Independent investigation into the care and treatment of Mr X

A Non-Executive Director will be nominated to carry specific responsibility at Trust Board Level to support the dissemination of learning from incidents. A Non-Executive Director has been identified to carry specific responsibility for supporting the dissemination and learning from incidents. Completed Dec. 2020. Endorsed by the Board.

a) The SLaM dual diagnosis policy contains clear pathways for supporting people with substance misuse issues. These will be disseminated to all complex care services in Southwark, including updated contact details of dual diagnosis specialists. b) All teams in the complex care pathway have at least one dual diagnosis lead (champion) who has/will complete the level two training and be supported to attend bimonthly leads’ development forum. c) Monthly dual diagnosis clinical support sessions to be established for the complex care pathway, to be facilitated by dual diagnosis specialists and Senior Clinical Psychologist. a) The Trust promotes an approach that encourages staff to ask people about their drugs and alcohol use, no matter what organisation is contacted. Drug and alcohol care pathways have been circulated to complex care services, including contact details of dual diagnosis specialists. Completed Nov. 2020. b) All teams have at least one dual diagnosis lead that has completed the level 2 training and attends leads’ development forum. Completed Dec 2020. c) Monthly clinical sessions commenced in January 2021, led by dual diagnosis specialists and Senior Clinical Psychologist. Additional Information: 1) In order to increase the rates of drug and alcohol assessment and intervention: i- Drugs and alcohol assessment tools are easily accessible in the electronic patients’ journey system ii- Admission checklists include time frames for assessing drug and alcohol use iii- Pathways for the management of drug and alcohol use are easily accessible via the Trust intranet iv- A centralised data monitoring system provides real-time feedback to teams about rates of drug and alcohol assessment & intervention. 2) The Trust promotes an integrated treatment model whereby most service users will have both their mental health and substance misuse needs addressed at the same time, by one worker or team. In some cases however, MH and substance misuse services work collaboratively to meet service users’ needs. The Trust has joint working agreements with CGL, the local addictions service. 3) Local mental health and addictions interface meetings have been established and take place monthly. These provide a space for workers from both services to discuss better ways of working with dual diagnosis issues. 4) The trust has several dedicated dual diagnosis specialist roles that work alongside staff teams and support service users to access better dual diagnosis care. 5) The Quality Centre in SLAM now has a programme of work aimed at improving dual diagnosis care standards in the trust. This includes improving the quality and consistency of simple psychological interventions that can be delivered by all staff and increasing prescribing of relapse prevention and harm reduction medication.

a) At least 60% of staff in the complex care pathway to complete the level one dual diagnosis course. b) At least two staff in each team in the complex care pathway to complete the level two training. a) Leaders have assessed the level of completion of the level one training within their teams and the baseline data is informing training targets. Completed Feb 2021. b) All teams have at least two staff that have completed the level two training. Completed March 2021. The Trust has a range of training and development opportunities for dual diagnosis: • A level 1 e-learning course teaches basic drugs and alcohol knowledge which provides an introduction to the nature of the relationship mental health and substance use. All registered, non-medical clinical staff are required to complete this course within 6 months of joining the Trust. • A level 2 course which provides the foundations for working with people with more complex needs. For example, it teaches staff how to support people build motivation for change, how to support people to reduce the negative impacts of use if they aren’t ready to stop. People with lived experienced are involved in the design and delivery of this course. • During the pandemic, several bite-size courses have been designed and are being delivered flexibly online to teams.