2023

Noted (AI summary) NHS England is implementing improvements to the CYMPH inpatient pathway, aiming to reduce out-of-area placements and move towards community-based care; they are also developing a national admission protocol for children and young people with multi-agency partners. The Department of Health and Social Care acknowledges the concerns and notes NHS England's response and approach to reduce reliance on inpatient mental health beds, moving towards community-based care.

Noted (AI summary) The Trust added a question to the pre-procedure checklist for endoscopy to identify recent investigations and created a local learning resource on parallel pathways. They will also aim to share learning with a former clinical endoscopist and are auditing photo documentation during endoscopy. The Department of Health and Social Care acknowledges the coroner's concerns and states that the local ICB has made recommendations to the Trust. It highlights the reformed cancer waiting time standards, including the Faster Diagnosis Standard.

Noted (AI summary) NIVAS plans to publish guidelines in 2024 concerning the use of real time ultrasound guidance for central venous catheter insertion and the identification and management of inadvertent arterial puncture. They will also give the subject prominence at their annual conference in June 2024. The Association of Anaesthetists, Royal College of Anaesthetists, Faculty of Intensive Care Medicine (FICM) and the Intensive Care Society (ICS) will ensure that updated "Safe Vascular Access" guidance has more explicit recommendations for checking CVC placement. The ICS is also developing a guideline for managing inadvertent arterial puncture during CVC insertion. NICE acknowledges the concerns but states that existing National safety standards for invasive procedures (NatSSIPs), ICS CVC Insertion Safety Checklist 2023, and AAGBI guidance already provide recommendations, and they do not consider that further NICE guidance would add to existing national recommendations. The Department of Health and Social Care acknowledges concerns about the absence of a national policy on CVC placement, but states that existing NICE guidance and national safety standards should inform local standards. They do not consider further action is needed at this time as the clinician departed from existing national recommendations, NICE guidelines and Trust policy.

Noted (AI summary) The Department of Health and Social Care outlines existing and planned initiatives to improve mental health support, including increased funding for community mental health services, expansion of NHS Talking Therapies, and investment in crisis care alternatives. They state that responsibility for staffing and operations of mental health services lies with the relevant trust.

Noted (AI summary) The London Ambulance Service conducted a clinical review, stating that naloxone was not mandated in this instance. They highlight existing support for naloxone administration and offer to discuss ongoing work to improve cardiac arrest survival in London.

Noted (AI summary) The Department of Health and Social Care acknowledges the concerns and outlines actions being taken by NHS England and EEAST to improve ambulance response times, including increased recruitment, clinical triage of calls, and the establishment of an Unscheduled Care Coordination Hub.

Noted (AI summary) DWP expresses condolences and outlines existing support and training for staff regarding vulnerable claimants, but does not commit to new actions. They state comprehensive guidance and a six-point plan are in place to support customers who discuss or imply that they intend to harm themselves.