Birmingham and Solihull Mental Health NHS Foundation Trust

Noted (AI summary) • The Trust has a form within Rio which clearly sets out the relevant areas for the s.117 meeting and ensures that both healthcare and social care are signed up to the plan. • All staff in Acute care have been made aware of the form and the need to complete it.

Noted (AI summary) NHS England will issue guidance to health systems on reviewing Serious Incident investigations to ensure lessons are learned and changes agreed upon. A national oversight group has been set up to review concerns and issues with RCRP, and this group feeds into a ministerial working group. West Midlands Police (WMP) has provided additional RCRP training to call handlers and officers and produced an exhibit detailing the escalation point of contact for partner agencies to West Midlands Police. WMP has also emphasised the need for officers to gather information from all sources and record the rationale for decisions made, particularly regarding vulnerable people. This is an appendix to the BSMHFT response, specifically the Trust's Missing Patient Policy. It outlines the actions to be taken when a patient is missing or AWOL, relating to Informal inpatients, Detained patients who are AWOL and patients in the community, read in line with National Partnership Agreement: Right Care, Right Person (RCRP). The National Police Chiefs' Council clarifies the aims of Right Care Right Person (RCRP) and states that it appears the situation concerning Mr. Bari was treated as a missing person case from the outset by West Midlands Police, and therefore RCRP principles would not apply. BSMHFT has updated their Missing Persons Policy in line with Right Care Right Person (RCRP) changes, incorporating feedback from the inquest, and a new Executive Director of Quality and Safety/Chief Nursing Officer will be accountable for the policy. The updated policy includes a revised Appendix C form focusing on the reasoning for critical concern and requires formal notification from the police with their decision and reasoning if they have decided not to deploy immediately. The APCC provides background on its role and the role of PCCs in local policing, noting that it has developed guidance for members on the Right Care, Right Person approach. It states that the NPCC is reviewing the report to identify relevant national learning. The Department of Health and Social Care acknowledges the concerns raised, noting that local policies should align with the Mental Health Act Code of Practice and that local partners should reassess joint processes on risk assessment, communication, and escalation. They emphasise the importance of collaboration between policing and health partners. The College of Policing is undertaking a full review of the Mental Health APP, and the points raised in regard to officers having regard to the expertise of mental health clinicians will be included within this review process. They are also working to ensure that the Missing Persons APP is as clear as possible in relation to communication between police and mental health services. The Home Office outlines the rationale and purpose of the National Partnership Agreement (NPA) and notes that decisions on implementation of Right Care Right Person (RCRP) are for individual Chief Constables. They state that missing persons cases are outside the scope of RCRP and existing police procedures should continue to operate.

Noted (AI summary) NHS England highlights national initiatives to improve digital systems, workforce, and mental health services, including the Long Term Workforce Plan and the Mental Health, Learning Disability and Autism Inpatient Quality Transformation Programme. All reports received are discussed by the Regulation 28 Working Group. BSMHFT is working jointly with the Integrated Care System and highlights other areas to assist with lack of resources, including 3 Places of Safety available. The Shared Care Platform has been enhanced allowing different organisations to access different clinical information across the system. NHS Birmingham and Solihull ICB clarifies that GPs are not contractually required to monitor the collection status of medicines that they have prescribed. Birmingham City Council is working with NHS partners on a new Memorandum of Understanding to increase AMHP capacity and will fund AMHP training for NHS staff. They also trained 8 AMHPs in 2022 with funding from Skills For Care and aim to train 5 per year. The Department of Health and Social Care acknowledges the concerns, highlights existing investment in mental health services and workforce, and points to integration of services through integrated care systems and the Major Conditions Strategy.

Noted (AI summary) The Department of Health and Social Care highlights national initiatives to improve mental health services, including expanding CRHTTs, integrating primary and secondary care, and establishing a national single point of contact for mental health crises. They also reaffirm commitment to suicide prevention and will continue measures through the existing suicide reduction programme. The Trust is developing training and guidance for staff on Personality Disorder and patients with Personality Disorder, to be mandated for all staff working within our Home Treatment Teams during 2019/20. A Personality Disorders Strategy which includes clinical standards to be met for patients with a diagnosis of Personality Disorder is being led by the Trust's Chief Psychologist. The CCG acknowledges the coroner's concerns and is unable to identify any correlation between funding and this death, but has recognised the need to continually improve its quality monitoring function and to also improve processes for learning from deaths at the earliest opportunity.