2023

Noted (AI summary) Wood Street Health Centre audited patients prescribed Zopiclone/Zolpidem, is reviewing their medication, has moved to acute prescriptions only (max 2-week supply), instructs 'as required' use on prescriptions, informed local pharmacists, and prepared a new shared care policy; 69 patients have had their medication stopped. North East London NHS Foundation Trust (NELFT) audited prescribing practice and revised its prescribing policy for hypnotics, is participating in a working group to improve medication monitoring across primary and secondary care, increased staffing in Crisis and Home Treatment teams, and ensured comprehensive documentation of patient information at handover. The Department of Health and Social Care acknowledges the concerns raised and notes that NHS England is working to support prescribers in managing repeat prescribing; it also acknowledges actions being taken by Wood Street Health Centre and North East London NHS Foundation Trust.

Noted (AI summary) NICE has made recommendations on the use of antidepressants in their guidelines on the treatment of anxiety and published guidance on safe prescribing of antidepressants, but considers that the MHRA would be best placed to address concerns regarding monitoring requirements. MHRA reviewed available evidence from the fluoxetine Summary of Product Characteristics, data from the UK Yellow Card Scheme, literature and the advice of their Expert Advisory Group and determined that routine blood level monitoring of antidepressants for all patients on treatment is not advised, although may be helpful in certain circumstances.

Noted (AI summary) NHS England is increasing access to CYPMH services, with 702,000 children and young people receiving support in the 12 months to June 2023 and a 46% increase in the CYPMH workforce since the start of the LTP. They will also ensure regional leadership are aware of the report's findings and the Regulation 28 Working Group will discuss all reports received. NELFT will implement the Oxford Centre for Suicide Research’s model of risk formulation and co-produce safety plans with clients and families, including training and system changes to support the roll out. NHS North East London is developing a business case for additional CAMHS funding, including proposals for seven-day/evening working and face-to-face initial assessments. They are also reviewing the current clinical model and participating in transformation work via their Mental Health, Learning Disability and Autism Collaborative. The Department of Health and Social Care acknowledges concerns about CAMHS resourcing and highlights increased spending on mental health services and workforce development initiatives, including training programmes and a new suicide prevention strategy.