2023

Noted (AI summary) NHS England expresses condolences and acknowledges the concerns raised. The response focuses on the NHS pathway of care for adults with gender dysphoria, national policy on mental health services for young people up to 25, and existing guidance for GPs. Together UK has information sharing agreements with NELFT and ELFT and follows a Standard Operating Procedure for Liaison and Diversion. The agency social worker would have received risk management, information sharing, and safeguarding training as part of their professional training.

Noted (AI summary) North West Fire Control is supporting the embedding of Joint Emergency Services Interoperability Principles (JESIP) and working with partners to implement electronic data transfer for improved information sharing, expected by March 2024. NHS England outlines existing guidance for ambulance services relating to overdoses and suicidal intent issued in April 2021, and describes ongoing work to improve ambulance performance. Cheshire Constabulary has signed the Joint Operating Protocol (JOP) with NWAS and supports its endorsement by other parties, with a coordination meeting scheduled for January 16, 2024. Lancashire and South Cumbria ICB reports that four North West police forces have agreed and gone live with their Joint Operating Protocols (JOPs) with NWAS, with Greater Manchester Police in the final stages of agreement, and learning will be overseen by the NWAS Regional Clinical Quality Assurance Committee. Cumbria Constabulary has signed a regional Information Sharing Agreement (ISA) and has been working under a Joint Operating Procedure (JOP) since October 2023; it also provides clinical support through its "treat and hear" facility. Lancashire Fire and Rescue Service states that it was not involved in the incident, but is committed to improvement and learning. The service outlines its support for JESIP, reviews policies/procedures/training, and has an Immediate Emergency Care SOP with guidance on various areas. The North West Ambulance Service (NWAS) have engaged with all the North West Police Forces to develop a Joint Operating Protocol (JOP). Four forces have agreed and gone live with their JOPs, ensuring clear process for sharing information, primacy understanding, and a clear escalation process for any operational issues. Four of the North West police forces, including Cheshire Constabulary and Merseyside Police, have agreed and implemented Joint Operating Protocols (JOPs) with the North West Ambulance Service to improve information sharing and escalation processes. BTP has adopted the "Ten Second Triage" (TST) tool nationally and is delivering associated training in 2024. They also use ESICTRL radio talk groups for direct communication between emergency service control rooms. NWAS reports that a Joint Operating Protocol (JOP) has gone live with Cheshire, Cumbria, Lancashire and Merseyside Police Forces, and that an updated version has been agreed with Greater Manchester Police and is scheduled for implementation across the whole North West following a meeting in late February 2024; also, the JOP has been extended to include British Transport Police, North West Fire Control, and Fire and Rescue Services. Merseyside Fire and Rescue Service states that its existing procedures for communicating casualty information to NWAS are sufficient, including written instructions and escalation options. Lancashire Police has agreed to Version 1.3 of a Joint Operating Protocol (JOP) with regional forces and NWAS to provide clarity and guidance to Control Room staff regarding escalation of incidents due to delays; awaiting final sign-off from GMP and Fire and Rescue. Response not parsable

Noted (AI summary) The Ambulance Service has disseminated posters addressing human factors, developed a new training package on decision-making under pressure, and is providing regular updates on best practice for asthma management. They have removed the skill of intubation for general paramedics and are rolling out Advanced Paramedics in Critical Care cars across the region. They have also implemented the Patient Safety Improvement Response Framework. Mid and South Essex NHS Foundation Trust has shared learning with teams about the JRCALC protocol on managing severe asthma in children and is delivering training sessions focusing on the role of Adrenaline; they have also sent an email to staff regarding the use of Adrenaline in pre-hospital asthma resuscitation. AACE will review the JRCALC asthma guideline and make changes if required, and will share the concerns with their national ambulance service medical directors’ group (NASMeD) to consider further education or awareness for clinicians regarding airway management and adrenaline administration. Essex Partnership University NHS Foundation Trust has implemented several changes in the Asthma & Allergy Children’s and Young Persons Service, including staff training, caseload reviews, translated care plans, smoking cessation courses, and links between universal services and the CAAS to improve education and training. Essex Partnership University NHS Foundation Trust has implemented several changes in the Asthma & Allergy Children’s and Young Persons Service, including staff training, caseload reviews, translated care plans, smoking cessation courses, and links between universal services and the CAAS to improve education and training. The Department acknowledges the concerns and describes the existing framework for healthcare professional training, including the National Capabilities Framework for Professionals who care for Children and Young People with Asthma. They note that employers are responsible for ensuring staff are trained to the required standards.

Noted (AI summary) NHS England acknowledges concerns about the death of Alice Litman and outlines its role as commissioner of gender dysphoria services. They note improvements being made to the NCMD alert system and planned analysis of reporting forms for children and young people who have died between April 2019 to March 2023 with gender distress. The Trust is developing a mandatory training package for all staff on working with people from the transgender community, co-produced with people with lived experience and their families. It is also reviewing and adding to its list of third sector organisations in its Supporting People who are Trans Policy. The RCGP expresses condolences and describes its existing work to improve care for transgender individuals, including e-learning packages and a transgender policy document. They highlight long waiting lists for specialist care and the role of GPs in providing holistic care but not specialist treatment decisions. The Tavistock and Portman NHS Foundation Trust acknowledges concerns about services for patients on the GIC waiting list. They describe the role of the GIC, noting the HA60 classification, and note new roles in development to support patients on the waiting list, and will engage with commissioners.

Noted (AI summary) NHS England acknowledges the concerns regarding insufficient medical staffing during the New Year bank holiday. They refer to the 7-Day Hospital Services Programme and the NHS Long Term Workforce Plan and note the actions taken by the University Hospitals of Leicester NHS Trust, also describing the R28 Working Group. The hospital trust has changed its electronic prescription system for anticoagulation, recruited new staff for an anticoagulation review service, included anticoagulation in its PSRIF, and increased medical staffing with consultant cover on bank holidays/weekends. They have also implemented a policy for patients/relatives to request an independent clinical review.

Noted (AI summary) HMPPS will revisit recording key dates as it continues to develop the Digital Prison Services (DPS), and it anticipates the ability to search for key words will be available by 2025. It will also issue a Senior Leaders Bulletin on the importance of recognising key dates and encouraging the use of local databases. NHS England describes the Health and Justice Information Service (HJIS) and options for flagging key dates, and refers to NICE guidance on managing medicines. It states that responsibility for cell searches lies with HMPPS. The Ministry of Justice acknowledges the concerns raised and states that HM Prison and Probation Service (HMPPS) will respond to the operational issues; the Minister endorses the HMPPS response.

Noted (AI summary) The Trust will review patient safety leaflets in accordance with guidance from professional bodies such as the Royal College of Radiologists and British Society of Interventional Radiology to ensure they are supporting patients with the most contemporary medical advice. The RCR acknowledges the concerns, noting points 1 and 4 are outside their remit. They endorse GMC guidance on consent and state they don't produce patient information leaflets.