Greater Manchester Mental Health NHS Foundation Trust

Noted (AI summary) This response is not classifiable as it consists of nonsensical characters and cannot be understood.

Noted (AI summary) Bodmin Road Health Centre provided context and clarified their actions regarding the patient's care, and noted a past apology to the patient's mother. They reflected on whether further information sharing would have made a difference. Trafford Aim has implemented a more streamlined process for receiving letters and faxes. CMHT staff have been reminded to consider alternative ways to carry out assessments and engage service users, and a dedicated duty worker role has been established. GMCA stated that Greater Manchester West Mental Health Foundation Trust implemented systems to capture and act upon letters or faxes received. They also set up a Dual Diagnosis Steering Group.

Noted (AI summary) Manchester Mental Health and Social Care Trust (MMHSCT) has agreed to provide UHSM with advice in respect of their development of a self-harm policy and guidance. Regular liaison meetings will be established between UHSM, MMHSCT and GMW. The Department of Health acknowledges the concerns raised and outlines several existing initiatives related to mental health and self-harm prevention, including national indicators, research funding, and the Mental Health Action Plan.

Noted (AI summary) The Department of Health acknowledges the concerns raised and highlights existing NICE guidance on self-harm and a government suicide prevention strategy. They note that Trusts develop their own transfer protocols with the private sector and refer to existing guidance from the Royal Pharmaceutical Society on patient transfer.

Noted (AI summary) Manchester Mental Health NHS will be reviewing its SIRI policy to consider the engagement of an independent investigator in complex cases and will develop further guidance for investigators regarding learning from this case. Matrons will carry out weekly checks on compliance with the quality of documentation on handover forms. The Head of Nursing is writing to all Ward Managers to instruct nursing staff to read recent admission records and risk information and compliance with this system will be monitored through audit. The Citywide Commissioning, Quality and Safeguarding Team has developed a revised governance process and the Trust now attends an established Citywide Patient Safety Committee. An inpatient capacity management plan has been developed and implemented. The Commissioner Assurance Plan for Quality Improvement (CAP-QI) was agreed by the Joint Commissioning Management Board in September 2013 and is monitored monthly. The Department of Health acknowledges the concerns and states that local healthcare organisations should ensure that all staff are trained to the appropriate standard. Concerns have been sent to the National Trust Development Authority (NTDA) which is in contact with MHSC Trust and has received an action plan.