take to control the exposure risk. They are also working with the Worktop Fabricators Federation to support development of their own information leaflet which they can share amongst their networks. DHSC states that they have no comments or suggestions and that responsibility for the Coroner's concerns sits with HSE. The Agglomerated Stone Manufacturers Association highlights existing efforts to promote safety and calls for governmental involvement, suggesting clear rules and/or a licensing program for fabricators. MHCLG is requesting an extension and states that the concerns fall within the remit of the HSE, offering to provide a formal response explaining the limitations of MHCLG's policy remit. The Worktop Fabricators Federation provides a 'state of the art' positioning statement on silica dust risks associated with quartz worktops, highlighting the need for safe working environments and suggesting potential market controls.

Noted (AI summary) NHS England acknowledges the concerns raised and refers to existing national guidance on COVID-19 testing for elective care. They also mention internal discussions and learning from PFD reports.

Noted (AI summary) NHS England will ensure all staff, including agency and bank staff, have timely access to all joint training, including ACCT, that is necessary for them to undertake their role effectively within the prison environment and regional teams will be asked to give assurance at a meeting planned for June 2024, that the proposed action has been delivered and agency and bank staff have timely access to ACCT training. The NPCC clarifies that Custodial Nurse Practitioners (CNPs) are qualified and trained to work in police custody, with appropriate clinical support and supervision, according to the National Healthcare Specification. They assert the 2003 Home Office circular is outdated and the current healthcare model for police custody is robust. The Home Office states that Home Office Circular 020/2003 is no longer extant and therefore they propose to take no action in response to the report. They note the NPCC response regarding the National Healthcare Specification for police custody and NHS England's response regarding training of prison healthcare staff in the ACCT process.

Noted (AI summary) NHS North West London has implemented a single children’s continuing care team with registered nurses and experienced managers providing a consistent service. A parental agreement has been developed which sets out expectations and responsibilities in regard to parental responsibility. NHS England highlights the resources provided by The National Tracheostomy Safety Project (NTSP) and notes the NWL's response addressing training, supervision and care packages. They also mention that all reports received are discussed by the Regulation 28 Working Group to share key learnings.